Management of Vincent Stomatitis

Antimicrobial Therapy and Dental Care

The American Dental Association recommends that any sharp edges or ill-fitting dental prostheses should be eliminated before or during treatment, as these sources of trauma perpetuate the condition 1

The American Dental Association suggests using 0.9% saline or sodium bicarbonate rinses (1 teaspoon salt with three-quarter teaspoon baking soda in 500 mL water) 4-6 times daily to maintain oral pH and reduce bacterial load 2, 3
Non-alcoholic mouthwashes are mandatory, as alcohol-containing products aggravate mucosal injury 4, 2
Consider adding 0.2% chlorhexidine digluconate mouthwash twice daily for additional antimicrobial coverage in moderate to severe cases 3

Patients with Vincent stomatitis should consume only soft, moist, non-irritating foods that are easy to chew and swallow; avoid acidic, spicy, salty, or rough foods 4, 2
Maintain adequate hydration by drinking plenty of water throughout treatment 4, 2
Use ice chips or ice pops to numb the mouth and reduce discomfort 2, 5
Apply lip balm for dry lips and consider salivary substitutes if xerostomia is present 2, 3

Topical anesthetics such as viscous lidocaine 2% can be applied for localized pain control 2, 5
Mucosal coating agents and benzydamine HCl provide additional symptomatic relief 5
For severe pain, consider systemic analgesics (acetaminophen or NSAIDs) rather than topical agents alone 5

Hospitalization is required for patients with inability to maintain oral intake, severe tissue necrosis, or systemic signs of infection 2

Avoid using corticosteroids before ensuring adequate antimicrobial coverage, as steroids can worsen the underlying anaerobic infection 3

Continue meticulous daily oral hygiene even after clinical resolution to prevent recurrence, as patients with Vincent stomatitis are plaque-intolerant 2, 5
Monitor for healing with intact epithelium and resolution of necrotic ulcers 5