Treatment for Viral Stomatitis

Prevention and Basic Management

The American Society of Clinical Oncology recommends maintaining good oral hygiene with non-alcoholic mouthwashes to prevent and manage stomatitis 3
Evaluating dental appliances before treatment is crucial as they can aggravate oral mucositis 3
Consuming soft, moist, non-irritating foods that are easy to chew and swallow is advised 3
Drinking plenty of water and using lip balm for dry lips is recommended 3
Using ice chips or ice pops as needed to numb the mouth can be beneficial 3

For mild stomatitis, the Multinational Association of Supportive Care in Cancer recommends using 0.9% saline or sodium bicarbonate rinses to soothe the mouth 3, 1
Consider prophylaxis against fungal, viral and/or bacterial infections for mild stomatitis 3
Treating any secondary infections with appropriate topical or systemic antimicrobials is essential 3
Continuing regular oral care with non-alcoholic mouthwash is crucial 1
For moderate stomatitis, increasing the frequency of sodium bicarbonate mouthwash up to hourly if necessary is recommended 1
Using sugarless chewing gum, candy, or salivary substitutes can help with oral dryness 1
Topical anesthetics, such as viscous lidocaine 2%, can be used for pain management 1
Mucosal coating agents can be used for pain management 3
Benzydamine HCl can be used for pain relief 3
Topical NSAIDs, such as amlexanox 5% oral paste, can be used for moderate pain 1
When NSAIDs are not tolerated, consider acetaminophen (paracetamol) 1

For highly symptomatic ulcers, consider systemic corticosteroids, such as high-dose pulse 30-60 mg or 1 mg/kg oral prednisone/prednisolone for 1 week followed by tapering over the second week 1
For persistent severe pain, consider more aggressive pain management with alternative administration routes (transdermal, intranasal) 1
Hospitalization may be indicated for severe cases 3

For immunocompromised patients or those with severe symptoms, consider prophylactic antiviral therapy 4

Distinguishing between viral stomatitis and more serious conditions like Stevens-Johnson Syndrome, which requires specialist assessment, is crucial 3