Angular cheilitis, commissural or mouth stomatitis is a skin disease (dermatosis). It is a wound in the corner of the mouth that is inflammatory so it is painful. It can appear on one side of the mouth (unilateral) or both (bilateral). It may bleed and form ulcers or scabs. It is common in the elderly, young children and adolescents. It is possible that angular cheilitis leads to candidiasis due to infection of the wound by the fungus ‘Candida albicans’.
The accumulation of saliva in the corner of the mouth is the cause of angular cheilitis. The main factors that produce this type of accumulation are:
– Aging and the appearance of wrinkles and folds that promote salivary accumulation.
– Using poorly fitted dental correction devices (orthodontics) or prostheses.
– Iron deficiency anemia.
– Lack of vitamins B2 and B9.
– Excess sugar consumption.
– Suffer from diabetes.
– Have a weakened immune system.
– Suffering from oral candidiasis.
– Maintain poor oral hygiene.
– Have psoriasis, atopic dermatitis or seborrheic dermatitis.
– Allergic reaction to products such as toothpaste.
– Have dry lips.
– Suffering from anorexia.
– Follow treatment with drugs that cause dry mouth.
Signs of angular cheilitis are wound or wounds in the corner of the mouth that are inflammatory and painful. It can appear on one side (unilateral) or on both sides (bilateral) and may bleed or form ulcers and/or scabs.
The physical examination is usually sufficient to diagnose angular cheilitis but it is also complemented by a mycological culture and blood tests to detect any nutritional deficiency.
The treatment depends on the cause. The goal is to prevent the injury from becoming chronic. Treatment usually consists of the application of alkalizing antiseptics; local antifungals if candidiasis is present; and vitamin and/or mineral supplements if deficiencies are detected in this area. The doctor will make the precise prescriptions and the duration of the treatment.
Topical solutions such as lozenges, nystatin creams, or rinses may also be recommended. Patients who wear orthodontic appliances or dentures should wash them with a chlorexidine gluconate solution and apply creams to the lesion.
Preventive measures against angular cheilitis include maintaining proper oral hygiene and a healthy, balanced diet. It is also recommended to control saliva accumulation by keeping the area dry and hydrated.