Stomatitis (Mukhapaka) Written by Monika Devi

Stomatitis (Mukhapaka)

I implies inflammation of the buccal mucosa and is characterized by erythema, swelling and superficial erosions accompanied by subjective complaints of burning, pain and tenderness which interfere with talking, drinking and eating.

The common causes of stematitis are:-

• Aphthous stematitis.
• Cantact stematitis.
• Dyspepsia
• Manilial stematitis (thrush)
• Tuberculosis.
• Diphtheritic stematitis.
• Syphilis
• Oral sepsis-Pyorrhoea alveolaris
• Vincents angina
• Infections fevers
• Deficiency diseases-Scurry, pellagra.
• Mercurial stematitis. Also due to lead, arsenic and bismuth.
• Muco-cutaneo-occlar syndrome
• Stematitis due to drugs- stomatitis medicementosa
• Gangrenous stematitis (Nama)
• Sclerosing stematitis.
• Blood disorder like leukaemia, aplastic anaemia.

Ayurvedic Concept Mukhapaka

Mukhapak is known since vedic period. It occurs in all over the oral cavity i.e. Mukha. Acharya Charak has described it as Mukhapak while Acharya sushrut and Acharya Vagbhatt had described it as Sarvasar.

Disease located in entire mouth are caused by vata, Pitta, Kapha and Rakta. Those caused by pitta and Rakta are usually oe and as such generalized disease of mouth are three. Those are named as Sarvasat. Sarvasat means, those which are mentioned as four types of Mukhapak as disease of entire oral cavity.

Acharya charak has mentioned 64 diseases of mouth, out of those he has mentioned 4 types of Mukhapak as diseases of entire oral cavity while Acharya vagbhat has described eight types of diseases of entire oral cavity.

Classification According to Ayurveda

Acharya Sushruta has mentioned 4 types of Sarvasat as follows:

• Vataj Sarvasar
• Pittaj Sarvasar
• Raktaj Sarvasar

Acharya Charak has described 4 types of Mukhapak as follows

1. Vataj Mukhapak
2. Pittaj Mukhapak
3. Kaphaj Mukhapak
4. Sannipataj Mukhapak

Acharya vagbhata has described 5 types of Sarvasar and three more diseases making total eight types as given below

• Vataj Sarvasar
• Pittaj Sarvasar
• Kaphaj Sarvasar
• Raktaj Sarvasar
• Sannipataj Sarvasar

And three more diseases

• Urdhvagad
• Kapharbud
• Putivaktrata

1. Vataj Sarvasar/Mukhapak

• Generalised mouth disease
• Mouth is covered with painful blisters all around.
• Dryness of mouth, roughness, shifting pain
• Salivation becomes cold
• Dribling of saliva present
• Piercing and teaching pain.

2. Pittaj Sarvasar/Kukhapak

• Mouth is covered with yellow coloured, burning and small blisters.
• Thirst, fever, eruption, burning sensation, inflammation, tearing sensation.
• Other various troubles caused by pitta along with appearance of various colours except white.

3. Kaphaj Sarvasar/Mukhapak

• Mouth is covered with the blisters of the same colour.
• Itching sensation and mild pain is also present along with sliminess, anorexia, stiffness, excessive salivation, nausea, drocosiness.

4. Raktaj Sarvasar/Mukhapak

• Shows same symptoms as produced by pitta

5. Sannipatik Sarvasar/Mukhapak

• All the symptoms caused by vata, pitta and Kapha together are found.

Treatment According to Ayurveda

General treatment of Mukhapaka

In every type of Mukhpaka we can use Kvatha of triphala, manukal and the leaves of jati with honey for Mukhdhavana. Also we can used the dravya from Kutheradigan.
Also, it is advised to use jatyadi tail for local application (Pretisarha) and Kamdudha for systemic treatment.

In mukhapaka venesection, head evacuation and purgation should be used frequently. The leaves of jati should also be used frequently. The leaves of jati should be also chewed regularly.

Treatment according to Doshas

Sarvaar chikitsa

1. The sarvasara caused by vata, local application of rocksalt powder is useful. Oil cooked with vata alleviating drugs should also be used as Gargle and Snuff.
2. In Paitika Sarvasara, after evacuating the patient (with purgation and enesis) all pitta alleviating measures particularly sweet and cold should be adepted.
3. In Kaphaja sarvasara, Kapha alleviating measures such as local application, gargle, smoking and evacuation should be followed.

Some of the formulation mentioned in Ayurveda Literatures are

• Jatipatradi gandusa
• Krsnajirakadi Churna
• Rasanjanadi Churna
• Decoction of the tender of five plants (Pancapallava)
• Decoction of Pancavalka or triphala mixed with honey is used as mouth wash.
• The decoction of daruharidra further solidified is known as casakriya mixed with honey it alleviates diseases of mouth, blood disorders and sinus.
• Saptacchadadi Kvatha
• Patoladi Kvatha
• Triphaladi Kvatha
• In case of burning of mouth (by lime etc.) gargle of any of the five-tila, nitotpala, ghee, sugar, and milk mixed with honey relives burning and inflammation.
• Gargles with oil or sour removes burning caused by limb.