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Aphthous Ulcer - Causes, Symptoms and Treatment

Alternative Name: Canker Sores


Aphthous ulcers are one of the most common problems that occur in the mouth. It is characterised by a painful oral or esophageal sore on a mucous membrane. The size of an aphthous ulcer can range from several millimeters to 2 cm in diameter.

It is a small sensitive painful ulcer of the mouth. Aphthous ulcers are also medically known as Canker sores. Aphthous ulcers typically last for around 10-14 days and they generally heal without leaving a scar.

Aphthous ulcers are single or multiple ulcers of the inside of the mouth that tend to recur. Although, lesions may affect patients at any age, but young adults are usually more succeptible to this disease.

It is a blister on the mucous membranes of the lips or mouth or gastrointestinal tract. Women are more likely than men are to have recurrent aphthous ulcer.

Causes of Aphthous Ulcers:

A mouth ulcer or canker sore is a painful open sore inside the mouth caused by a break in the mucous membrane.

Some of the Possible Causes of Aphthous Ulcer includes:

  • One of the main cause of Aphthous ulcers is due to Iron Deficiency.
  • Family history: If you have the family history of aphthous ulcer, then there are 60% chances to get affected by aphthous ulcer.
  • Injury - such as badly fitting dentures, a graze from a harsh toothbrush, etc. may lead to aphthous ulcer.
  • Changes in Hormone Levels: If there is imbalance in the production of hormones, then it may lead to aphthous ulcer.
  • A reaction to some medication is a rare cause. For example, Nicorandil, anti-inflammatory drugs, and oral nicotine replacement therapy have been reported to cause mouth ulcers in some people.
  • Certain inflammatory bowel disorders, such as Crohn's disease increases the chances of occuring aphthous ulcer.
  • If there is an infection of AIDS virus, it may lead to aphthous ulcer.
  • Aphthous ulcers may also be caused by a Vitamin-B deficiency.
  • Bacterial infections, such as stomach ulcers caused by the bacterium, H. pylori is also one of the main cause of aphthous ulcer.
  • Stress or trauma in the mouth, such as biting the tongue, is the main cause of aphthous ulcer.
  • The acidic foods, such as tomatoes and pineapples may increase the chances of aphthous ulcer.
  • The detergents found in many types of toothpaste can cause aphthous ulcers in some individuals.

There are basically 3 types of Aphthous Ulcers:

  • Recurrent minor aphthous ulcers, which occur in up to 80% of aphthous ulcer cases. They are usually less than 5mm in diameter and heal within 1-2 weeks.
  • Major aphthous ulcers, which are large ulcers i.e. more than 10mm., that take weeks or months to heal.
  • Herpetiform Ulcers, which are multiple pinpoint ulcers that heal within a month. commonly occurs on tounge.

Symptoms of Aphthous Ulcers:

Some important symptoms of aphthous ulcer includes:

  • The burning or Tingling sensation are the early symptoms of aphthous ulcer.
  • General discomfort or uneasiness.
  • Round, white sores with a red edge can also be seen in the patient of aphthous ulcer.
  • Listlessness.
  • The lymph nodes will get swell.
  • Skin lesion on mucous membranes of the mouth may occur, which are painful and begins as a red spot or bump.
  • Fever: Fever may also be developed in aphthous ulcer.
  • Painful sore or sores inside your mouth - on your tongue, under your tongue (soft palate), inside your cheeks or lips, and at the base of your gums.

Treatment of Aphthous Ulcer:

There is no cure for aphthous ulcers. The main goal of treatment is to lessen the pain and discomfort they cause and promote healing of the ulcers.

Some treatments options that may aid the healing process are :-

  • Chlorhexidine Mouthwash may reduce the pain. It may also help ulcers to heal more quickly. It also helps to prevent ulcers from becoming infected. Chlorhexidine mouthwash is usually used twice a day.
  • The use of benzydamine spray, or choline salicylate gel is very beneficial for the treatment of aphthous ulcer.
  • Aciclovir, a type of antiviral medication may sometimes be helpful for mouth ulcers caused by the herpes simplex virus.
  • Where available, superficial tissue cauterization using Debacterol or use a silver nitrate stick
  • Avoid products or food mostly acidic food, that you know trigger or exacerbate ulcers.
  • Improve diet or take dietary supplements of vitamins or minerals that are effective for the treatment of aphthous ulcer.
  • Treatment of aphthous ulcers may include corticosteroids applied as a paste or used as a mouthwash.
  • In aphthous ulcer, topical or oral tetracycline suspension may be given.
  • Steroid lozenges: It is used to reduce the pain, and may help ulcers to heal more quickly. A steroid lozenge works faster.
  • Steroid paste (gel) is an alternative to a lozenge.
  • Numbing agents such as the local anaesthetics benzocaine and lignocaine (lidocaine) to help reduce pain.
  • Antibacterial mouthwashes to reduce swelling area of the skin.
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