Definition of Recurrent Aphthous Stomatitis: A common oral disease characterized by the development of painful, recurring solitary or multiple ulcerations of the oral mucosa.
- Aphthous ulcers
- Canker sores
Etiology of Recurrent Aphthous Stomatitis:
- Bacterial infection – L form of streptococci – streptococcus sanguis – immunologic hypersensitivity reaction to L form of streptococci
- Immunologic abnormalities – altered immune response against non pathogenic oral flora & host oral tissue
- Iron, Vitamin B12 or folic acid deficiency
- Emotional stress and lack of sleep
- Mechanical trauma, for example self-inflicted bite
- Nutritional deficiencies
- Certain foods including chocolate
- Certain toothpastes
- Menstrual cycle
- Endocrine conditions
- Pshychic factors
- Allergic factors
- Recurrent aphthous minor
- Recurrent aphthous major
- Recurrent herpetiform ulcerations
- Recurrent ulcers associated with Behcets syndrome
Recurrent Aphthous Minor:
Number: Single / multiple
Size – 2-3mm to 10mm
Site – labile mucosa not bound to periosteum – buccal & labial mucosa, buccal & lingual sulci, tongue, soft palate, pharynx & gingiva
Presents as well circumscribed superficial erosions covered by a gray membrane & surrounded by an erythematous halo
Recurrent Aphthous Major:
Age: no predilection
Sex: F > M
- 1-10 in number
- More than 5mm in diameter
- Large Ulcers which are mostly Painful
Site: lips, cheeks, tongue, soft palate & fauces
Lesions occur at frequent intervals & persist upto 6 weeks; healing occurs with scarring.
Treatment of Aphthous Ulcers:
There is no medical treatment for aphthous ulcers.
Main concern for the Treatment is to decrease the discomfort of the patient and to promote the healing of Ulcers on their own.
Most recurrent minor aphthous ulcers heal within 1-2 weeks without any treatment and Major Aphthous Ulcers heal within 6 weeks.
General measures for Aphthous Ulcers Treatment:
- Antiseptic Gels should be used which as well act as a barrier from external irritation.
- Local anaesthetics benzocaine and lignocaine (lidocaine)
- Medicated toothpaste without sodium laureth sulfate
- Regular Mouth Wash usage which decrese the bacterial colonization
- Help the patient get out of Stress. (most common cause of aphthous ulcers is “Stress”)
- Lotions, creams and paste containing Topical corticosteroids
- Triamcinolone in dental paste
- Mouthwash containing Tetracycline
Systemic Medication – (Used only in Severe Cases)
Medications used are
- Systemic steroids
- Immunosuppressive agents
- Tumour necrosis factor (TNF) antagonists (adalimumab, etanercept, infliximab)
John @ rockymtnendodontics.com says
It’s really so discomforting and painful to have these moth ulcers but nobody is exempted. One method that worked for me is I put salt in it. It is extremely painful when you do that but it quickens the healing process effectively.