Aphthous Ulcers - Causes, Symptoms, Treatment, and Prevention

Introduction:

Majority of people complain that they have difficulty eating due to pain from an injury in the mouth. This injury is more commonly due to a mouth ulcer, which is medically referred to as aphthous ulcer or canker sores. This is the most common type of ulcer found in the oral cavity and is primarily located on the soft tissues like underneath the tongue, lips, and oral mucosa like cheeks.

This ulcer can be identified easily due to its location and shape, which is mostly well-circumscribed and measures around 5 mm or more. Ulcers less than 5 mm occur in clusters, but in case the ulcer is large, then it occurs either singly or in pairs. In some cases, many small ulcers fuse and form a large irregular ulcer, which resembles the irregularly shaped ulcer of herpes. The most widely found ulcer is recurrent aphthous stomatitis, which occurs for seven to ten days and then disappears. This period is associated with all symptoms of an ulcer.

What Are the Common Symptoms?

The common symptoms of the ulcer are:

• Pain and burning in the mouth.
• Difficulty in eating.
• Difficulty in taking hot liquids and spicy foods.
• Fever and lymphadenopathy in some cases.
• Dehydration due to inability to eat properly.

What Are the Causes?

There are several causes associated with it. These include:

1. Emotional stress among young age groups like relationship affair.
2. Poorly fitting dentures, abrasions, and injuries to the oral mucosa.
3. Underlying diseases like Crohn's disease.
4. Vitamin deficiency diseases.
5. Pregnancy and associated hormonal changes.
6. Using mouthwashes and toothpaste containing sodium lauryl sulfate.
7. Patients allergic to foods like eggs.
8. Genetic factors.
9. Frequent oral sex damaging the epithelial lining of the mucosa.

What Are the Treatment Options?

There are several treatment modalities available:

• Use of topical corticosteroids like Triamcinolone gel three times daily for 5 to 7 days.
• Use an antiseptic mouthwash daily for 5 to 7 days to prevent infection of the ulcer.
• Antibiotics are prescribed if the patient has a fever and lymph node enlargement.
• Vitamin supplementation.
• Treatment of underlying cause.

What Are the Preventive Measures?

Patients and the general public can follow preventive measures like:

• Stop smoking, as it increases the incidence of aphthous ulcers in susceptible patients.
• Avoid taking hot liquids and foods.
• Use properly fit dentures.
• Avoid oral sex, as it can damage the epithelium of the mucous membranes. It can result in severe infections like syphilis and gonorrhea.
• Avoid stress and anxiety. If you frequently get ulcers, consult a psychologist.
• If you develop an ulcer after using toothpaste or mouthwash, then stop using it.
• Pregnant women and lactating mothers should take proper diets to ensure a balanced nutrient supply, as they are susceptible.
• Treatment of underlying diseases like Crohn's disease.

Conclusion:

Patient education is essential as it leads to early treatment during prodromal phases to reduce discomfort. Patients with extensive ulcers must take proper diet and hydration, as food and hydration is decreased in case of ulcers. If patients are using palliative measures like topical numbing medication, they must be aware of the trauma to anesthetized areas during eating or sleeping. The patient must also avoid precipitating factors, like trauma, allergens, and other potential triggering agents.