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Aphthous Ulcers - Causes, Symptoms, Treatment, and Prevention

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Aphthous Ulcers - Causes, Symptoms, Treatment, and Prevention

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The majority of people complain that they have difficulty eating due to pain from an injury in the mouth. Read the article to know more.

Medically reviewed by

Dr. Sneha Kannan

Published At May 10, 2019
Reviewed AtAugust 4, 2023

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.

Frequently Asked Questions

1.

Which Is the Main Causative Factor of Mouth Ulcers?

The main triggering factors of mouth ulcers are,
- Stress.
- Minor trauma (self bite, toothbrush injury, injury due to dentures, and high temperatures from hot food).
- Vitamin B12 deficiency.
Other triggers include,
- Pregnancy.
- Weak immune system.
- Allergy.
- Irritant food items like spice foods, coffee, and chocolate.
- Family history.
- Oral hygiene products consisting of sodium lauryl sulfate.
These triggers also act to prolong the healing of these ulcers.

2.

How Does an Aphthous Ulcer Present Like?

Minor aphthous ulcers measure less than 5 mm in diameter, and major aphthous ulcers measure greater than 5 mm in diameter. They are somewhat circular or oval and range from pale yellow to gray with a red ring of inflammation. Some inflamed ulcers are reddish in appearance.

3.

Why Do My Aphthous Ulcers Pain a Lot?

Aphthous ulcers are a kind of wound of the lining of the mouth. They get infected and swell up. They frequently get irritated by teeth, tongue, fingers, cutleries, and food or get bitten by mistake. All these lead to pain.

4.

When Do Aphthous Ulcers Heal?

Minor aphthous ulcers heal within a week or a maximum of ten days. Major aphthae take several weeks (approximately two to four weeks) to heal.

5.

Which Other Conditions Are Aphthous Ulcers Associated With?

Aphthous ulcers at times occur secondary to celiac diseases, Crohn’s disease, Behcet’s disease, inflammatory bowel diseases, diabetes, and HIV (human immunodeficiency virus) infection.

6.

Do Autoimmune Diseases Cause Mouth Ulcers?

Mouth ulcers occur in people with autoimmune disorders like systemic lupus erythematosus (SLE), Behcet’s syndrome, and Crohn’s disease. But these are not aphthous ulcers.

7.

How Does a Lesion Differ From an Aphthous Ulcer?

Aphthous ulcer is one of the lesions. Lesions mean the damage caused to the tissue due to a physical condition like trauma or injury and medical condition that can be inflammatory, infective, malignant, or pre-malignant in origin.

8.

When Will the Aphthous Ulcer on My Tongue Heal?

Tongue ulcers heal on their own without any intervention within two weeks. It differs from person to person. In some people, it heals within a week; in some, it may be prolonged. However, the maximum period of healing is two weeks.

9.

For What Duration Do Aphthous Ulcers Last?

Minor aphthous ulcers last for a week or ten days, and the duration of major aphthous ulcers range from two weeks to months.

10.

How Can One Prevent Aphthous Ulcers?

Following measures must be taken to prevent aphthous ulcers to some extent.
- Living a stress-free life.
- Being careful while brushing or eating to avoid injuries to the lip, tongue, and inner cheek region.
- Correction of nutritional deficiencies.
- Management of systemic disorders.
- Avoiding foods that irritate the mouth’s lining like spicy foods, hard and crunchy foods, fruits like pineapple, lemon, orange, etc.

11.

What Medicines Treat Aphthous Ulcers?

Medications like topical Lidocaine and Benzocaine numb the ulcer to reduce pain. Antiseptic mouthwashes like Chlorhexidine mouthwash, vitamin and mineral supplements, and topical steroids are prescribed for mouth ulcers.

12.

How to Get Rid Of Aphthous Ulcers Promptly?

Though there is no cure for aphthous ulcers, they regress within their designated duration. During their presence, symptoms of pain and discomfort can be managed with medications. Saltwater mouth rinse, anesthetic ointment application, and ice application can be done to relieve pain and swelling at home. In addition, identification and elimination of the trigger are necessary for rapid healing.

13.

What Treatment Options Heal Aphthous Ulcer of the Uvula?

There is no treatment to cure aphthous ulcers in general. However, mouthwash with anti-inflammatory and pain-relieving properties can be used. Chlorhexidine mouthwash, drinking cool water, and saltwater gargle help ease pain and discomfort. They heal on their own.
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Dr. Soheel Hussain Zargar
Dr. Soheel Hussain Zargar

Dentistry

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