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Aphthous Ulcer - Definition, Causes, Symptoms and Treatment


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An aphthous ulcer is a type of mouth ulcer, caused by a break in the mucous membrane. Aphthous stomatitis is a condition which is characterized by recurrent discrete areas of ulceration which are almost always painful. They can occur one at a time or as a group of sores. It has been used for many years to describe areas of ulceration on mucous membranes. Although these sores are not serious, other mouth sores may be. Unlike herpes, however, aphthous ulcers cannot spread from one person to another. Rather, they are thought to result from a reaction of the immune system. They tend to occur more often in women than men. They often occur for the first time between the ages of 10-40. Aphthous ulcers are more common in HIV-positive people and are more likely to recur in HIV-positive people. Aphthous ulcers are also commonly present in other medical conditions, including Crohn's disease and inflammatory bowel disease. The ulcers are shallow and are often accompanied by soreness and pain. The ulcers usually last one to two weeks.

Gluten intolerance is a common cause of aphthous ulcers. Women are generally affected more often than men. Aphthous ulcers can also be caused by emotional stress and lack of sleep. If you bite the inside of your cheek, this can also result in an aphthous ulcer. Aphthous ulcers develop in childhood and adolescence, and continue sporadically throughout life. Trauma to the mouth is a common cause of aphthous ulcers. Physical trauma, such as toothbrush abrasion, poking with sharp food, accidental biting, or dental braces can cause mouth ulcers by breaking the mucous membrane. People with nutritional problems, such as vitamin B, iron, and folic acid deficiency, are also more likely to develop aphthous ulcers. Most ulcers do not need any treatment and heal in around a fortnight . The application of Topical cortisone treatment helps in reducing the healing period and provide some relief.

Causes of Aphthous ulcer

The exact cause of aphthous ulcers is unknown. It is believed that certain foods, fever or mental stress may precede  the outbreak of these lesions. A well-known cause for ulcers in the mouth is when the skin inside the mouth is opened up, a common cause of this is biting one's lip or any tissue within the mouth. Trauma to the mouth is a common cause of aphthous ulcers. Some drugs, such as nicorandil, have been linked with mouth ulcers. Other factors, such as chemical irritants or thermal injury, may also lead to the development of ulcers. However, in many cases the cause is unknown.

Common causes and risk factors of Aphthous ulcer:

  • Stress or trauma in the mouth.
  • Iron Deficiency.
  • A family history of aphthous ulcer.
  • Vitamin-B deficiency.
  • Bacterial infections, such as stomach ulcers.
  • Steroids.
  • Drug sensitivity eruptions.

Signs and Symptoms of Aphthous ulcer

Aphthous ulcers typically occur on the inner surface of the cheeks and lips, on the tongue, and the soft palate. It progresses to form a bump or a redspot in a few days. It is then followed by an open ulcer. Usually they are an open, shallow sore with a slightly raised, yellowish-white border often surrounded by a red border. Some people get aphthous ulcers two or three times per year, while others develop lesions continually one after another. The ulcer, which itself is often extremely painful, especially when agitated, may be accompanied by a painful swelling of the lymph nodes below the jaw, which can be mistaken for toothache.

Sign and symptoms may include the following :

  • Tingling sensation.
  • Fever.
  • Round, white sores with a red edge.
  • Skin lesion.
  • Single or clusters, often appears in groups.

Treatment for Aphthous ulcer

Most Aphthous ulcers do not need any treatment and heal in around a fortnight . In case deficiency of vitamins or iron is the cause then in such cases multi-vitamins should be taken everyday. Rembrandt toothpaste is advisable for people having Aphthous ulcer. Pain can be treated with several pain-relieving gels, such as Anbesol, Bonjela, Campho-Phenique, Orabase B, Zilactin, available in drugstores. Some people claim that such gels also accelerate the healing of their ulcers.

Treatment may include:

  • Antibacterial mouthwashes to reduce swelling area of the skin.
  • The use of benzydamine spray, or choline salicylate gel is very beneficial for the treatment of aphthous ulcer.
  • In aphthous ulcer, topical or oral tetracycline suspension may be given.
  • Aciclovir, a type of antiviral medication may sometimes be helpful for mouth ulcers caused by the herpes simplex virus.
  • Enamel Saver Toothpaste prevents aphthous ulcers.