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Aphthous Ulcer

Aphthous ulcer is a small sensitive painful ulcer crater in the lining of the mouth. Commonly it is called a canker sore. Canker sores are one of the most knowing types of mouth ulcer. Aphthous ulcers are caused by a break in the mucous membrane. Canker sores are thought to form when, for unexplained reasons, a person's immune system identifies the presence of chemical molecules that it does not recognize. This ulcer is seen in an individual with AIDS and is located in front and just below the bottom teeth. The most common type of an aphthous ulcer is known as recurrent minor aphthous ulcer. At least 1 in 5 people develop aphthous mouth ulcers at some stage in their life. Women are much more affected than men. Canker sores are common, but the cause in many cases is unknown. Canker sores can occur at any age, but often they first appear when you are between 10 and 40 years of age. Aphthous ulcers can be classified into three different types:

  1. Minor Aphthous ulcers - Minor aphthae are generally located on labial or buccal mucosa, the soft palate and the floor of the mouth. They can be singular or multiple, and tend to be small (less than 1 cm in diameter) and shallow.
  2. Major Aphthous ulcers - Major aphthae are larger and involve deeper ulceration. Major aphthae may also be more likely to scar with healing.
  3. Herpetiform Aphthous ulcers - Herpetiform aphthae frequently are more numerous and vesicular in morphology. Patients with benign aphthous ulcers should have no other findings such as fever, adenopathy, gastrointestinal symptoms or other skin or mucous-membrane symptoms.

Aphthous Ulcer Causes

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. Also, approximately 40% of people who get ulcers have a family history of aphthous ulcers. They often occur for the first time between the ages of 10-40.
The following conditions may make certain people more prone to developing these mouth sores:

  • Stress or trauma in the mouth, such as biting the tongue
  • Certain foods (especially acidic foods, such as tomatoes and pineapples)
  • Family history
  • Changes in hormone levels
  • The detergents found in many types of toothpaste can cause aphthous ulcers in some individuals.  Conventional toothpaste contains irritating detergents (sodium lauryl sulfate, sodium lauroyl sarcosinate), which have been shown to greatly increase the occurrence of mouth sores.
  • Deficiencies of iron, lysine, vitamin B12, and folic acid also can lead to canker sores. Several studies showed that nutrient deficiencies are common among recurrent canker sore sufferers than in the general population. A study of 330 patients with recurrent canker sores showed that forty-seven (14.2 percent) were deficient in iron, folate, vitamin B12, or a combination of these nutrients.

Symptoms of Aphthous Ulcer

The symptoms of a mouth ulcer depend on the cause but may include:

  • A round sore or sores inside the mouth
  • Swollen skin around the sores
  • Tenderness
  • Problems with chewing or toothbrushing because of the tenderness
  • Irritation of the sores by salty, spicy or sour foods
  • Loss of appetite.
  • Halo border is bright red (a red halo may not always be present.
  •  May have gray membrane just prior to healing

Aphthous Ulcer Treatment

Good toothpaste to use is Rembrandt, toothpaste specially made for patients with aphthous ulcers.  Rembrandt is available without a prescription at your local drug store. Aphthous Ulcer Treatment is different in different cases. 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. It may stain teeth brown if you use it regularly.

An oral rinse, such as viscous lidocaine used every three hours or before meals, provides short-term relief from pain caused by aphthous ulcers. halidomide has been shown to be a very effective treatment for aphthous ulcers. However, it is only approved in the United States for the treatment of leprosy. While it is possible to fill a prescription for thalidomide to treat aphthous ulcers, the drug must not be used by women who are pregnant.

Prevention of Aphthous ulcers

Using a toothpaste free of sodium lauryl sulfate or changing toothpastes has been shown to be helpful in some cases. Topical use of steroids, mouth rinses, may decrease recurrence. Recently, pentoxifylline has been used to prevent recurrent aphthous ulcers in an open label trial. However, blinded studies are lacking.

 
 

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