Aphthous stomatitis
Aphthous stomatitis, or recurrent aphthous stomatitis (RAS), is a common condition characterized by the repeated formation of benign and non-contagious mouth ulcers (aphthae) in otherwise healthy individuals. The informal term canker sore is also used, mainly in North America, although it may also refer to other types of mouth ulcers. The cause is not completely understood but involves a T cell-mediated immune response triggered by a variety of factors which may include nutritional deficiencies, local trauma, stress, hormonal influences, allergies, genetic predisposition, certain foods, dehydration, some food additives, or some hygienic chemical additives like SDS (common in toothpaste).
| Aphthous stomatitis | |
|---|---|
| Other names | Recurrent aphthous stomatitis (RAS), recurring oral aphthae, recurrent aphthous ulceration |
| Canker sore on the lower lip | |
| Specialty | Oral medicine, dermatology |
| Symptoms | A round, often painful sore inside the mouth that is white or gray with a red border;
Tingling or burning sensation prior to sore development; Fever, sluggishness, and/or swollen lymph nodes (severe cases only) |
| Complications | Cellulitis (a bacterial skin infection); fever; sores that appear outside of the mouth; pain while brushing teeth, eating, and/or talking |
| Usual onset | 1 to 2 days, before visual appearance |
| Duration | 7–10 days |
| Causes | Behçet's disease; celiac disease; food allergies; HIV infection; lupus; oral injuries; poor oral hygiene; stress; vitamin deficiency |
| Risk factors | Anyone can develop canker sores. |
| Prevention | avoiding foods that irritate the mouth, including acidic, hot or spicy foods; avoid irritation from gum chewing; avoiding oral hygiene products containing sodium lauryl sulfate, brushing with a soft-bristled brush after meals and flossing daily. |
| Treatment | mouth rinses; nutritional supplements; oral medication |
| Medication | good oral hygiene, topical agents |
| Frequency | ~20% of people to some degree |
| Deaths | None reported. |
These ulcers occur periodically and heal completely between attacks. In the majority of cases, the individual ulcers last about 7–10 days, and ulceration episodes occur 3–6 times per year. Most appear on the non-keratinizing epithelial surfaces in the mouth – i.e. anywhere except the attached gingiva, the hard palate and the dorsum of the tongue – although the more severe forms, which are less common, may also involve keratinizing epithelial surfaces. Symptoms range from a minor nuisance to interfering with eating and drinking. The severe forms may be debilitating, even causing weight loss due to malnutrition.
The condition is very common, affecting about 20% of the general population to some degree. The onset is often during childhood or adolescence, and the condition usually lasts for several years before gradually disappearing. There is no cure, but treatments such as corticosteroids aim to manage pain, reduce healing time and reduce the frequency of episodes of ulceration.