Introduction:

Aphthous ulcers, commonly known as canker sores, are small, shallow lesions that develop on the soft tissues in the mouth or at the base of the gums. Unlike cold sores, aphthous ulcers are not contagious and can be quite painful, often making eating and talking uncomfortable.

Epidemiology:

• Prevalence: Very common, affecting about 20% of the population.
• Risk Factors: Family history, stress, minor mouth injury, certain foods, nutritional deficiencies, allergic responses, and some medical conditions.

Pathophysiology:

The exact cause of aphthous ulcers is not well understood, but they seem to result from a combination of factors, including genetic predisposition and environmental triggers.

Clinical Features:

• Appearance: Round or oval with a white or yellow center and a red border.
• Size: Typically less than 1 cm in diameter for minor ulcers; major ulcers can be larger and more painful.
• Location: Inside the mouth on the movable parts, such as the inner lips, cheeks, tongue, and soft palate.
• Symptoms: Pain, burning sensation before the sore appears, and difficulty eating or talking.

Diagnosis:

• Clinical Examination: Usually diagnosed based on medical history and appearance.
• Biopsy: Rarely needed, but can be performed if cancer is suspected or ulcers are unusually large, persistent, or painful.

Treatment:

• Topical Treatments: Corticosteroids, antimicrobial mouth rinses, or topical pastes to reduce pain and inflammation.
• Oral Medications: If severe, oral medications may be prescribed, such as sucralfate or colchicine.
• Nutritional Supplements: If related to a deficiency, supplements such as vitamin B12, folic acid, or iron may be recommended.
• Laser Therapy: In some cases, laser treatments can reduce pain and promote faster healing.

Complications:

• Secondary Infection: Rare but can occur, especially if hygiene is not maintained.
• Severe Pain: Can interfere with daily activities, especially when eating or speaking.

Prevention:

• Dietary Changes: Avoiding foods that can trigger ulcers, such as spicy foods, acidic fruits, and sharp-edged foods.
• Oral Hygiene: Maintaining good oral health and using a soft-bristled toothbrush.
• Stress Management: Techniques like meditation or counseling can help manage stress.

Prognosis:

• Healing Time: Minor aphthous ulcers typically heal within one to two weeks without scarring. Major ulcers may take longer and can leave scars.
• Recurrence: Common, with many individuals experiencing multiple episodes throughout their lives.

Conclusion:

Aphthous ulcers are a common oral health issue that can cause significant discomfort. While they typically resolve on their own, persistent or severe cases may require medical treatment. Understanding potential triggers and maintaining good oral hygiene can help manage and prevent these ulcers.

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