Everything You Need to Know About Aphthous Stomatitis

Mouth sores can be a source of discomfort and frustration, especially when they keep coming back. One of the most common types of oral sores is aphthous stomatitis, more widely known as canker sores. These painful lesions, typically found on the buccal mucosa, gingiva, soft palate, or floor of the mouth, can make everyday activities like eating and talking difficult. While typically harmless, recurrent episodes can make it uncomfortable.

By understanding the causes, symptoms, and treatment for aphthous ulcers, you can easily manage this condition and prevent future outbreaks. Continue reading to explore the underlying factors contributing to aphthous stomatitis and how to treat and prevent it to maintain oral health.

Aphthous stomatitis, derived from the Greek term "aphtha,” meaning ulceration, is commonly known as canker sores. It is an oral mucosal condition characterised by the recurrent development of small, round, or oval ulcers on non-keratinized oral mucous membranes. These ulcers typically appear on the soft tissues, such as the inner cheeks, gums, lips, and tongue. Unlike cold sores, which are caused by the herpes simplex virus and appear outside the mouth, aphthous ulcers are non-contagious and develop only within the oral cavity.

They can be present in different forms and severity, typically classified as minor, major, or herpetiform. Minor aphthous ulcers are small, oval sores less than a centimetre wide, causing mild discomfort and healing within a week or two without scarring. Major aphthous ulcers are larger, more painful, and may persist for up to six weeks, often leaving scars. Herpetiform ulcers appear in clusters of tiny bumps, causing intense pain and forming groups in one mouth area.

While the exact cause or aetiology of aphthous stomatitis is still unknown, some factors have been identified that contribute to its development. Common aphthous stomatitis causes include:

• Injury to the Mouth: A minor injury or trauma to the oral mucosa, such as accidentally biting the inside of your cheek or tongue, aggressive tooth brushing, or injuries from dental appliances, can lead to the formation of aphthous ulcers.

• Nutritional Deficiencies: Lack of essential nutrients, particularly vitamins and minerals like vitamin B-12, folic acid, and zinc, has been linked to an increased risk of developing recurrent aphthous stomatitis.

• Stress and Hormonal Changes: Emotional stress and hormonal changes or variations, especially in women, are known to be one of the major causes of mouth sores.

• Food Allergies: Certain foods, like spicy or acidic, can irritate the mouth lining and trigger sores in some individuals.

• Family History: Genetic predisposition is considered to be a major contributing factor to the prevalence of aphthous stomatitis among 24% to 46% of patients.

• Side Effects of Medications: Certain medications can irritate the mouth and increase the likelihood of developing oral ulcers.

To maintain good oral hygiene and reduce the risk of aphthous stomatitis, consider using Colgate Total Advanced Health Toothpaste. With its unique formulation of Dual Zinc and Arginine, this toothpaste effectively combats germs on your teeth, gums, cheeks, and tongue, offering protection for up to 12 hours.

Aphthous stomatitis may appear with distinct symptoms. The primary symptoms include the appearance of small, painful ulcers inside the mouth. Other common aphthous stomatitis symptoms include:

• Small, round, or oval lesions that are white, yellow, or greyish with a red border.

• Burning, tingling, or itching sensation in the affected area.

• Swollen tissues around the ulcers.

• Fever, fatigue, and physical tiredness in severe cases.

While aphthous stomatitis typically resolves on its own, various treatments can help reduce pain and speed up the healing process. Here are some effective aphthous stomatitis treatment options that you may try:

• Topical medications: Over-the-counter topical corticosteroids, creams, gels, or ointments can provide temporary pain relief and help reduce inflammation when administered under supervision.

• Mouth rinses: Antimicrobial mouthwashes or rinses containing ingredients like chlorhexidine may help minimise the risk of infection and soothe the sores.

• Home remedies: Some individuals find relief through natural remedies, such as using salt water or baking soda rinses, which may promote healing and reduce pain.

• Oral Medicines: Consider using anti-inflammatory tablets or pills to help manage symptoms.

Recurrent aphthous ulcers may signal underlying health problems such as celiac disease (gluten-sensitive enteropathy) and inflammatory bowel disease like Crohn’s disease or ulcerative colitis. It is often accompanied by gastrointestinal symptoms. Additionally, Behcet’s disease, an inflammatory disorder, may also contribute to painful mouth ulcers along with other lesions. In these cases, an imbalance of antibodies or antigens might cause an immune response, leading to inflammation in the lymphocytes and other immune cells.

Nutritional deficiencies, particularly vitamin B12, folate, and iron, are another cause of recurrent mouth sores and canker sores. Moreover, individuals with weakened immune systems due to disorders like HIV (human immunodeficiency virus) or AIDS may experience increased susceptibility to recurrent ulcers. If you frequently encounter severe or persistent outbreaks, consulting a healthcare professional is crucial for evaluating your symptoms.

Most cases of aphthous stomatitis heal on their own within a week or two. However, you should see a dental professional if your sores are unusually large, last longer than two weeks, or cause severe pain. If the ulcers make it hard to eat or drink, aphthous stomatitis treatment may be needed to help with the discomfort.

If you get aphthous stomatitis frequently, it could be a sign of an underlying health issue. You should also seek help if your ulcers come with other symptoms like periodic fever, fatigue, swollen lymph nodes, or stomach problems. In cases of suspected systemic disease like Behcet’s syndrome, the healthcare provider might suggest further testing and a differential diagnosis to rule out other conditions.

Although there is no guaranteed way to prevent aphthous stomatitis from forming, there are steps you can take to lower the chances of getting it. These include:

• Dietary Adjustments and Supplements: Avoid foods that may irritate your mouth, and consider taking vitamin or mineral supplements if necessary.

• Good oral hygiene: Use a soft-bristled toothbrush and fluoride toothpaste, and make sure to floss daily.

• Addressing the triggers: Identify and treat any underlying causes, like vitamin deficiencies, weak immunity, trauma to the epithelium from brushing, hormonal changes, or emotional stress, that might lead to sores.

Aphthous stomatitis, while common, can be uncomfortable and disrupt daily activities. Understanding its causes and triggers, like stress or nutrient deficiencies, can help manage and prevent outbreaks. Good oral hygiene, dietary changes, and proper treatment can ease symptoms. If you have recurrent oral ulcers, seeing a healthcare professional is important. Taking these steps can help maintain good oral health and reduce discomfort.

1. Are aphthous stomatitis and canker sores the same?

Yes, aphthous stomatitis and canker sores refer to the same condition. They describe painful, non-contagious ulcers that occur inside the mouth on soft tissues like the inner cheeks, gums, and tongue.

2. Can aphthous stomatitis be contagious?

No, aphthous stomatitis is not contagious. Aphthous ulcers are caused by factors like injury, stress, or nutritional deficiencies, and they cannot be spread from person to person.

3. What foods should I avoid if I have aphthous stomatitis?

As spicy and acidic foods are common aphthous stomatitis causes, avoiding them can reduce the irritation and discomfort from the sores.

4. What are the main causes of recurrent aphthous stomatitis?

Several factors, including mouth injuries, nutritional deficiencies, hormonal changes, stress, certain food allergies, and a family history of the condition can cause recurrent aphthous stomatitis. Additionally, some medications and underlying health issues may contribute to its recurrence.