Aphthae in the mouth: symptoms, development, treatment
Canker sore aka discomfort in everyday life
What is a canker sore?
Canker sore, also known as aphthous stomatitis, is an ulceration of the mucous membrane in the oral cavity, characterized by a yellowish or whitish color surrounded by an inflamed area.
The occurrence of canker sores
Canker sores are relatively common mucosal lesions that appear multiple times throughout the lives of many individuals. Some experience them more frequently, others less so, and occasionally they do not occur at all. Their occurrence ranges from 5% to 55% in various populations, with a higher frequency among women. In North America, they are particularly prevalent.
For those particularly prone to them, canker sores often recur at regular intervals, appearing repeatedly (recurrent aphthous stomatitis, or RAS).
…but what causes them to develop?
Causes and development of canker sores
The mechanism behind the formation of canker sores remains not fully understood to this day, and the causes of canker sores, as well as predisposing factors, can vary from individual to individual. For example:
- Stress, stressful lifestyle
- mechanical injury
- vitamin deficiency
- hormonal changes
- viruses
- bacteria
- allergic reactions
- gastrointestinal disorders
- autoimmune diseases
- consumption of certain foods, reactions to specific foods (nuts, red berries)
all can play a role in their development.
Symptoms of canker sores
Symptoms before the appearance of ulcers
Many report a burning, itching, or stinging sensation hours before the appearance of the ulcer.
Pain
The most uncomfortable symptom of canker sores is the intense pain. Interestingly, the severity of the pain often does not correlate with the extent of the lesion. Canker sores in the mouth can be surprisingly painful, making eating and speaking difficult. If the canker sore is located on the tongue, swallowing can also be uncomfortable.
The appearance and size of the aphthous ulcer
They develop on the cheek, the palate, or the tongue, ranging from small to large circular or oval shapes, occasionally less regular in shape initially, appearing as yellowish, then grayish-white ulcers. The ulcers on the mucous membrane are surrounded by a red, inflamed area. They can appear individually or in small clusters.
The size of canker sores varies considerably (1-30mm), but they are most commonly the size of a peppercorn.
General symptoms of canker sores
Rarely, usually in severe cases, canker sores can also be accompanied by general symptoms. These may include fever, fatigue, and overall malaise. Swelling of the nearby lymph nodes can also occur.
Az afta fertőző?
Canker sore is a benign, non-infectious inflammation of the oral mucosa.
Canker sore or herpes?
Despite certain types of canker sores bearing clinical similarities to lesions caused by the herpes simplex virus (see below), canker sores are not caused by herpes simplex virus (HSV1, 2), thus they are not contagious. The virus responsible for oral herpes hides in nerve cells, remains dormant, and occasionally becomes activated, causing symptoms.
Types of canker sores
The three main types of canker sores in the oral cavity are:
1. Minor aphthous ulcer (MiRAS)
Minor aphthous stomatitis (MiRAS), also known as Mikulicz ulcer, is the most common type (affecting 80% of RAS sufferers). They are typically smaller than 5 mm in size, occurring singly or in clusters, and are oval or round in shape. They usually affect the movable, non-keratinized mucosa.
They heal within 7-10 days without scarring. The ulcers are shallow in depth. Recurrence is very common, but the duration of ulcer-free periods varies from person to person. They typically involve mild pain.
2. Major aphthous ulcer (MaRAS)
Major recurrent aphthous ulcer (MaRAS), also known as Sutton ulcer, is generally less common (affecting 10% of RAS sufferers) and larger in size, exceeding 5mm. It is more common in adulthood. Typically, its diameter ranges from 10-20 mm, but it can reach 2-3 cm and penetrates deeper. It usually affects the non-keratinized oral mucosa but can also appear on the gums.
They often appear multiple times in the palate and throat area. Due to their larger size, the healing time can be up to 30 days or even longer in some cases. They typically heal with scarring. This type of ulcer is more painful and makes eating and swallowing difficult.
3. Herpetic ulcer
Less commonly occurring (affecting 1-10% of RAS sufferers), its symptoms resemble those caused by the herpes virus, but it is not caused by herpes virus. Their size is smaller than 1 mm, and there can be up to a hundred lesions present at one time, where those close to each other may merge, forming a larger and irregularly shaped herpes-like ulcer. It is more common with women.
Treatment of canker sores, what can we do against canker sores?
There are several methods for treating canker sores, the effectiveness of which varies. The aim of treatment is to alleviate symptoms, shorten the healing process, and prevent recurrence.
Healing of gum canker sore
In most cases, aphthous lesions heal spontaneously within a few days, but one should expect discomfort and pain for 10-12 days. The duration of the healing process depends on the type of lesion, so in some cases, it can last for 30 days or longer.
Local treatments: home remedies for canker sore treatment
If the condition is not severe, there is no need to consult a doctor, as the symptoms will usually resolve on their own, and the ulcers will heal. It's important to avoid irritating factors and treat the affected area gently. Use a soft toothbrush and avoid consuming overly acidic, spicy, or hot foods, as they can exacerbate the pain.
With the recommendation of our dentist, the use of topical anaesthetic gels for canker sore or creams may help reduce pain by forming a protective barrier over the ulcer. Many of these products contain hyaluronic acid.
Sucking tablets or antimicrobial mouthwash for canker sores can also provide symptomatic relief.
Treatment of canker sores in more severe cases, the use of medication for canker sores
Applying topical corticosteroids for canker sores can reduce the extent of local inflammation. It is advisable to complement this with pain relievers.
Various immunomodulatory medications and mouthwashes may also be considered, but systemic administration of colchicine or pentoxifylline can also aid in healing.
It is strongly advised to conduct a general health examination in severe cases to detect any underlying conditions that may be present.
Prevention of canker sores: what can we do to prevent gum canker sores?
To prevent the development of gum canker sores, it is advisable to avoid stress, eat healthily, avoid spicy foods, take good care of our teeth, and ensure we are getting adequate vitamins and minerals (especially vitamin C, vitamin B12, folic acid, zinc). These measures can help prevent gum canker sores, among other things.
If you experience any discomfort, feel free to visit our clinic, where we can provide you with appropriate advice and topical treatments to help facilitate a speedy recovery. You can reach us at 053 9301 323, or contact us via e-mail so we can assist you!
FAQ - About canker sores
Is mouthwash effective against canker sores?
There are mouthwashes specifically recommended for treating canker sores, as well as spray products that can be used to alleviate symptoms. However, not all mouthwashes are recommended, as some alcohol-containing products may "sting," thus exacerbating the discomfort.
What should I do if I have a canker sore in my mouth?
Canker sores generally do not require special treatment, so alleviating the symptoms is usually sufficient. In most cases, they will go away on their own after a few days to 1-2 weeks.
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