Aphthous stomatitis

Blood is often taken to assess the hemoglobin, iron, folate and vitamin B12 levels

Aphthous stomatitis, commonly known as canker sores, is a widespread condition identified by recurrent formation of benign, non-contagious mouth ulcers, or aphthae, in otherwise healthy individuals. Though the term "canker sores" is mainly used in North America, it can broadly refer to any type of mouth ulcer.

Classification

Aphthous stomatitis is typically classified into three types:

Minor Aphthous Ulcers: These are the most common type and are typically small, round, or oval-shaped with a white or yellow center and a red border.

Etiology

The precise cause of aphthous stomatitis is not well understood. However, several factors are believed to trigger its onset, including stress, hormonal changes, food sensitivities (especially to acidic or spicy foods), certain toothpastes and mouthwashes, vitamin B12, iron, and folic acid deficiencies, and mechanical trauma. Some systemic diseases, like celiac disease and inflammatory bowel diseases, can also be associated with aphthous ulcers.

Clinical Presentation

The hallmark symptom of aphthous stomatitis is the recurring presence of mouth ulcers. These ulcers usually appear on the non-keratinized oral mucosa - the inner cheeks, lips, and the floor of the mouth. They are typically round or oval with a yellow or white fibrous center and a red halo.

Diagnosis

Diagnosis is primarily based on clinical examination and patient history. Additional tests may be conducted if ulcers are persistent, unusually large, or accompanied by other symptoms such as fever, to rule out other conditions like oral cancer, viral infections, or systemic diseases.

Management and Treatment

While aphthous stomatitis is self-limiting and the ulcers often resolve on their own within one to two weeks, symptomatic treatment can help manage the pain and inflammation. Over-the-counter topical gels or patches, mouth rinses, or systemic medications may be used to alleviate symptoms and hasten healing. Avoidance of identified triggers can also help in managing the condition.

Prognosis

Although the condition is chronic and recurrent, the prognosis is generally good with no associated increase in the risk of major illness or mortality.

References

• Ship, Jonathan A. (1996-02-01). "Recurrent aphthous stomatitis. An update". Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 81 (2): 141–147.
• Scully, Crispian; Porter, Stephen (2008-07-05). "Oral mucosal disease: Recurrent aphthous stomatitis". British Journal of Oral and Maxillofacial Surgery. 46 (3): 198–206.

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