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Aphthous Ulcer - recurrent aphthous ulcer treatment

Aphthous ulcers also known as Canker sores or Mouth ulcers are most commonly occuring infection. Typically, they are a shallow ulcer with a white or whitish/yellow base surrounded by a reddish border. This ulcer is seen in plenty in an individual with AIDS and is located in front and just below the bottom teeth. They occur in women more often than men. They may occur at any age, but usually first appear between the ages of 10 and 40.

Aphthous Ulcer Picture

Aphthous ulcer picture

Types of Aphthous ulcers

A phthous ulcers can be classified into three different types:

  1. Minor Aphthous ulcers- Minor aphthae are generally located on labial or buccal mucosa, the soft palate and the floor of the mouth. They can be singular or multiple, and tend to be small (less than 1 cm in diameter) and shallow.
  2. Major Aphthous ulcers- Major aphthae are larger and involve deeper ulceration. Major aphthae may also be more likely to scar with healing.
  3. Herpetiform Aphthous ulcers- Herpetiform aphthae frequently are more numerous and vesicular in morphology. Patients with benign aphthous ulcers should have no other findings such as fever, adenopathy, gastrointestinal symptoms or other skin or mucous-membrane symptoms.

Causes of Aphthous ulcers

The exact reason why aphthous ulcers develop is not yet clearly defined. Current thinking is that the immune system has been disturbed by some external factor and this results in the development of aphthous ulcers. Also, approximately 40% of people who get ulcers have a family history of aphthous ulcers. The list of possible underlying conditions mentioned in various sources as possible causes of Canker sores includes:

  • Viral (coxsackievirus, herpesvirus),
  • systemic illness (Crohn's disease, lupus, Behçet's disease, erythema multiforme),
  • Streptococcus sanguis
  • Infection
  • Stress
  • Premenstrual syndrome
  • Dietary deficiencies
  • Certain foods
  • Pickles
  • Potato chips
  • Rough dentures
  • Dental braces
  • Rough tooth brushing
  • Food allergies
  • Pregnancy - some women become more prone to canker sores during pregnancy.
  • Vitamin B12 deficiency
  • Folic acid deficiency
  • Emotional stress

What is the treatment for aphthous ulcers?

There is no cure for aphthous ulcers. The main goal of treatment is to lessen the pain and discomfort they cause and promote healing of the ulcers. The lack of predictability of the efficacy of a particular treatment mirrors the mystery surrounding the etiology of the condition.

Most recurrent minor aphthous ulcers heal within 1-2 weeks without any treatment. The following remedies and precautions may help:

  • A multi-vitamin with iron should be taken every day to counteract any possible vitamin or iron deficiency.
  • A good toothpaste to use is Rembrandt, a toothpaste specially made for patients with aphthous ulcers.  Rembrandt is available without a prescription at your local drug store.
  • Topical cortisone treatment applied to the ulcers several times a day may relieve the pain and shorten healing time. 
  • Avoid products or food that you know trigger or exacerbate ulcers.
  • Sucking on zinc gluconate lozenges is anecdotally reported to provide local relief and speeding of healing time for aphthous ulcers.

How to get rid of Aphthous ulcers

  • Amlexanox 5 percent paste (Aphthasol) has been examined in several studies of the treatment of aphthous ulcers. The paste was applied to ulcers two to four times a day. Healing time was improved with this agent.
  • Thalidomide (Thalomid) is the agent most frequently used for management of aphthous ulcers that cause severe pain with eating.
  • Reduce stress!
  • Antibacterial mouthwashes to reduce secondary infection.

Home remedy for Aphthous ulcers

The easiest home remedy is to apply hydrogen peroxide (1 part hydrogen peroxide and one part water with a cotton swab) on the canker sore. Then dab a small amount of milk of magnesia on the canker 3-4 times a day. This is not only soothing, but appears to help healing.

Prevention of Aphthous ulcers

Using a toothpaste free of sodium lauryl sulfate or changing toothpastes has been shown to be helpful in some cases. Topical use of steroids, mouth rinses, may decrease recurrence. Recently, pentoxifylline has been used to prevent recurrent aphthous ulcers in an open label trial. However, blinded studies are lacking.

 

What others have contributed to this page?

The local application of dispersible aspirin gives rapid relief & faster healing. Applying 10 min before food allows to have food.Halve the tab &make it paste by mixing own saliva or 2 drops of water. --DR SATHISH NAYAK

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