The Aphthous minor ulcer, commonly known as a ” canker sore”, has been the focus of
study and research for many years. Basically, it is a chronic, inflammatory disease
characterized by a painful, oral ulcer that occurs with varying frequency. Hence the
term “Recurrent Aphthous Stomatitis ” (RAS).

Categorized as as an idiopathic (origin unknown) disease,aphthous minor ulcers are
frequently misdiagnosed, treated incorrectly or simply ignored. They are inflammatory
lesions of the mucous membrane of the oral cavity which may include the cheeks, gums,
tongue, lips, roof and floor of the mouth.

Although they have been studied and researched for many years, their exact eitiology
is still unknown. It is one of the most common, persistent and most annoying dental
lesion of the mouth!

The lesion is usually quite painful in the beginning and associated with redness, some
swelling and in the latter stages, a whitish ulceration. It usually appears singularly,
but can appear in clusters as well, but this is less common. Once the white lesion appears,
there is much less pain to endure.

Initially, it is very painful and very sensitive to touch and hot spicy foods. Manifestation
of the disease can range from mild to severe and in some extreme cases, may hinde
a person’s ability to ingest foods,thereby making that person susceptible to malnutrition.

Although the cause is unknow, several factors are suspected
including trauma, genetics, stress, nutritional deficiencies, diet, hormonal changes and
immunological disorders.

Because the specific cause has not yet been determined, it has been difficult to find a
definitive cure.Consequently, current recommended treatments are aimed towards alleviating
the symptoms until they complete their cycle.

Some current treatment options include topical agents,systemic and topical steroids,
corticosteroids, cauterization, antibiotics, mouth rinse containing active enzymes, laser
treatments and any combination therapy.

Because most of these types of lesions ae located in very inconspicuous areas of he mouth,
it is very difficult and somewhat challenging to apply any topical agents that have been
suggested.

The most common of aphthous stomatic ulcers (minor forms), usually occurs in about 85 to
95 % of all RAS lesions. They seem to be more prevalent in the female population during
ovulation and menstruation cycles.They have about a 7 to 14 day cycle and hardly ever leave a scar.

A major aphthous form ,usually appears with more than one ,which accounts for 10 to 15 % of
all RAS cases. Obviously, more pain is associated with this type and their duration may last
6 or more weeks.

The third and most uncommon type of aphthous lesion is called a Herpertiform ulcer which
accounts for only 5-10 % of the cases reported. They differ from the simple and major forms
of aphthous lesions because they can occur on both keratinized and non-keratinized tissue.

Overall, the majority of aphthous stomatic lesions effect an estimated 15-20% of the world
population. One should be aware that an aphthous lesion can result, following dental
treatment.

Some dental procedures can be traumatic to the tissue. For example, a dental needle injection,
accidental bite on the lip or inner cheek or trauma from a toothbrush bristle or ingestion of
a sharp food like a piece of very strong cheese.

That said however, authorties are in agreement that aphthous ulcers do not represent acute
infections and are not considered contagious.

You should also be aware that aphthous lesions of the herpetic variety,cannot be treated with
antibiotics.Why ? Herpetic lesions are viral in nature and are not susceptible to antibiotic therapy !

Primary care physicians and dentists should be aware and familiar with the management of aphthous
lesions and be able to offer therapeutic options that will meet their patient’s needs.

If you are a person who is susceptible to aphthous ulers, let your dentist know it. He or she may
be able to take the necessary precautions to reduce the effect of dental trauma during dental
procedures.

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