Recurrent apthous stomatitis : type , cause of Apthous ulcer and medical treatment of Apthous Ulcer-Oral Ulcer

Apthous Ulcer


Recurrent apthous stomatitis(apthous ulcer) is common oral ulcer in limited to mouth ,that typically starts with childhood and adolescence as recurrent small round ovoid ulcer with circumscribed round margin erythematous haloes and gray or yellow flores.
Apthous ulcer : type ,cause of Apthous ulcer and treatment of Apthous ulcer


Types of Apthous Ulcer:

1. Minor ulcers

This is the most common . 80% people have minor ulcers. It can be small, round or oval. It is normally less than 10 mm in size. Its color is light yellow, but the surrounding area is swollen and red. Usually one but up to 5 can be. Lasts 7-10 days and heals without medication, leaving no scars.
They recur at interval of 1 to 4 month . It goes without saying that there is no pain in minor ulcers.

2. Major ulcer

About 10 % people have major ulcers. Its size is larger than 10 mm. There may be 1 or 2 at a time. Not more than that. May last from 14 days  to several months. It hurts a lot. Even eating is hard.

3. Herpetiform ulcers

About 10% people have herpetiform ulcers. Tiny, pin-shaped, 1-2 mm in size. They are many at once and sometimes come together to form unequal, bumpy shapes. Each ulcer lasts from 1 week to 2 months.the ulcer seems to be stomatitis herpetiformis which caused by herpes simplex virus. But herpetiform ulcer not caused by herpes simplex virus  .

Aphthous ulcers causes:


The reason is unknown. Not for any infection. So you can't catch it beforehand. These are usually seemingly healthy people without any reason.

There is no exact cause but some factors or diseases are responsible for it. E.g.
Family history
Lack of iron, vitamin B-12 and folic acid can also occur.
Injuries: If the dentures do not fit properly, uneven toothbrushes can cause injuries.

Hormonal level changes: Some people have their period before. Some may be after menopause.

This can happen after some people quit smoking.

Sometimes it can also be a side effect of certain medications. Such as oral nicotine therapy, 
nicorandil,
anti-inflammatory drugs etc. May also be due to allergies.
Stress can be due to anxiety. There may also be hereditary reasons.
People with Crohn's disease, celiac disease, and HIV infection can have mouth sores. But it may not be the epithelial type.

Laboratory Investigations of Apthous Ulcer:

  • Complete Blood Count(CBC)
  • Iron profile
  • Red cell folate assay
  • Serum Vitamin B12
  • Transglutaminase assay
  • Biopsy indicated in some cases

Treatment of Apthous Ulcer:

Topical steroid is the mainstay of treatment.topical corticosteroids reduce the pain burning.
  • Hydrocortisone 2.5 mg tab orally 3 times or,
  • prednisolone 5mg used as a lozens or,
  • triamnicolone acetonide  mouth preparation4 times daily orally or,
  • Betamethasone for mouth rinse by .5mg o tablet add with 15ml water then rinse mouth

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