Aphthous Ulcers: What Are They, Symptoms, Diagnosis, and Treatment

Aphthous ulcers, also known as canker sores, are small, shallow lesions that appear on the soft tissues inside the mouth or at the base of the gums. These sores can sometimes cause intense pain and difficulty with eating and speaking. Unlike cold sores, aphthous ulcers do not appear on the lips and are not contagious. Most aphthous ulcers heal on their own within one or two weeks. However, ulcers that continue to grow without healing may pose health risks, and it is essential to have these evaluated by a doctor.

What Are the Symptoms of Aphthous Ulcers?

Aphthous ulcers are typically white or yellowish on the inside, surrounded by a red, circular or oval border. These lesions may appear on the top or underside of the tongue, inside the cheeks or lips, at the base of the gums, or on the soft palate. Before the sore appears, tingling or burning sensations may occur a few days prior. Other possible symptoms include:

Painful sores inside the mouth that may occur singly or in clusters
High fever accompanying the sore
Swollen lymph nodes
Difficulty speaking or swallowing

These symptoms can disrupt a person’s daily routine and quality of life.

Types of Aphthous Ulcers

There are different types of aphthous ulcers based on the size of the sore and associated symptoms:

Minor Ulcers: Also known as minor aphthae, these are most common among young people aged 10 to 20, and are less than 1 cm in diameter. They usually heal on their own within about a week.
Major Ulcers: Known as major aphthae, these are larger than minor ulcers, often over 1 cm in size, and may take more than two weeks to heal. They may leave behind noticeable scars in the affected area.
Herpetiform Ulcers: These are a rarer type of aphthous ulcer and often occur in adults. They tend to heal on their own within one or two weeks without leaving scars and may have irregular edges.

Causes of Aphthous Ulcers

The exact causes of aphthous ulcers are not fully understood, but several factors may trigger sores in the mouth:

Insufficient hygiene during dental treatments
Brushing teeth aggressively, causing damage to the mouth
Zinc deficiency
Accidental cheek biting
Use of unsuitable toothpaste
Lack of folic acid in the body
Sensitivity to certain foods
Iron deficiency
Low levels of vitamin B12
Allergic reactions to specific oral bacteria
Bacteria such as Helicobacter pylori, which can cause ulcers
Hormonal changes during menstruation
Emotional stress

Certain conditions and illnesses may also contribute to the development of aphthous ulcers, including:

Celiac Disease: A condition triggered by sensitivity to gluten, a protein found in many grains, which may result in mouth sores.
Autoimmune Diseases: Diseases like Crohn's disease and ulcerative colitis can lead to aphthous ulcers.
Behçet's Disease: A disease that causes sores in various areas of the body, including the mouth.
Weakened Immune System: A compromised immune system can reduce the body's defense against viruses and bacteria, leading to ulcers.

Treating these underlying conditions effectively can help prevent aphthous ulcers from forming.

Can Mouth Ulcers Be Prevented?

Certain preventive measures can help reduce the occurrence of mouth ulcers. Some of these measures include:

Being Mindful of Food Choices: Some foods can irritate the mouth lining. Avoiding foods that may cause irritation can help prevent mouth ulcers. Additionally, mouth ulcers can arise from allergies to specific foods. Eating trigger foods in moderation can help prevent ulcer formation.
Maintaining a Balanced and Healthy Diet: A well-balanced diet that includes carbohydrates, fats, proteins, vitamins, and minerals can support the body’s defense mechanisms and help prevent ulcers.
Paying Attention to Oral Hygiene: Regularly brushing your teeth and maintaining good oral hygiene can help prevent mouth sores.
Reducing Stress: Stress can trigger mouth sores. Effectively managing stress and avoiding stressful situations can help prevent stress-related ulcers.

How Is a Mouth Ulcer Diagnosed?

Generally, no specific tests are needed to diagnose mouth ulcers. A physical examination by a doctor or dentist is usually sufficient. However, certain underlying conditions can cause persistent mouth ulcers that may not heal quickly. Identifying and treating the underlying cause is essential for recovery. Some features of serious mouth sores that may indicate an underlying health issue include:

Sores spreading across different areas of the mouth,
Lesions lasting three weeks or longer,
Pain that persists despite pain relief and worsens over time,
High fever accompanying the sore.

Blood tests may be required to identify potential causes, and your doctor may order these tests accordingly.

How Are Mouth Ulcers Treated?

Small ulcers often heal on their own within a week or two, so no additional treatment may be needed. However, severe or persistent ulcers that cause intense pain may require medical treatment. Some common treatment options for mouth ulcers include:

Mouthwash: A doctor may prescribe a mouthwash to reduce pain and inflammation caused by sores.
Creams: Certain creams suitable for oral use can be prescribed to help heal the ulcers.
Medication: If mouthwash or creams do not promote healing, medication may be recommended by a doctor to relieve pain and speed up recovery.
Cauterization of the Affected Area: In some cases, a doctor may cauterize the ulcer to treat it.
Nutritional Supplements: Deficiencies in folic acid, vitamins B6 and B12, or zinc may contribute to mouth ulcer formation. Your doctor may recommend supplements if these levels are low.

Selecting the appropriate treatment method is essential, and having a doctor guide the treatment plan can ensure effective and accurate treatment. Therefore, if you notice mouth ulcers, it’s important to seek medical care.

Last Updated Date: 09 August 2023

Publication Date: 09 August 2023