Aphthous Ulcers

Recurrent Aphthous Stomatitis

(also known as recurrent aphthous ulcers or canker sores)

Recurrent aphthous stomatitis (also known as recurrent aphthous ulcers or canker sores) is the most frequently occurring ulcerative disease of the lining of the mouth. The clinical term for canker sores is Recurrent Aphthous Ulcer or RUA. As classically described, RUAs are painful shallow ulcers that are round and have a well-defined erythematous margin with yellow pseudomembranes in their center. RUAs usually occur in healthy people but also are seen with immunologic diseases. They are typically located on the cheeks, gums, and tongue. Potential causes of RAUs include vitamin deficiencies, oral flora, psychosocial stress and immune dysregulation. Although most RAUs are called minor forms and are less than 1 cm in diameter. Minor RAUs heal spontaneously within 1 week. Severe forms of RAU are larger than 1 cm in diameter, may take more than 30 days to heal, and may cause scarring of the mouth. Up to 50% of people are affected by RAUs.

A variety of medications are used to treat RAUs. Topical medications that are applied to ulcers include emollients. These medications, in the form of gels or pastes, are also known as lubricating agents. They work by forming an occlusive oily film over the oral mucosa. This in turn enhances mucosal water retention and thus decreases transmucosal water loss. Topical antiseptic agents such as chlorhexidine are also recommended for RAUs. Stronger oral treatments for RAUs include topical corticosteroids and antibiotics. Compounded medications, often containing lidocaine as a local anesthetic are commonly used to reduce pain that is associated with RAUs.