Recurrent ulcers of the oral cavity are very painful commonly seen in the patients.They could be solitary ulcers or multiple ulcerations of the oral mucosa. They are seen more commonly in women than in men. The number or frequency of attacks is seen to be variable. While some may have an attack during a year others will have one or two attacks every month.
The apthous ulcers begin as single nodules ,vesicle like lesions Containing mucous. Low grade fever is not uncommon.This lesion is very painful and interferes with eating for several days .They persist for 7-14 days and heal gradually.
Recurrent apthous major presents itself as large painful ulcers,on the lips, cheeks, tongue & soft palate.They persist for upto 6 weeks and leave a scar on healing.
CAUSES:
1.BACTERIAL INFECTION: Sterptoccocus sanguis and hemolytic streptococcus have been found to be causative agents .
2.DEFICIENCY : Iron,vitamin B12 or Folic acid deficiency plays a significant role in the etiology of apthous stomatitis.
PRECIPITATING FACTORS:
1.Trauma: self inflicted bites ,oral procedures ,tooth brushing ,needle injections and ill fitting dentures.
2. Endocrine conditions: Menstrual periods and during pregnancy.
3.Psychic factors: Stress and tension and psychologic problems seem to aggravate the attacks.
4.Allergic factors: Asthma,hay fever or food or drug allergies.
TREATMENT:
1. Tetracycline mouthwash (250mg per 5ml) used four times daily for 5-7 days.
2. chlorhexidine rinses for large necrotic ulcers .
3.Topical steroid cream or gel with 1.5 %cortisone acetate.
4. Benzocaine 20% ointments provide temporary relief in pain & triamcinolone (topical steroid)is found to be effective.
5 . Patients should avoid stress and eat healthy food rich in iron and vitamins .
6. Drink plenty of water to keep on flushing the mouth
Dr. Rukhsana Ali