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Aphthous Ulcers-Causes and treatment

29 August, 2020 Shivya Soni

What is Aphthous Ulcers? 

Aphthous Ulcers is a benign, non-contagious ulcerative inflammatory condition of the oral cavity and most common form of oral ulceration. Most commonly seen in childhood and adolescence. It is a painful condition which impairs a patient's ability to eat, drink, or speak. The condition is also known as Canker sores. 

These shallow ulcers are usually round or ovoid in shape with well defined erythematous margins with a halo surrounding yellow or grey floor in the center. Aphthous ulcers vary in size and can either occur as a single ulcer or in clusters. The most commonly affected sites are soft areas of the mouth such as the tongue, labial, and buccal mucosa and inside of the lip. The Reoccurrence of these ulcers is common and each episode lasts for nine to ten days. 

Clinical Presentation of Aphthous Ulcers : 

Major Aphthous Ulcers

A most common form of Aphthous ulcers

  • They are usually small in size
  • Oval shaped ulcers with a red erythematous halo. 
  • They Heal without scarring in one or two weeks. 

Major Aphthous Ulcers

  • These are the least common form of aphthous ulcers. 
  • Are larger and deeper,  size being > 10mmm
  • Are characterized with well-defined borders but may have irregular edges when becomes larger. 
  • Is extremely painful 
  • May take weeks or months to heal and extensive scarring

Herpetiform Ulcers

These ulcers are most uncommon and occur in later stages of life. Herpetiform ulcers are so-called because of the similarity in appearance with herpes infection with a difference that herpetiform ulcers are not caused due to herpes virus. 

  • often are pinpoint in size. 
  • occur in clusters of 10 to 100 sores, but may coalesce into one large ulcer
  • Characterized by irregular edges

What Are The Causes Of Aphthous Ulcers? 

The exact cause of aphthous ulcers remains unknown. But it is found that immune dysfunction and family history play an important role in the development of ulcers. 

Though there are certain factors that trigger the formation of ulcers namely:

1.) Due To Certain Diseases And Conditions:

  • Minor injuries during dental treatment like cuts on side of lips, burns, ill-fitted dentures, or pricking of a needle.
  • An allergic reaction to bacteria
  • Deficiency of vitamins like Vit. B-12, folate, iron
  • In cases of anemia
  • Immunodeficiency which weakens the immune system to, fight against certain bacteria or viruses
  • Due to hormonal changes during pregnancy
  • Celiac diseases, an intestinal disorder due to deficiency of gluten
  •  Crohn's disease and ulcerative colitis
  • A rare disorder that causes inflammation throughout the body, including oral cavity- Behcet syndrome. 
  • HIV/AIDS, which suppresses the immune system

2.) Due to Medications:

  • Nicorandil- a drug used to treat angina pectoris
  • anti-inflammatory medicines like Ibuprofen
  • Oral nicotine replacement therapy
  • Aspirin, if it is dissolved in mouth in the mouth instead of being swallowed. 
  • Illegal drugs such as cocaine
  • Sodium lauryl sulfate – it is an  active ingredient in some toothpaste and mouthwashes if used for a long period

Other Trigger Factors:

  • Some food and drinks like coffee, chocolate, eggs and cheese, acidic or spicy foods
  • Tobacco, also the replacement products used for quitting the same. 
  • EMOTIONAL STRESS- Stress being the most important factor and being the universal cause of almost every disease and it affects the healing process by delaying it. But the situation can be vice versa, in the presence of ulcers, the person  becomes stressed too.

How the ulcers can be prevented? 

A person can reduce the risk of reoccurrence of ulcers by following: 

a)  Reduce Stress

We are living a life that comes with the perks of having stress. But it depends on us how to deal with it. We should stop stressing over little things and try to handle it calmly. Daily exercising can help us focus on solutions than problems thereby reducing stress. 

b) Healthy diet

It's very important to that we eat a healthy balanced diet which will keep our immune system strong and also by avoiding certain food that predisposes our oral cavity to ulcers, we can reduce the risk. Avoid food that irritates your tongue or mucosa. 

c) Good oral hygiene 

It is important that keep your mouth healthy and hygienic. Brush your teeth daily and rinse them with lukewarm water. Use toothpaste that doesn't contain any irritative ingredients and don't brush your teeth vigorously. 

d) Avoid Medicines

Avoid certain medications that cause ulcers and consult a doctor for alternative drugs. 

Above are the methods of prevention and home remedies to prevent ulcers. 3MEDS provides generic anti-cancer medicines in Delhi online.

What is the Treatment of Aphthous Ulcers? 

Ulcers usually heal by themselves and there is no treatment to cure them. Only symptomatic treatment is given for the same to reduce pain and difficulty in eating or speaking. The treatment modalities are :


Topical analgesics like benzocaine, hydrogen peroxide are to be applied topically on ulcers. They are available in the form of gels, paste. 

Mouthwashes are recommended which contain steroid dexamethasone. 


It is given only in severe cases, involves antibiotics like tetracycline or minocycline's are given.  If Canker sores don't respond to treatment, oral steroids like Prednisolone can is prescribed by the doctor. 

Topical as well as oral medication is available online from online medicine purchase app Delhi


Cauterization of ulcers is done in extreme cases. 

IN NUTSHELL, a healthy lifestyle and diet are very important to keep the diseases away. Ulcers even though it heals by themselves but it takes time and the periods becomes difficult as you can neither eat nor speak easily. So it is important to take care of your diet or lifestyle to prevent the ulcers.