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 WHAT ARE APHTHOUS ULCERS?
Aphthous ulcers (canker sores) are small, painful sores in the oral cavity, usually with a grayish-white surface and a red border. They can occur in almost any area of the oral cavity, such as the inside of the lip, the cheeks, under the tongue, on the tongue, and on the gums. Aphthous ulcers are common; approximately one in five adults suffers from them. They usually involve one or a few ulcers, with a diameter of 3 to 10 millimeters. However, there are also variants where dozens of ulcers can develop simultaneously, or
with larger ulcers. Aphthous ulcers usually disappear spontaneously within 1 to 2 weeks, without the need for treatment. In some people, the ulcers can recur repeatedly, becoming very bothersome.
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aphthous ulcers |
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HOW DO APHTHOUS ULCERS DEVELOP?
The exact cause is unknown. It is known that superficial damage to the mucous membrane (for example, caused by biting the cheek, brushing with a brush that is too hard, sharp edges on teeth or dentures, or eating hard toast or overly spicy food) can develop into an aphthous ulcer. However, why an ulcer develops in such cases is unclear. Bacteria in the oral cavity may play a role. There also appears to be a genetic predisposition; in any case, it occurs more frequently in some families. Other possible causes include iron deficiency, vitamin deficiencies (vitamin B12, folic acid), food allergies, infections, and a weakened immune system. In most cases, however, no underlying cause is found.
Aphthous ulcers occur more frequently in a number of diseases, including Behçet's disease, in which ulcers on the genitals may be present in addition to oral ulcers, and in a number of intestinal diseases such as celiac disease (gluten sensitivity), Crohn's disease, and ulcerative colitis.
WHAT IS THE BEST TREATMENT FOR
APHTHOUS ULCERS?
In most cases, no treatment is necessary: the ulcers will go away on their own. Only if there are a lot of ulcers or if they recur very regularly does it make sense to try a treatment. Various products are available for ulcers, both over-the-counter products at the pharmacy or drugstore and medications that require a doctor's prescription. Not all products have been conclusively proven to speed up ulcer healing or prevent their recurrence. The most commonly used products are local analgesics, antibacterial mouthwashes, and anti-inflammatory agents (corticosteroids).
Local analgesics
If the pain is severe, you can dab the ulcers 4-6 times a day with a cotton swab soaked in an anesthetic liquid or gel (e.g., lidocaine gel). You can also use regular painkillers such as paracetamol. Rinsing with an anesthetic liquid just before meals is also an option.
Antibacterial/antiseptic mouthwashes
Antiseptic mouthwashes reduce the number of bacteria in the mouth. Examples include chlorhexidine mouthwash (Corsodyl, chlorhexidine mouthwash 0.2%), chlorhexidine lozenges (Hibitane), hydrogen peroxide, sodium perborate (Bocasan), and tetracyclin mouthwash 5%.
Anti-inflammatory agents (corticosteroids)
These agents suppress the inflammatory response in and around the ulcer, thereby reducing the pain.
Special corticosteroid ointments, gels, and sprays are available for use in the oral cavity, in various strengths. They can have side effects (for example, overuse can lead to fungal overgrowth in the oral cavity) and are available by prescription only.
Other
remedies
include Pyralvex, a topical solution containing salicylic acid, and Zendium, an enzyme-based toothpaste that has been shown to have a beneficial effect on canker sores.
In rare cases, where many painful ulcers are present, it may be necessary to take strong anti-inflammatory medications for a short time, such as prednisone, colchicine, or cyclosporine.
WHAT CAN I DO MYSELF?
The best thing to do is to wait patiently for them to heal spontaneously. You can use a painkiller such as
paracetamol if necessary. Avoid touching the canker sores as much as possible; biting or scraping them only slows healing.
If you notice that small wounds or mucosal injuries are turning into canker sores, you can take measures to prevent them, such as adjusting your diet and not biting your cheek (if you have used a local pain reliever, the sensation in your mouth will also have changed, making it easier to accidentally bite your cheek or tongue). Avoid hard toast or spicy foods. Brush your teeth gently.
Furthermore, maintain good general health and oral hygiene. A visit to the dentist can be helpful. They can thoroughly examine your mouth for any abnormalities, remove sharp edges on teeth, adjust ill-fitting dentures, and advise you on which techniques and products you might try (hard or soft toothbrushes, regular toothpaste or special toothpaste, such as Zendium).
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