Canker sores
Canker sores, also known as aphthous ulcers, are small, round ulcers that develop on the mucous membranes of the mouth. Their exact cause remains unknown, though they may be linked to factors such as stress, hormonal changes, vitamin deficiencies, or potential infections. Typically measuring one to two millimeters in diameter, these ulcers are characterized by a painful, red base and a yellowish center, and can appear as solitary or multiple lesions. While discomfort usually lasts about a week to ten days, the ulcers can take up to three weeks to heal completely. In some cases, more severe forms, known as major aphthous ulcers, can develop and may last longer than a month. Treatment primarily focuses on pain relief through the use of steroid-containing gels, anesthetic sprays, and mouthwashes, with oral steroids prescribed in severe instances. Canker sores can recur and may be associated with certain health conditions, including Crohn’s disease and Behçet's syndrome. Understanding these nuances can help individuals manage their symptoms and seek appropriate care.
Subject Terms
Canker sores
ALSO KNOWN AS: Aphthous ulcers, ulcerative stomatitis
ANATOMY OR SYSTEM AFFECTED: Mouth, skin
DEFINITION: Small, round ulcers of the mucous membranes that line the mouth.
CAUSES: Unknown; possibly herpesvirus infection, stress, or illness
SYMPTOMS: Small, round ulcers of mucous membranes in mouth
DURATION: Acute, often recurrent
TREATMENTS: Pain relief (steroid-containing gel or paste, anesthetic spray, mouthwash), oral steroids
Causes and Symptoms
Aphthous ulcers are the most common lesions of the mucous membranes that line the mouth. The exact cause of this easily recognized problem is unknown; however, some evidence points to infection with the human herpesvirus 6, one of a family of viruses that cause a variety of diseases, including cold sores, genital herpes, and shingles. Possible triggers may include mouth injury, stress, vitamin deficiency, hormonal changes, and food allergies.
In most cases, a canker sore is a painful, small, round ulcer on a red base with a yellowish center. The redness also surrounds the like a halo. Sores are usually about one to two millimeters in diameter but may be as large as one to two centimeters. They may occur as either single or multiple lesions and are found on the mucous membranes lining the mouth and tongue. These lesions tend to recur; the recurrences may be associated with stress or illness. The associated pain usually lasts for a week to ten days, and the ulcers heal completely within three weeks. Major aphthous ulcers, another variety, start out as nodules under the mucous membranes, which then break down and form craterlike ulcers that may last more than a month.
Aphthous ulcers may occur on their own, but they may also be associated with some diseases and disorders of the collagen, problems such as Crohn's disease, bacterial infections, and Behçet’s disease. This last condition is a syndrome that involves painful ulcers of the tongue and oral mucous membranes, in addition to a variety of eye, skin, joint, gastrointestinal, and problems.
Treatment and Therapy
The treatment of canker sores is geared toward relieving the associated pain rather than curing the lesion. Treatments include a steroid-containing gel or paste applied directly to the ulcer, an spray, or a mouthwash that the patient “swishes and spits.” Oral antibiotic rinses may be prescribed; however, an oral infection known as "candidiasis" or "thrush" may develop as a result. In severe cases, oral tapered over one week may provide relief.
Perspective and Prospects
In patients with infection, aphthous ulcers may be extremely painful or extensive. If the ulcers do not respond to conventional treatment, then the drug may be useful. However, it must be used with extreme caution, as this drug is known to cause severe birth defects if taken during pregnancy.
Bibliography
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