APHTHOUS ULCERS

Aphthous ulcers (AU) are painful superficial oral erosions. They often come in crops. Trauma may induce them. The majority of cases are idiopathic. 

Aphthous ulcers appear as white or gray oval areas with a bright red surrounding erythema in the oral cavity. They most commonly occur on the buccal and labial mucosa.

Occasionally, patients may have a more severe presentation with larger or more persistent lesions. The term major aphthous stomatitis has been used and is defined as ulcers greater than 1 cm that are present for more than two weeks and often heal with scarring.

Triggers

Many triggers have been reported including spicy foods, citrus, walnuts, pineapple, trauma (e.g., from the toothebrush, self-biting, dental procedures), menstruation, pregnancy, menopause and stress.

Treatment

• Gentle dental care, e.g., use soft toothbrush
  
• Vitamin B12, e.g., 1000 mcg sublingual nightly
• Topical steroids
• Antibiotics
• Amlexanox
• Magic Mouthwash
• Prednisone short course

Aphthous ulcers need not be treated if uncommon.

RegionalDerm

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