Recurrent Aphthous Stomatitis (Recurrent Aphthous Ulcer, Recurrent Oral Ulcer)

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Recurrent Aphthous Stomatitis
Body Parts: Head
Medical Subjects: Skin Oral Cavity Genetic disease
Overview

What Is Recurrent Aphthous Stomatitis

What disease is recurrent aphthous stomatitis?

The "oral ulcer" that usually occurs in people is actually "aphthous ulcer", which is a lesion of the mouth with pain. Commonly known as "aphtha".

Because a person may have multiple aphthous stomatitis, it is also called "recurrent aphthous stomatitis", "recurrent aphthous stomatitis", and "recurrent aphthous stomatitis".

This is a recurrent oral ulcer with marked burning pain, manifested as "yellow, red, pitting, and painful". The etiology of aphthous ulcer is not very clear. It may be related to immune factors, genetic factors, systemic diseases, infection, psychological factors, environmental factors, etc., but it has nothing to do with "excessive internal heat" and vitamin deficiency.

Because the etiology is unclear, the therapeutic effect is not satisfactory and the disease is prone to repeated attack. The current treatment focuses on relieving symptoms, prolonging the intermission period and shortening the onset period, and the root cannot be completely broken.

Is the incidence of recurrent aphthous stomatitis high?

According to the epidemiological surveys in various countries, at least one in five people have ever had an ulcer, and it can happen regardless of gender, age or race.

How does recurrent aphthous stomatitis divide?

Aphthous ulcers also differ in severity and are often classified as mild, severe, and herpetiform ulceration.

  • Mild aphthous ulcers are the most common, accounting for about 80%, and generally smaller, well-circumscribed, and less numerous.

  • Severe aphthous ulcers occur when the ulcer is large and deep, up to 3 cm in diameter, and the pain is intense, leaving a scar after healing.

  • Herpetic aphthous ulcer occurs with a large number of ulcers and a small ulcer surface, which is scattered in any part of the mouth like "Gypsophila paniculata". Sometimes the adjacent ulcer surfaces can be fused into sheets, and sometimes it is accompanied by fever, headache and other symptoms.

Cause

What Is The Cause Of Recurrent Aphthous Stomatitis

What factors are responsible for recurrent aphthous stomatitis?

Although some people with extremely similar life styles repeatedly grow ulcers, some people never know the taste of ulcers. The etiology and pathogenesis of oral ulcer have not yet been determined, and there are significant differences among different individuals.

At present, there are different views on the occurrence of recurrent aphthous stomatitis, and it is generally recognized that the "triad theory" of genetic, environmental and immune factors refers to the abnormal immune response caused by genetic background and appropriate environmental factors, including but not limited to the following factors that may cause or promote the recurrence of ulcers:

  • Familial heredity;
  • Mental stress, overworked working environment and high-pressure social environment;
  • Immune diseases, trauma, bacterial and viral infections.

Is recurrent aphthous stomatitis caused by excessive internal heat?

Many people say they get irritated after having oral ulcers, and then buy their own medicines to "lower the fire". In fact, oral ulcer has nothing to do with excessive internal heat. even from the perspective of traditional medicine, oral ulcer cannot be generalized by the so-called "excessive internal heat".

Is recurrent aphthous stomatitis associated with vitamin or trace element deficiency?

Although the cause of recurrent aphthous stomatitis (aphthous stomatitis) is still unclear, there is a consensus that the common recurrent aphthous stomatitis is not the "vitamin deficiency" we usually think of, and is neither lack of vitamin C nor vitamin B12 (or folic acid and other trace elements).

Is recurrent aphthous stomatitis associated with psychiatric factors?

The occurrence of oral ulcer in some patients is related to mental factors. Some studies have found that the incidence of oral ulcer among students increases significantly before the examination. Mental stress and anxiety may induce oral ulcer.

What are the possible causes of recurrent aphthous stomatitis?

Since the etiology of recurrent aphthous stomatitis is not completely clear, we can only speculate that it may be related to the following conditions.

  • Eating spicy food, often eat rough, hard food;
  • Irregular work and rest, often stay up late, lack of sleep;
  • Mental stress, tension and anxiety;
  • Partial eclipse and imbalanced nutrition;
  • Oral hygiene is poor, with residual roots in the mouth and sharp tips or edges of teeth and dentures.

Is recurrent aphthous stomatitis associated with poor oral hygiene?

Poor oral hygiene and high incidence of dental calculus do increase the risk of dental ulcer attack or lead to prolonged ulcer healing. Therefore, it is necessary to maintain good oral hygiene habits for people who easily develop ulcers.

Will recurrent aphthous stomatitis be inherited?

There is a certain genetic tendency, parents are prone to oral ulcers, children may also be easy to happen.

Other than recurrent aphthous stomatitis, are there other conditions that can cause ulceration in the mouth?

Oral ulcer is more common in daily life, the most common disease is recurrent oral ulcer, also known as aphthous ulcer, recurrent aphthous ulcer, is the most common oral mucosal disease. In addition, Behcet's disease, oral mucosal eosinophilic ulcer and other diseases will also appear the manifestation of oral ulcer.

Symptom

What Symptom Does Recurrent Aphthous Stomatitis Have

What are the characteristic manifestations of recurrent aphthous stomatitis?

Recurrent aphthous stomatitis often occurs on the non-keratinized or poorly keratinized mucosa of the lip, tongue, cheek, soft palate, and most of them are within 5 mm in size. The characteristic of ulcer is very typical, can use 4 words to generalize: Huang, red, concave, painful.

  • Yellow—The ulcer surface has a yellow pseudomembrane;
  • Red—a red, reddening band around the ulcer;
  • Concave—the center of the ulcer is slightly concave;
  • Pain-Ulcers can cause marked burning pain.

Another feature of recurrent aphthous stomatitis is that there is a certain periodicity from its occurrence to development to healing. Even without any treatment, ulcers begin to heal 5 days after they occur and heal within 7 to 10 days, generally without leaving a scar.

Of course, in addition to the above-mentioned 80% mild relapsing aphthous stomatitis, there are other types of ulcerous manifestations that should also be noted.

For example, when severe relapsing aphthous stomatitis occurs, the ulcer is large and deep, except for severe pain, and cicatrix will form after healing. For example, herpes-like recurrent aphthous stomatitis may present with small and scattered ulcers, similar to "gypsophila" distributed on the oral mucosa, and sometimes accompanied by systemic symptoms such as headache and low grade fever. Specialist help should be sought when these serious "oral ulcers" develop.

Detect

How To Check For Recurrent Aphthous Stomatitis

How is recurrent aphthous stomatitis diagnosed?

The doctor can diagnose recurrent aphthous stomatitis by asking the history and examining the mouth. If the doctor doesn't think it's like a classic case of relapsing aphthous stomatitis, he may arrange tests like biopsy to rule out other diseases.

What diseases should be distinguished from recurrent aphthous stomatitis?

Severe aphthous ulcers need to be distinguished from cancerous and tuberculous ulcers:

  • Severe aphthous ulcer generally occurs in the young and middle-aged, and is prone to occur in the posterior part of the mouth. The edge of the ulcer is neat, and the bottom is slightly concave, covered by a pale yellow pseudomembrane, and it is self-limited, so the patient's whole body condition is better.

  • Cancerous ulcer is more common in the elderly, prone to occur in the tongue and abdomen, lateral margin or quarrel and other parts, the edge of the ulcer is not neat, the substrate is hard, some patients at the bottom of the ulcer dish pattern, and patients are poor constitution.

  • The periphery of the tuberculous ulcer was murine-like, with granulation tissue at the bottom, and most patients had systemic symptoms of tuberculosis.

It is recommended that if the ulcer is large and deep and does not heal for a long time, the patient should visit the hospital in time and obtain a definite diagnosis through biopsy.

In addition, recurrent aphthous stomatitis needs to be distinguished from carcinomatous ulcer, tuberculous ulcer and necrotizing sialometaplasia. In addition, it should be differentiated from Behcet's disease when the ulcer not only occurs in the oral mucosa, but also has similar ulcer manifestations in the skin, genital mucosa, and conjunctiva.

Prevention

How To Prevent Recurrent Aphthous Stomatitis

Can recurrent aphthous stomatitis be prevented?

Because the etiology of this disease is unclear, it cannot be prevented for the time being. The occurrence of this disease may be the result of a combination of many factors, which is mainly related to immune factors, genetic factors, systemic diseases, infection, psychological and environmental factors. Referring to the "Precautions for Life" above may help to reduce its occurrence or recurrence.

Treatment

How To Treat Recurrent Aphthous Stomatitis

Which department should you go to for recurrent aphthous stomatitis?

After the occurrence of recurrent aphthous stomatitis, the special department of oral mucosa is the first choice for treatment.

However, considering that most hospitals are not necessarily specialized hospitals with no such breakdown, we can also go to oral departments such as Department of Stomatology and General Department of Stomatology for help from stomatologists with experience in the treatment of oral mucosal diseases.

How to treat recurrent aphthous stomatitis?

For recurrent aphthous ulcer, the treatment should firstly identify and improve the precipitating factor, secondly apply external medicine to relieve the symptoms, and finally consider oral medication.

For the ulcer with no obvious symptoms, the doctor will not take excessive treatment measures, because for most mild relapsing oral ulcer, the incurable ulcer will automatically heal, and the healing cycle is relatively short, and the self-healing can be carried out in one to two weeks. Therefore, long ulcers, if you do not want to go to the hospital, can be conservative treatment, during the ulcer pay attention to ensure oral hygiene, more gargle, pain will gradually weakened with the passage of time.

Therefore, the treatment of oral ulcer aims not at "radical cure", but at reducing the times of recurrence, prolonging the recurrence period, relieving ulcer pain and accelerating healing.

Patients who have a slightly more serious ulcer or are reluctant to treat it conservatively and want to improve their symptoms as soon as possible should consult an dentist. Doctors usually use "ulcer mask" and "ulcer gel" for symptomatic treatment. For severe aphthous stomatitis, analgesics (such as lidocaine and dyclonine) and corrosive drugs (such as silver nitrate) or laser can be used to relieve pain and cauterize deep and large ulcers. Hormones (such as triamcinolone acetonide and lidocaine) can also be used for blocking. For ulcers caused by systemic factors, immunomodulatory drugs (such as thalidomide, or "thalidomide") can also be used for regulation.

Medication for oral mucosal diseases is recommended after doctor's face-to-face examination and evaluation, because there are often various side effects, which should not be used without authorization.

In addition, in case of special conditions, such as the ulcer fails to heal after more than one month, or even the ulcer is larger and deeper than usual and the pain is more obvious, we should be vigilant to prevent the occurrence of "cancerous ulcer". At this time, the doctor's intervention or even surgical resection may be required for pathological examination.

Is it useful to take anti-inflammatory drugs when recurrent aphthous stomatitis occurs?

The etiology of recurrent aphthous stomatitis is currently not fully understood and bacterial infection is not the primary cause of recurrent aphthous stomatitis, oral use of antibiotics is not recommended. At present, local medication is mainly used to diminish inflammation, relieve pain, prevent infection and promote healing. Use of antibiotics is considered only if the ulcer is severe and secondary to infection.

How long can recurrent aphthous stomatitis be good generally?

In general, mild aphthous and herpes-like aphthous ulcers last for 7 to 14 days and severe aphthous ulcers last for 4 to 6 weeks.

Can recurrent aphthous stomatitis become cancerous?

Recurrent aphthous stomatitis is not cancerous, but for residual roots, dentures and other oral ulcers caused by the same location repeated attack has the risk of cancer. Therefore, high vigilance is required for recurrent ulcerations in the same location.

Life

What Should Patients With Recurrent Aphthous Stomatitis Pay Attention To In Life

What should patients with recurrent aphthous stomatitis pay attention to in life?

Neither complete treatment nor absolute prevention of recurrent aphthous stomatitis is possible. But here are a few life tips that might be good guidance:

  • Mental factors are very important factors for the occurrence of oral ulcer, so adjust the rhythm of work and study, the combination of work and rest, to ensure sleep time;

  • Keep good eating habits, not picky about food or partial food, ensure balanced nutrition;

  • If there are broken teeth or dentures in your mouth, it's recommended to repair or adjust them as soon as possible.

What should patients with recurrent aphthous stomatitis pay attention to in diet?

  • There is no special taboo on diet, and a healthy and balanced diet is enough.

  • Pay attention to less salt when cooking, less oil, less high salt seasoning, eat less pickled vegetables, pickled meat, etc.;

  • Don't only eat refined rice and white flour as the main food; coarse grains, miscellaneous beans, potatoes, and pumpkins can be used to replace some of the main food.

  • Reasonable collocation of meat and vegetable, meat preferred chicken, duck, fish and other white meat, eat less fat, eggs, milk is an important source of protein and other nutrients;

  • If you are a vegetarian, you can eat more beans and soy products to supplement protein;

  • Eat more fruits and vegetables;

  • Try not to drink.

Is the use of mouthwash in patients with recurrent aphthous stomatitis good for aphthous stomatitis?

At present, there are many kinds of mouthwash on the market. Patients can use the mouthwash when they feel pain, but not all of the mouthwash is effective for the treatment of oral ulcers. The most commonly used mouthwash for the treatment of oral ulcers is chlorhexidine mouthwash, which is used 4 to 5 times a day, with about 5 minutes each time.

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