Ulcers

Ulcers

Mouth ulcers are a common condition. Often they are caused by trauma and heal quickly on their own. The recurrent, bothersome form is known as recurrent apthous stomatitis or simply apthous ulcers.

Apthous Ulcer	A cluster of Apthous Ulcers

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What causes Apthous Ulcers?

The cause is unknown although it is believed to be some sort of immune mediated condition. There is evidence that using a "sodium lauryl sulphate free" toothpaste.

Despite being quite common, mouth ulcers are not contagious. Apthae may also be a symptom of various systemic diseases for example, Bechet's syndrome, HIV, autoimmune disorders, Crohn's disease, etc

Common Recurrent Apthous Stomatitis

Characteristics: These ulcers are almost always found on the "loose" tissues of the mouth i.e. the cheek, inner lip, tongue, soft palate, floor of mouth, and sometimes the throat. They are usually small, less than 5mm in diameter, and have a reddish halo around them. A less common form, major apthae, can get quite large and take weeks to heal. The individual usually gives a history of repeated episodes of the ulcers.

Triggers: Usually difficult to pin down. Stress, acidic foods, specific foods for the individual, trauma, chemical sensitivities, and the like all can play a role in setting off an attack. Some studies have indicated that toothpastes containing the additive sodium lauryl sulphate (SLS) can trigger attacks in some people. Using an SLS free toothpaste has been shown to reduce attacks significantly (50-70 per cent) in susceptible individuals.

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How can Apthous Ulcers be treated?

There is no cure for apthous ulcers but avoiding known triggers is helpful. There is evidence that using a "Sodium Lauryl Sulphate" free toothpaste eg. Biotene toothpaste, can eliminate the trigger in many patients. A healthy diet with vitamin supplements is recommended. Excellent oral hygiene, including use of antibacterial rinses (Rx Savacol or Listerine), has been shown to reduce frequency of attacks. Reducing stress is important as well.

Topical steroid treatments are quite useful in reducing the pain and duration of the lesions. Usually a weaker steroid is used first and stronger varieties are attempted until results are achieved.

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