Aphthous Stomatitis: How and Why it Happens

A hurt boy sitting on a couch

Aphthous stomatitis sounds more serious than in actuality. But what is it? 

It’s a common disorder that causes aphthous ulcers or canker sores in the mouth. These sores, typically painful, appear inside the cheeks and lips and sometimes on the tongue. The disorder sometimes recurs (called recurring aphthous stomatitis, or RAS) and generally begins at childhood.

What Causes Aphthous Stomatitis?

Doctors refer to the cause of aphthous stomatitis as “idiopathic,” which means “of unknown cause.” To this day no one has been able to determine why this common disorder occurs in children and adults. But some factors may trigger it.

These factors include:

  • Trauma to the mouth
  • A weak immune system
  • Viruses and bacteria
  • Certain types of food, or poor nutrition
  • Allergies to oral hygiene products
  • Stress

Oddly enough, aphthous stomatitis is reportedly more common in smokers who quit and nonsmokers. Other findings also reveal that the common disorder affects more girls and women, and those in the affluent population. The mouth ulcers will afflict kids and adolescents from 10 to 19. 

Fortunately, they’re not contagious.

What Does it Look Like?A person's mouth with Aphthous stomatitis

Most parents may well be alarmed when their child tells them they’ve got something painful in their mouth. When the inside of their lips reveals wound-like lesions, the very first thing that comes to mind could be something more severe than the typical canker sore. Other parents may start to think oral cancer, which looks different from mouth ulcers resulting from aphthous stomatitis. 

So it’s crucial to go see your doctor before coming to any conclusion.

What do ulcers from aphthous stomatitis look like?

  • The sore is shallow and round (or oval)
  • It has a red border and a gray or yellow center
  • A small sore is less than 1 centimeter in diameter
  • A larger sore is less than 3 centimeters in diameter
  • It appears in clusters of two or three

The ulcers do not just appear; they “announce” their appearance with symptoms. A person developing aphthous stomatitis will feel pain or burning sensation in the affected area. A couple days later, the ulcers happen.

In severe cases, these small ulcers in the mouth can affect your entire body. Swelling of the lymph nodes may occur, and you may feel lethargic. Fever may also accompany some severe aphthous stomatitis cases.

To be certain that what you or your child has is the common mouth ulcer, your doctor will need to take a complete medical history and examine you physically.

Some tests may be needed to confirm the diagnosis further. These tests include:

  • A culture of the lesion or sore
  • Blood test

Your doctor could also order a biopsy.

A check up for mouth ulcers is not frivolous because the diagnosis may uncover an underlying illness; instead of the ulcer being the disorder itself, it may just be a symptom of a complex medical condition. These conditions could be Crohn’s disease, an inflammation of the digestive system and Celiac disease, a lifelong condition that causes the immune system to react to gluten.

How is Aphthous Stomatitis Treated?

Woman in White Suit with Stethoscope Talking to a Person

Once your physician confirms that what you or your child has is aphthous stomatitis, and nothing else, the treatment can begin. The goals for treating the mouth ulcers are to reduce the pain, bring about healing and prevent the condition from recurring.

Your doctor will likely prescribe topical medication, like topical steroids in paste or gel form and rinses to manage the pain. An aggressive treatment may include a local steroid injection done once. If you or the child has accompanying fever, some acetaminophen may be taken.

Part of the treatment will also mean avoiding food and drinks that exacerbate the disorder. These would include spicy and salty dishes with highly acidic beverages. If the mere act of eating and drinking typical meals brings on discomfort, imagine the pain from spices, salt and acid. 

Can You Prevent Mouth Ulcers?

Because the probability of recurrence is likely, your doctor may list a few lifestyle changes you’ll want to follow. These things would address the triggers associated with the onset of mouth ulcers.

  • A balanced diet, with dietary supplements of iron, zinc and B12
  • A gluten-free diet if you’ve been diagnosed with celiac disease
  • Follow a stress management routine

Aphthous stomatitis is not a serious disorder, but some cases may indicate a severe medical condition. So it’s always a good idea to see your doctor to eliminate anything serious.

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