Recurrent Aphthous Stomatitis

Summary about Disease


Recurrent Aphthous Stomatitis (RAS), commonly known as canker sores, is a common condition characterized by the repeated appearance of small, shallow ulcers in the mouth. These ulcers are painful and can make eating, drinking, and speaking uncomfortable. RAS is not contagious and typically resolves on its own within a few weeks.

Symptoms


Small, round or oval ulcers inside the mouth (on the tongue, inner cheeks, lips, or gums)

A tingling or burning sensation before the sores appear

Pain, especially when eating or speaking

Redness around the sores

In severe cases, fever, swollen lymph nodes, or feeling sluggish

Causes


The exact cause of RAS is unknown, but several factors are thought to contribute:

Minor mouth injuries (e.g., from dental work, hard brushing, or sports accidents)

Stress

Certain foods (e.g., acidic fruits, chocolate, coffee, nuts, cheese)

Hormonal changes

Vitamin deficiencies (e.g., B12, folate, iron, zinc)

Certain medications

Underlying medical conditions (e.g., celiac disease, inflammatory bowel disease, Behcet's disease)

Sodium lauryl sulfate (SLS), a common ingredient in toothpaste and mouthwash

Medicine Used


Treatment aims to relieve pain and speed healing. Common medications include:

Topical corticosteroids (e.g., triamcinolone acetonide paste)

Topical anesthetics (e.g., benzocaine)

Antimicrobial mouthwashes (e.g., chlorhexidine)

Oral corticosteroids (for severe cases, but with potential side effects)

Nutritional supplements (if deficiencies are present)

Silver nitrate to cauterize the lesions (used cautiously)

Aphthasol (amlexanox) oral paste

Other medications as prescribed by a dentist or physician

Is Communicable


No, Recurrent Aphthous Stomatitis (canker sores) is not contagious or communicable. You cannot spread it to another person through kissing, sharing utensils, or any other form of contact.

Precautions


Avoid foods that trigger outbreaks (e.g., acidic, spicy, or abrasive foods).

Maintain good oral hygiene: brush gently and floss regularly.

Use a soft-bristled toothbrush.

Consider using toothpaste and mouthwash without sodium lauryl sulfate (SLS).

Manage stress through relaxation techniques.

Address any nutritional deficiencies.

Protect your mouth from minor injuries.

Avoid chewing gum, which can irritate the sores.

How long does an outbreak last?


Canker sores typically last for 1-2 weeks. Minor sores usually heal within 7-10 days, while major sores may take several weeks to heal and can sometimes leave scars.

How is it diagnosed?


RAS is usually diagnosed based on a visual examination of the sores by a dentist or physician. No specific lab tests are typically required. However, if the sores are severe, frequent, or associated with other symptoms, further testing may be done to rule out underlying medical conditions. A biopsy is rarely needed.

Timeline of Symptoms


Prodromal phase (1-2 days): A tingling or burning sensation may be felt before the sore appears.

Ulcer formation (1-2 days): A small, red spot develops, which then turns into a shallow, painful ulcer with a white or yellow center and a red border.

Pain and inflammation (3-4 days): The ulcer is most painful during this phase. Eating and speaking may be difficult.

Healing (7-14 days): The ulcer gradually heals on its own, without scarring (except for major ulcers).

Important Considerations


RAS is a recurring condition, and there is no cure. Treatment focuses on managing symptoms and reducing the frequency and severity of outbreaks.

If canker sores are unusually large, painful, frequent, or accompanied by other symptoms (e.g., fever, rash), it's important to see a dentist or physician to rule out other conditions.

While most canker sores are harmless, they can significantly impact quality of life due to the pain and discomfort.

Maintaining a healthy lifestyle, including a balanced diet, stress management, and good oral hygiene, can help reduce the risk of outbreaks.

Self-treating with over-the-counter remedies is generally safe, but if symptoms worsen or don't improve after a few weeks, seek professional medical advice.