Aphtha is a kind of oral ulcer that can be in different sizes and appearances anywhere on the oral mucosa, sometimes the moist covering in the mouth called the mucous epithelium, and sometimes it reaches deeper tissues and forms lesions. Most of the time, the aphthae seen on the cheek and lip in the mouth, on the tongue, on the palate or on the gums, have an oval or round shaped, yellow, white, gray colored, reddened appearance. Due to the sensation of sensitivity and pain it creates, it can be such that it prevents the person from smiling, eating, drinking, speaking and even controlling his saliva. Aphtha, which is frequently seen in the community; It can occur due to genetic, immunological, hematological and microbiological reasons.
What is aphtha?
Aphthous ulcer, also known as mouth ulcer among the people, is an oral ulcer that is seen in 20% of the population and causes pain, itching and burning. Cheek biting, hard brushing, burning of the inside of the mouth due to hot foods, braces used in orthodontic treatment, vitamin deficiency, infection and a symptom of a systemic disease may also occur. When evaluating aphthae, which usually has a cottony appearance in the mouth, the age of the person, the location of the wound in the mouth, its shape, number, course and duration of existence, whether it is painful and other detailed history become important. They are mostly acute painful aphthous ulcers that recur at irregular intervals and heal on their own within two to three weeks. Although they are usually seen alone, they can also be seen in multiple regions at the same time. In some cases, while someone is recovering, another occurs. Although factors that trigger aphtha formation and worsen its course have been identified, the cause has not been determined exactly. Aphthae are examined in three main groups according to their sizes:
- Minor Aphthous: The most common, moderately painful oral aphtha type. Although they can be seen singly or in large numbers, they are less than 1 cm in diameter. Minor aphthae seen in 85% of patients are superficial ulcers that usually heal within one or two weeks without leaving any traces on the mucosal epithelium.
- Major Aphthae: These rarely seen ulcers are larger than 1 cm in diameter, mostly gray and white in color. It is a type of aphtha that heals by leaving a scar within 2 to 6 weeks. In some cases, a blockage in the space called the oropharynx, located just behind the throat, can cause swallowing difficulties. It may be accompanied by fever and malaise.
- Herpetiform Aphthous: Herpetiform aphthae, which are 1 to 2 mm in diameter, in groups and in large numbers, usually tend to coalesce. It is very rare and heals within 7 to 30 days without scarring. It is more common in older ages.
recurrent aphthae
Recurrent aphthae, defined as recurrent aphthous ulcer, are seen in any area of the oral mucosa, with reddish edges, off-white, oval-shaped, sharp-edged, distinctly shaped type. The occurrence of 3 or more aphthae in one year is defined as recurrent aphthous. As in many diseases, especially the weakening of the immune system is also effective in the formation of oral aphthae. This type of aphthae, which often has no cause, may also occur in some cases as a result of genetic factors, drug side effects, emotional stress and traumas. It may increase during pregnancy. Iron, phosphate, zinc, and, B1, B2, B6, B12, vitamin C deficiency can cause this type of aphthae at a rate of 20%. In bone marrow diseases known as myelodysplastic syndromes, Aphthous ulcers can be seen in lupus and reiter’s diseases. It is also one of the findings of HIV, Behçet’s disease and some types of cancer, which collapses the immune system. Suspected aphthous ulcers that do not heal within 4 to 6 weeks can be biopsied when deemed appropriate by the physician. In general, anti-inflammatory mouthwash and mouth ointments are applied in its treatment. Different drugs can be applied according to the condition of the patient and the disease. It is recommended to stay away from the factors that affect its emergence.
There are also oral ulcers that are not aphthous. These mouth sores, which should not be confused with aphthae, can be seen as a result of bites, broken teeth, other mucosal traumas and as a symptom of many different diseases. Vincent’s disease, Noma, hand, foot and mouth disease, syphilis, tuberculosis, infections caused by viruses and bacteria such as HSV, VZV, Hepangina, drug-related lesions and mucositis can be confused with many other causes.
Why does aft occur?
Aphthae seen in 20% of the population usually consist of recurrent aphthous, that is, recurrent aphthae. Aphtha, which is a recurrent and painful oral mucosal disease, is mostly seen in people with high socioeconomic status and more common in women than men. In addition to genetic predisposition, trauma, stress and anxiety disorders, smoking, tobacco chewing, premenstrual period, drug use, vitamin deficiencies such as folic acid, B12, iron and zinc, periods of illness when the immune system is weak, hormonal changes, vinegar, pickles, salty Many factors such as consumption of spicy and spicy foods, the foaming agent called sodium lauryl sulfate in the toothpaste, systemic diseases and allergies can cause aphtha formation.
What is good for sore throat in the mouth?
Oral aphthae or mouth ulcers, known as mouth sores, in some cases make themselves felt with tingling and redness in the mouth before they occur. It goes away on its own within 1-2 weeks if no treatment is applied. However, since it is painful, it can reduce the person’s quality of life. In such cases, irritating foods that are hot, acidic and caustic should be avoided. After food consumption, the area of aphthae can be cleaned with oxygenated water and food residues can be removed from the area. It may be beneficial to rinse the mouth with salt water or carbonated water, and to choose products that do not contain sodium lauryl sulfate when choosing toothpaste. However, in order to prevent aphthae in the long term, it may be beneficial to quit smoking, eat a regular and balanced diet, and avoid very hot drinks.
How does aphtha go?
Treatment of recurrent aphthous ulcers is mostly empirical and has 4 main goals. These are to accelerate the healing of the aphthae and to reduce the formed lesions, to reduce the pain and suffering caused by the aphtha, to determine the diet of the patient and to prevent the recurrence of the disease. In general, it is recommended to stay away from hard foods such as toast, nuts and acidic beverages, as well as salty and bitter foods, and reduce the consumption of carbonated drinks and alcohol. Topical treatment, that is, treatment options applied to the surface, is preferred because it is cheap and effective. Therefore, the treatment is usually recommended by a specialist physician to use anesthetic creams, topical gels, mouthwash with antiseptic properties, and pomade, which are used to reduce pain. With systemic treatment options, which is another treatment method, systemic examination of the patient is performed and the factor causing aphtha formation is searched, if any. If the aphtha is thought to be caused by hematological deficiencies, laboratory tests and complete blood count, folate and vitamin B12 levels are examined by the physician. If necessary, zinc sulfate, cyanocobalamin, vitamin B12 support can be provided. Systemic immunosuppressive drugs can also be administered in frequent and severe aphthae. In aphthae approached with a multidisciplinary approach, patients should consult a dermatologist for diagnosis and treatment options. After the definitive diagnosis is made, different treatments can be applied according to the type of aphthae. For a healthy life, do not forget to have your check-ups at regular intervals. If the aphtha is thought to be caused by hematological deficiencies, laboratory tests and complete blood count, folate and vitamin B12 levels are examined by the physician. If necessary, zinc sulfate, cyanocobalamin, vitamin B12 support can be provided. Systemic immunosuppressive drugs can also be administered in frequent and severe aphthae. In aphthae approached with a multidisciplinary approach, patients should consult a dermatologist for diagnosis and treatment options. After the definitive diagnosis is made, different treatments can be applied according to the type of aphthae. For a healthy life, do not forget to have your check-ups at regular intervals. If the aphtha is thought to be caused by hematological deficiencies, laboratory tests and complete blood count, folate and vitamin B12 levels are examined by the physician. If necessary, zinc sulfate, cyanocobalamin, vitamin B12 support can be provided. Systemic immunosuppressive drugs can also be administered in frequent and severe aphthae. In aphthae approached with a multidisciplinary approach, patients should consult a dermatologist for diagnosis and treatment options. After the definitive diagnosis is made, different treatments can be applied according to the type of aphthae. For a healthy life, do not forget to have your check-ups at regular intervals. If necessary, zinc sulfate, cyanocobalamin, vitamin B12 support can be provided. Systemic immunosuppressive drugs can also be administered in frequent and severe aphthae. In aphthae approached with a multidisciplinary approach, patients should consult a dermatologist for diagnosis and treatment options. After the definitive diagnosis is made, different treatments can be applied according to the type of aphthae. For a healthy life, do not forget to have your check-ups at regular intervals. If necessary, zinc sulfate, cyanocobalamin, vitamin B12 support can be provided. Systemic immunosuppressive drugs can also be administered in frequent and severe aphthae. In aphthae approached with a multidisciplinary approach, patients should consult a dermatologist for diagnosis and treatment options. After the definitive diagnosis is made, different treatments can be applied according to the type of aphthae. For a healthy life, do not forget to have your check-ups at regular intervals.
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