What is an aphtha?
An aphtha is a lesion in the form of an erosion or ulcer that appears most often on the mucosa of the cheeks, lips, the lateral parts of the tongue, the soft palate and the back wall of the throat.
How does an aphtha manifest?
The literature describes three types of aphthae, which differ from one another in several features, but each of them can manifest with pain and discomfort in the mouth.
- Minor aphthae (Mikulicz aphthae) – round erosions, less than 1 cm in diameter, covered with a white or yellow fibrin coating and surrounded by reddened mucosa. They heal within 2 weeks without leaving a scar.
- Major aphthae (Sutton aphthae) – ulcers more than 1 cm in diameter. Besides the larger lesion, there is induration and infiltration of the tissue. The patient may have systemic symptoms such as weakness, fatigue, fever, and difficulty with clear speech and eating. They heal over as long as several weeks, unfortunately leaving scars.
- Herpetiform aphthae – most often observed in women around the age of 30. They occur in large numbers, up to 100 lesions at once, and are much smaller (1–2 mm). They can appear anywhere in the mouth, even on the gums and hard palate, and merge with one another, forming larger, irregular lesions. They heal within 3 weeks without leaving a scar.
In whom do we observe aphthae most often?
Aphthae can occur in all patients, even in children. They most often appear in people exposed to a lot of stress. According to epidemiological studies, they occur slightly more often in women.
What are the causes of aphthae?
Most often these are mechanical injuries caused by irritation of the mucosa by a prosthesis, an element of an orthodontic appliance, a sharp fragment of a tooth or of food (e.g. the harder crust of crispy bread or crisps). Besides this, a frequently mentioned factor is an immune disturbance caused by stress, fatigue, weakness, food allergies, hormonal disorders, taking contraceptive medication or menstruation, as well as deficiencies of vitamins and minerals such as iron, vitamin B12 and folic acid.
Aphthae can be one of the first symptoms of chronic diseases such as ulcerative colitis, Crohn's disease, Duhring's disease, coeliac disease, Behçet's disease, systemic lupus erythematosus, Addison's disease and Biermer's disease.
Are aphthae contagious?
No. It is one of the most common non-infectious diseases of the mucosa. Aphthae arise as a result of a disturbance of the body's immunity.
How to treat aphthae?
Above all, one should take care of the best possible oral hygiene – thorough brushing, flossing and the use of rinses with the addition of chlorhexidine (for a maximum of 2 weeks). It is worth finding out the cause of the aphtha by making an appointment with the dentist or family doctor and having the appropriate tests carried out. It helps to strengthen immunity by improving the quality of sleep, the way of eating and avoiding stress. Over-the-counter medicines in the form of gels or sprays with analgesic and disinfecting properties are available at the pharmacy. If aphthae recur or do not heal for a long time, consult a doctor. More about everyday prevention and hygiene.
Studies
-
Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis
Liu H., Tan L., Fu G., Chen L., Tan H. (2022) · Medicina · systematic review and network meta-analysis
Several topical treatments shortened healing time or reduced the pain of recurrent aphthae, but differences between preparations were not always certain. Treatment is primarily symptomatic and should be matched to severity and how often ulcers recur.
-
Treatment of recurrent aphtous stomatitis: A systematic review
Parra-Moreno F. J., Egido-Moreno S., Schemel-Suárez M., González-Navarro B., Estrugo-Devesa A., López-López J. (2023) · Medicina Oral Patología Oral y Cirugía Bucal · systematic review
Topical corticosteroids and selected analgesic or protective agents can reduce pain and how long lesions last. With frequent, numerous or atypical ulcers it is important to look for coexisting disease and deficiencies.
-
Evaluation of zinc sulfate mucoadhesive formulation on recurrent aphthous stomatitis: a randomized double-blind, placebo-controlled clinical trial
Ghorbani A., Akbari J., Boorboor M., Nekoukar Z., Eslami G. (2020) · BMC Oral Health · randomised placebo-controlled trial
Zinc supplementation reduced some symptoms of recurrent aphthae in the group studied. That does not mean zinc should be used routinely without assessing diet, deficiencies and contraindications.