Patiented_5e_prelims.indd

Aphthous ulcers
What are aphthous ulcers?
What is the management?
Aphthous ulcers are very painful ulcers that arise in the In most cases the ulcer will heal without any treatment lining of the mouth, usually in the gums between the and only feel uncomfortable for 3 to 4 days. If the ulcer has a known cause, such as a jagged tooth or rough denture, your dentist should be consulted. Some patients simply ‘grin and bear it’ and wait for healing to occur without applying any agents to the ulcer; they may just What do they look like?
take mild pain-killers. Many choose to have treatment to relieve the discomfort.
e ulcers are small (about 2 to 3 mm across), shallow and yellow or grey in colour. Each ulcer is surrounded Eating and drinking
• Avoid eating spicy or sharp-tasting acidic foods (e.g.
Who gets aphthous ulcers?
• Avoid any foods that aggravate the ulcer.
• Drink plenty of fl uids and eat soft foods such as
Any person can get the ulcers. However, they occur most oft en in adolescents and young adults and tend to occur • Reduce the pain by sipping liquids through straws.
more oft en in women, especially just before a period. Aphthous ulcers are very common and aff ect at least 1 Pain relief
Apply a topical anaesthetic such as lignocaine gel or paint (e.g. SM-33 adult paint formula or SM-33 gel for What causes aphthous ulcers?
children every 3 hours). Apply this with a cotton bud. e cause is not precisely known. One theory is that a is helps eating if applied before meals.
virus or bacteria is able to ulcerate the gum surface when Healing methods
the immune system is below par. Known associations for this are: ere are several methods that can help healing. One • emotional or physical stress
simple method is to rinse the mouth regularly with a • being ‘run down’
salt solution (1 teaspoon to 500 mL of warm water). • premenstrual tension
One of the following can be tried during the painful • injury such as from rough dentures, dental work, hot
• Th
e teabag method: Apply a wet, squeezed-out, black • irritation from certain foods such as citrus fruits,
teabag directly to the ulcer 3 to 4 times daily. Th salted nuts, acid foods and chocolate.
• Topical steroid paste: Apply triamcinolone 0.1% (Kenalog
What are the symptoms?
in orabase) paste as soon as the ulcer appears, 3 to 4 times a day.
e fi rst thing you usually notice is eating something • Topical steroid spray: Th
acidic (such as a grapefruit or spicy food) that makes the (such as beclomethasone) can be sprayed onto the ulcer smart. Sometimes there is burning or tingling for • Tetracycline suspension rinse for several ulcers: Empty
for the fi rst 3 days that they make eating or speaking the contents of a 250 mg tetracycline capsule into 20 to 30 mL of warm water and shake it. Swirl this solution in the mouth for 5 minutes every 3 hours. Th What is the usual outcome?
terrible taste and should be spat out aft er rinsing.
Aphthous ulcers are not a serious problem. Most ulcers heal without scarring within 10 to 14 days. Recurrent attacks of ulcers are quite common in some people. Any ulcer that lasts beyond 3 weeks is unusual. If the doctor is concerned about an ulcer, a blood test or biopsy may be taken.
JOHN MURTAGH’S PATIENT EDUCATION, FIFTH EDITION MCGRAW-HILL

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