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Apthous Ulcer
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Commonly among Mouth Ulcers, Apthous ulcers are seen. It is a common disease and is characterized by the development of the painful, recurring solitary or multiple ulcerations of the oral mucosa. Apthous Ulcer is also known as Canker Sores.

Causes of Apthous Ulcer

There are various causative factors for Apthous Ulcers. It is mainly caused due to bacterial infection. The chief causative organism is (alpha) haemolytic streptococci or Streptococcus sanguis. The administration of Streptococcus to guinea pigs and rabbits has produced lesions of the skin and oral mucosa which appear clinically similar to apthous ulcers in the human. Recurrent aphthous ulcers have also been though to occur as a result of an autoimmune response of the oral epithelium.

During a fluorescent antibody technique, both IgG and IgM are seen binded to the spinous layer of the oral epithelium in patients suffering from Apthous ulcer. While no such binding is seen in normal healthy persons. Iron, Vitamin B12 or Folic acid deficiency may also lead to development of Apthous

Ulcer are greater during the premenstrual period. While in some cases women may get relief from ulcers during pregnancy but shows rapid ulcer development after delivery. Any Psychological problem may also lead to ulceration. Patients with Recurrent Apthous Ulcer may also show a history of Asthma, Hay fever or food or drug allergies.

Clinical Features of Apthous Ulcer :It is seen more commonly in women than in men. The disease develops between the ages of 10 to 30 years. The apthous ulcer starts developing as single or multiple superficial erosion caused by a gray membrane. It generally has a well circumscribed margin surrounded by on erythematous halo

The lesion is commonly very painful, so it interferes with eating for several days. Sometimes, it was though that the apthous ulcer begins with the formation of a vesicle, but it was not as such in general. Major Apthous ulcer are characterized by the occurrence of large painful ulcers, usually one to ten in number and are present commonly on the lips, cheeks, tongue, sot palate, etc.

Herpetiform Ulcer: There are numberous small lesions found on any intraoral mucosal surface. These lesions begin as small pinhead sized erosions that slowly enlarge and unite with each other. Lesions are very painful and are present continuously for one to three years. The patient receives immediate but temporary relief from symptoms with a 2 percent tetracycline mouthwash.

Treatment of Apthous or Herpetiform Ulcers: There is a no specific treatment, although various drugs have been used. A steroid ointment about 1.5 percent cortisone acetate, applied locally shows good effect. Antibiotic mouthwashes are also helpful. For egr Tetracycline Mouthwash (250 mg per 5 ml), used four times daily for 5 to 7 days, produced a good response in near about 70% of the patients. Chemical cautery reduces pain but had no other beneficial effects. Levamisole, have been used and found to increase the immune response in a variety of ways.

Traumatic Ulcer- It has been observed that the Traumatic Ulcer may also develop of the oral mucous membrane.It is a caused by some sort of trauma. This may be an injury such as biting the mucosa, denture irritation, toothbrush injury, exposure of the meious membrane to a sharp tooth or carious lesions, or it may be injury to the mucosa by some other external irritant. The traumatic ulcers are also known as sore spots.

Symptoms of Apthous Ulcer

The traumatic ulcer is seen on the sites such as lateral border of the tongue, on the buccal mucosa, on the lips and occasionally on the palate. In case of the oral mucous membrane, the healing is rapid. The denture ulcers commonly develop within a day or two after the insertion of a new denture.

This may be a result of over-extention of the flanges of the roughened or high spots on the inner surface of the denture. There ulcers are small, painful, irregularly shaped lesions which are usually covered by a delicate gray necrotic membrane and surrounded by an erythematous halo.

Treatment of Traumatic Ulcer: The treatment for the traumatic denture ulcer consists in correction of the underlying cause i.e., the relief of the flange, relief of the high spots, removal of tiny underlying bone or seguestum. When this is accomplished, the ulcer usually heals promptly.


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