Aphthous stomatitis

Aphthous stomatitis
Other names	Recurrent aphthous stomatitis (RAS), recurring oral aphthae, recurrent aphthous ulceration
Canker sore on the lower lip
Specialty	Oral medicine, dermatology
Symptoms	A round, often painful sore inside the mouth that is white or gray with a red border; Tingling or burning sensation prior to sore development; Fever, sluggishness, and/or swollen lymph nodes (severe cases only)
Complications	Cellulitis (a bacterial skin infection); fever; sores that appear outside of the mouth; pain while brushing teeth, eating, and/or talking
Usual onset	1 to 2 days, before visual appearance
Duration	7–10 days
Causes	Behçet's disease; celiac disease; food allergies; HIV infection; lupus; oral injuries; poor oral hygiene; stress; vitamin deficiency
Risk factors	Anyone can develop canker sores.
Prevention	avoiding foods that irritate the mouth, including acidic, hot or spicy foods; avoid irritation from gum chewing; avoiding oral hygiene products containing sodium lauryl sulfate, brushing with a soft-bristled brush after meals and flossing daily.
Treatment	mouth rinses; nutritional supplements; oral medication
Medication	good oral hygiene, topical agents
Frequency	~30% of people to some degree[1]
Deaths	None reported.

Aphthous stomatitis,^[2] or recurrent aphthous stomatitis (RAS), commonly referred to as a canker sore, is a common condition characterized by the repeated formation of benign and non-contagious mouth ulcers (aphthae) in otherwise healthy individuals.

The cause is not completely understood but involves a T cell-mediated immune response triggered by a variety of factors which may include nutritional deficiencies, local trauma, stress, hormonal influences, allergies, genetic predisposition, certain foods, dehydration, some food additives, or some hygienic chemical additives like SDS (common in toothpaste).

These ulcers occur periodically and heal completely between attacks. In the majority of cases, the individual ulcers last about 7–10 days, and ulceration episodes occur 3–6 times per year. Most appear on the non-keratinizing epithelial surfaces in the mouth – i.e. anywhere except the attached gingiva, the hard palate and the dorsum of the tongue – although the more severe forms, which are less common, may also involve keratinizing epithelial surfaces. Symptoms range from a minor nuisance to interfering with eating and drinking. The severe forms may be debilitating, even causing weight loss due to malnutrition.

The condition is very common, affecting about 20% of the general population to some degree.^[1] The onset is often during childhood or adolescence, and the condition usually lasts for several years before gradually disappearing. There is no cure, but treatments such as corticosteroids aim to manage pain, reduce healing time and reduce the frequency of episodes of ulceration.