Lymph nodes

RECURRENT APHTHOUS ULCER (CANKER SORE)

Recurrent aphthous ulcers (RAUs) have following characteristics:

  1. They are recurrent, painful, superficial oral ulcers that persist 8 to 14 days;
  2. They are associated with a tender regional lymphadenopathy (swelling of lymph nodes in the head and neck area);
  3. They heal spontaneously, usually without sequelae in healthy patients.

The causes and the course of the disease

Several theories about the cause of recurrent aphthous ulcers have been proposed; they include nutritional, trauma, allergic, microbial, endocrine, autoimmune and psychological mechanisms.  

The clinical features

The recurrent aphthous ulcers, in the usual course of events, appear, regress, and heal within 4 to 10 days. The patients are requested not to brush their teeth in the affected area until the lesions have completely disappeared.

However, in rare cases, the lesions may appear without remission for as long as 2 or 3 months. In these cases the patient has reported the lesions are constantly present but have shifted location during the disease. Necrotic tissue and uncharacteristic ulceration are usually present in these cases. Instead of forming on the oral mucosa, the lesions characteristically occur on the attached gingiva. 

The recommended treatment

Most of recurrent aphthous ulcers resolve in 8 to 14 days without treatment. 

  1. Oracort ointment
  2. Oral and topical analgesics are administered if necessary. 
  3. Oral steroids may be needed for severe cases.

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