Aphthous oral ulcer (canker sore)

At a Glance

Aphthous ulcer (canker sore) is a small, round, painful ulcer that occurs in the mouth; it is generally not cancerous and differs from herpes simplex labialis (cold sore).

It primarily appears as painful lesions with red edges and a gray center on the mucosa of the inner cheeks, under the tongue, or at the back of the throat.

How the disease works

Suggested contributing factors include viral infection, stress, food allergies, vitamin and mineral deficiencies, and hormonal changes, but there are also cases where the cause cannot be identified.

The exact pathogenesis has not been definitively established, but it is understood to involve both mucosal damage and immune and inflammatory responses.

Variations in presentation among individuals

Stress, certain foods, nutritional deficiencies, and hormonal changes can act as individual triggers, so the frequency of occurrence and level of discomfort vary from person to person.

The broad framework of diagnosis and management

Most lesions improve without special treatment, but eating or speaking may be uncomfortable due to pain, and some individuals may experience recurrences.

Diagnosis centers on a clinical evaluation that integrates the shape, location, pain, course of onset, and oral examination of the lesion.

Current status of treatment

In cases of recurrent or persistent ulcers, lesions in atypical locations, or those accompanied by systemic symptoms, other oral diseases or systemic diseases must be differentiated.

The basis of management is to observe the course while reducing pain and avoiding irritation; avoiding hot or spicy foods may be helpful during the symptomatic period.

Most cases resolve spontaneously, and some ointments, creams, or oral rinses may be used for pain relief.

How to read clinical trials

Clinical trials require verifying the condition, participant criteria, assessment timing, and whether results are disclosed; the fact that a study is completed does not, in itself, imply positive results.

Points to verify during clinical consultations

In clinical practice, it is important to check the timing of onset and recurrence, triggering factors, pain and difficulty in eating, accompanying systemic symptoms, medications being used, and nutritional status.