Causes and risk factors:
The exact cause of canker sore is not known .However certain predisposing factor have been laid down. Among it mineral and vitamin deficiency (particularly Vitamin B12 Deficiency), stress and injury to the mouth while eating, due to fall or hard brushing are the most common ones. In females it can also be seen along with menstrual irregularities which indicated that hormonal changes can also predispose canker sores. Sudden changes of toothbrush or toothpaste or certain food substances like intake of excessive spicy food, smoking and alcohol or food allergies can also cause aphthous ulcers Canker sores can also be due to some underlying diseases like gastric complaints (Celiac diseases, inflammatory bowel diseases) or in people with weak immune system like HIV.
Clinical presentations:
The patient presents with ulcer formation on the oral mucosa. The common locations are on the either side of inner aspect of cheeks or on tongue or on lips. On lips it is seen on the inner side. They either erupt single or in multiple numbers. In some cases recurrent complaints are seen. As one ulcer heals the other grows up. On examination small oval or round ulcers are seen. They are reddish yellow in color. The mucosa surrounding the ulcer shows congestion. The patient comes up complaining of pain at the affected site. The pain is typically burning types. It causes difficulty in talking, eating, drinking and swallowing. Any of these movements induces pain. In some patients increase salivation and increase thirst is seen. This difficulty in swallowing also leads to decrease appetite.
Diagnosis and investigations:
The symptoms narrated by the patient and the local examination carried out by the doctor can help in diagnosing the case. In most of the cases no investigations are required, however in cases of recurrence Routine blood test, Blood test for checking the vitamin and mineral levels; Hormonal test etc can also be advised.
Treatment:
Usually the canker sores heals on its own in a week or more in cases of recurrent ulcers correction of the underlying cause is the main line of treatment. The doctor can advise medications like topical gels and mouth rinsers. During the active ulcers certain preventive measures needs to be taken. It consists of avoiding of spicy food, alcohol and smoking. Use of soft brush is recommended. High fluid intake should be taken.
Other modes of treatment:
The other modes of treatment can also be effective in treating the pain. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
