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Aphthous Ulcers

Learning Objectives:  

After listening to this podcast, the listener should:
  • Understand how to identify and classify aphthous ulcers in patients
  • Learn the difference between different types of aphthous ulcers
  • Know how to treat and handle aphthous ulcers in different types of patients

Many oral lesions are early indicators of immune deterioration. It is imperative for the healthcare team to recognize these manifestations and refer these patients for appropriate treatment. Early detection and successful treatment of these debilitating lesions most certainly increases the patient's quality of life. Recurrent aphthous ulcerations have been divided into three clinically distinctive categories: major recurrent aphthous ulceration, minor recurrent aphthous ulceration, and herpetiform ulcerations. For more information about this topic, we encourage you to visit our article by Suzanne Zunt on this topic.

*Director of Hospital Dentistry, Division of General Dentistry, East Carolina University School of Dental Medicine, Greenville, NC

Related Reading:

 

  1. Porter SR, Scully C. Orofacial manifestations in primary immunodeficiencies: Polymorphonuclear leukocyte defects. J Oral Pathol Med 1993;22(7):310-311.
  2. Brooke RI, Sapp JP. Herpetiform ulceration. Oral Surg Oral Med Oral Pathol 1976;42(2):182-188.
  3. Natah SS, Häyrinen Immonen R, Hietanen J, et al. Quantitative assessment of mast cells in recurrent aphthous ulcers (RAU). J Oral Pathol Med 1998;27(3):124-129.
  4. Pederson A, Klausen B, Hougen HP, Ryder LP. Peripheral lymphocyte subpopulations in recurrent aphthous ulceration. Acta Odontol Scand 1991;49:203-206.
  5. Herlofson BB, Barkvoll P. The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand 1996;54(3):150-153.
  6. Herlofson BB, Barkvoll P. Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study. Acta Odontol Scand 1994;52(5):257-259.
  7. Skaare AB, Rölla G, Barkvoll P. The influence of triclosan, zinc or propylene glycol on oral mucosa exposed to sodium lauryl sulfate. Eur J Oral Sci 1997;105(5):527-533.
  8. Skaare AB, Herlofson BB, Barkvoll P. Mouthrinses containing triclosan reduce the incidence of recurrent aphthous ulcers (RAU). J Clin Periodontol 1996;23(8):778-781.
  9. Olson JA, Feinberg I, Silverman S Jr, et al. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1982;54(5):517-520.
  10. Nolan A, Lamey PJ, Milligan KA, Forsyth A. Recurrent aphthous ulceration and food sensitivity. J Oral Pathol Med 1991;20(10):473-475.
  11. Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol 1984;57(5):504-507.
  12. Miller MF, Ship II. A retrospective study of the prevalence and incidence of recurrent aphthous ulcers in a professional population, 1958-1971. Oral Surg Oral Med Oral Pathol 1977;43(4):532-537.
  13. Yaacob HB, Ab Hamid J. Use of antidepressants in aphthous ulceration—A clinical experience. Dent J Malay 1985;8(1):33-38.
  14. Wood TA Jr, De Witt SH, Chu EW, et al. Anitschkow nuclear changes observed in oral smears. Acta Cytol 1975;19(5):434-437.
  15. Hunter L, Addy M. Chlorhexidine gluconate mouthwash in the manage­ment of minor aphthous ulceration. A double-blind, placebo-controlled cross-over trial. Br Dent J 1987;162(3):106-110.
  16. Wright EF. Clinical effectiveness of lysine in treating recurrent aphthous ulcers and herpes labialis. Gen Dent 1994;42(1):40-42.
  17. Khandwala A, Van Inwegen RG, Alfano MC. 5% Amlexanox oral paste, a new treatment of recurrent minor aphthous ulcers: I. Clinical demonstration of acceleration of healing and resolution of pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83(2):222-230.
  18. Khandwala A, Van Inwegen RG, Charney MR, Alfano MC. 5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: II. Pharmacokinetics and demonstration of clinical safety. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83(2):231-238.
  19. Binnie WH, Curro FA, Khandwala A, Van Inwegan RG. Amlexanox oral paste: A novel treatment that accelerates the healing of aphthous ulcers. Compend Cont Educ Dent 1997;18(11):1116-1118, 1120-1122, 1124 passim.
  20. Pimlott SJ, Walker DM. A controlled clinical trial of the efficacy of topical applied fluocinonide gel in the treatment of recurrent aphthous ulceration. Br Dent J 1983;154(6):174-177.
  21. Hayrinen-Immonen R, Sorsa T, Pettila J, et al. Effect of tetracyclines on collagenase activity in patients with recurrent aphthous ulcers. J Oral Pathol Med 1994;23(6):269-272.
  22. Chandrasekhar J, Liem AA, Cox NH, Paterson AW. Oxipentiyllin in the management of recurrent aphthous oral ulcers: An open clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87(5):546-567.
  23. Meiller TF, Kutcher MJ, Overholser CD, et al. Effect of an antimicrobial mouthrinse on recurrent aphthous ulcerations. Oral Surg Oral Med Oral Pathol 1991;72(4):425-429.
  24. Matthews RW, Scully GM, Levers BGH, Hislop WS. Clinical evaluation of benzydamine, chlorhexidine, and placebo mouthwashes in the management of recurrent aphthous stomatitis. Oral Surg  Oral Med Oral Pathol 1987;63:189-191.

 

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