Aphthous stomatitis is also known as a canker sore. It is one of the most common mucosal lesions that dentists and physicians observe in patients. It is seen more commonly in females. No specific etiology has been documented for Aphthous stomatitis. However, some factors like auto antibodies, and vasculitis mediated by immune complex have been brought forward as possible etiological factors. Some factors that can precipitate it include stress, trauma, hormones, heredity and chemical irritants. (Casiglia, 2010). Certain food materials have also been implicated, including coffee, cheese, potatoes, figs, nuts, citrus and chocolate (Casiglia, 2010). Also, some nutrient deficiencies, like vitamin b12 and folate have also been associated with Aphthous ulcers. streptococci has frequently been isolated from the ulcers raising the issue that complex fixation and antibody formation by this bacteria is involved in the pathophysiology of Aphthous ulcers. Genetics has also been implicated in the diseases, with a polygenic form of inheritance and a multifactorial penetrance. Some systemic diseases like inflammatory bowel disease and Crohn's disease present with recurrent Aphthous ulcers as symptoms. (Casiglia, 2010).
Recurrent Aphthous ulcers may present with occasional ulcers that are self limiting, or the debilitating form which is known as major recurrent Aphthous stomatitis. (Casiglia, 2010).
The minor type usually manifests during the second decade of life and the ulcers reducing in severity and frequency. Major Aphthous ulcer, however, is less common and more severe. It is also referred to as Sutton's disease. The ulcers are large and deep and it presents with severe pain, tenderness and edema of the face. And the ulcers may become chronic. (Malamed, 2010)
Diagnosis involves a careful history of the course of events. Also, the aggravating and relieving factors are also sought. Other associated symptoms, including ocular, urogenital and musculoskeletal symptoms are also elicited.
Examination of the ulcer to characterize it, and assessment of other organ system is carried out. Diagnostic evaluation most times is carried out other etiologies. Differential diagnosis includes Herpes simplex infection, Shingles, herpangina, Varicella and Bechet's disease. Crohn's disease is an inflammatory disease that may involve any part of the gastrointestinal tract. It may present with oral ulcers.
There is no definite therapy to cure Aphthous ulcers given the unclear etiology of the disease. However, in both major and minor stomatitis, pain control is paramount. Medication for speeding up ulcer healing is prescribed. (Malamed, 2010)
Lifestyle changes that the individual can adopt to control the disease include avoiding the trigger factors when there is an identifiable one. Food that can act as triggers include chocolate, potatoes, nuts, cheese, coffee, and citrus foods. However, it might be difficult for the individual to adhere to abstinence from these food materials because they are ingredients for so many delicious food products and snacks. Asking the individual to abstain from these food substances would seem like a cruel thing to do. However, the individual must be encouraged to stay away from these foods because they can be done without. (Malamed, 2010)
Lifestyle changes are a lot cheaper to prescription medication for the management of any disease. Aside from the fact that they do not have any side effect like prescription medication, they are also inexpensive and can be afforded by anyone who chooses to adopt them, unlike prescription medication which may be too expensive to purchase. In the light of these, I believe that lifestyle modification should be chosen over prescription medications, when the option arises for the use of the former to manage any disease condition.
References
Jeffery, Casiglia (2010). Aphthous Stomatitis. Medscape Reference: Drugs. Disease & procedures.
Farhad, Malamed (2001). Aphthous Stomatitis. UCLA Department of Medicine.
Mary, Mulvhill et al (2005). Human Disease: A Systemic Approach. 6th Ed.
