The precise cause of acute stomatitis is unknown; however, experts are inclined to think that this disorder results from the combination of a set of concomitant factors.
Typically, the symptoms of aphthous stomatitis are limited to ulcers on the oral mucosa; rarely, however, the appearance of these lesions can also be associated with systemic symptoms, such as fever or malaise.
With a completely characteristic appearance, the ulcers produced by aphthous stomatitis undergo spontaneous resolution usually within 1-2 weeks.
As a rule, the diagnosis of aphthous stomatitis is clinical, that is, based on a physical examination and anamnesis.
For the moment, there is no definitive cure for aphthous stomatitis; however, patients can rely on various symptomatic remedies; moreover, with aging, the disease tends to gradually reduce the frequency with which it produces oral lesions.
Typical of young people and young adults, aphthous stomatitis is not a contagious disease, therefore those affected do not pass it on to healthy people in the vicinity or who have contact with them.
Meaning of the words Stomatitis and Aphthous
In medicine, the term "stomatitis" indicates any acute or chronic inflammation of the oral cavity; the word "aphthous", on the other hand, is a reference to mouth ulcers, which are benign ulcerative lesions of the oral mucosa ("oral mucosa" is the "non-specific expression used to describe the mucosa that lines the internal components of the mouth) .
According to the literal meaning of the aforementioned terms, aphthous stomatitis is the inflammation of the oral cavity characterized by the presence of canker sores on the oral mucosa.
Epidemiology
Statistics say that aphthous stomatitis affects between 5% and 66% of the general population; this numerical data places it at the top of the ranking of the most common diseases of the oral cavity.
Aphthous stomatitis is widespread all over the world; however, it is easier to observe in developed countries.
For reasons still unclear, aphthous stomatitis more often affects people belonging to an upper socioeconomic class.
Aphthous stomatitis usually arises at a young age, to be precise between 10 and 19 years of life; this condition does not favor a particular sex, which means that it afflicts males and females equally.
According to what has been observed in the United States - a highly multi-ethnic country - aphthous stomatitis would have a predilection for people with white complexion (Caucasian population).
Did you know that ...
According to some statistical research, in 80% of the people who are affected, aphthous stomatitis would arise before the age of 30.
. Studies on the subject have shown that many cases of aphthous stomatitis are characterized by an improper immune response, whose protagonists are T lymphocytes and cytokines IL-2, IL-10 and TNF-alpha;
- Food allergies to foods such as chocolate, coffee, nuts, almonds, citrus fruits, eggs, strawberries, cheese and tomatoes;
- The stress;
- Some viruses and some bacteria;
- Trauma to the mouth;
- Poor nutrition;
- Some medications;
- The presence of systemic diseases, such as: systemic lupus erythematosus, inflammatory bowel diseases, "reactive arthritis, celiac disease, Behçet's disease, cyclic neutropenia, nutritional deficiencies, IgA deficiency," immunosuppression due to " HIV, MAGIC syndrome, PFAPA syndrome, Sweet's syndrome or Lipschutz ulcer;
- Familiarity for aphthous stomatitis. Scientific studies have shown that, in a significant number of cases, those suffering from aphthous stomatitis have relatives affected by the same condition; this has led experts to think that aphthous stomatitis may have, at least in a certain percentage of patients, a hereditary nature.
Did you know that ...
From some scientific studies on aphthous stomatitis it has emerged that the state of pregnancy, the use of oral contraceptives and nicotine have a protective function against the formation of new canker sores in the mouth.
very annoying, which becomes acute when you eat; they are always lesions of a benign nature; finally, they are temporary: in fact, except for some sporadic cases in which they persist for over a month, they disappear naturally within 7-14 days.
TYPES OF ULCERS
To be more specific, aphthous stomatitis can produce three different types of aphthous mouth ulcers:
- Minor aphthous ulcers. They represent the most common type: they are observed, in fact, in 85% of cases of aphthous stomatitis.
Typically, they measure 2-3 millimeters; in any case, they are never larger than 8 millimeters.
They have a predilection for the internal mucosa of the lips, for the lateral and ventral portions of the tongue, and for the mucosa of the pharynx.
As a rule, they heal in about 10 days. - Major aphthous ulcers. They characterize 10% of cases of aphthous stomatitis, which makes them the second most common type of aphthous ulcers.
Compared to minor aphthous ulcers, they are larger (they can reach dimensions greater than one centimeter), more durable (they can take more than a month to heal) and more painful.
As regards the sites of formation, they tend to affect mainly the internal mucosa of the lips, the mucosa of the soft palate and the mucosa of the pharynx.
Finally, major aphthous ulcers are noted for their possible association with systemic symptoms, such as fever and / or general malaise. - Herpetiform aphthous ulcers. They are the least common type of aphthous ulcers: they distinguish, in fact, the remaining 5% of cases of aphthous stomatitis.
Similar to the lesions caused by the herpes virus (which justifies the name), they begin as many small spots of 1-2 millimeters, which in a few days join in a single ulcer of important dimensions.
Capable of lasting up to 2 weeks, herpetiform aphthous ulcers are more common among women (the reason for this is unknown) and, compared to other types of aphthous ulcers, tend to affect people of slightly older age.
How often do Ulcers form?
The frequency with which aphthous stomatitis determines the appearance of an ulcer on the oral mucosa varies from patient to patient: for some, this annoying phenomenon occurs 2-4 times a year; for someone else, however, it is much more frequent, so much so that at times it can happen to witness the formation of a new lesion where the previous one is still healing.
Important!
Those suffering from aphthous stomatitis are subject to the periodic formation of an "ulcer on the oral mucosa.
This means that aphthous stomatitis tends to recur with a certain frequency.
Prodromal Symptoms
Readers are reminded that prodromal symptoms are non-specific clinical manifestations that precede the typical symptom picture of a certain disease or medical condition.
In aphthous stomatitis, it often happens to herald the appearance of an "ulcer in the mouth are a pain and an annoying sense of burning where the future oral lesion will appear.
Typically, these prodromal symptoms of aphthous stomatitis occur 1-2 days before the actual symptoms.
Evolution of Aphthous Stomatitis in adulthood
Aphthous stomatitis is considered a young age disorder; with aging, in fact, the appearance of aphthous ulcers related to it becomes less and less frequent, until it practically no longer occurs (with rare exceptions).
The frequency with which aphthous stomatitis produces ulcers on the oral mucosa begins to decrease around the age of 30.
In general, in old age, aphthous stomatitis no longer gives manifestations of itself; in a sense it is as if, with aging, it heals.
- Culture analysis of aphthous ulcer after buccal swab. It is used by the physician when in doubt that the lesion is due to an oral herpes virus (the reader is reminded that some aphthous ulcers may have the appearance of lesions produced by the herpes virus).
- Ulcer biopsy. Consists in the laboratory analysis of a small sample of cells taken from the ulcer.
It allows to establish the exact nature of the lesion and to identify all its peculiarities.
Rarely practiced, it is useful when the doctor has the doubt that the ulcer is the sign of a squamous carcinoma of the skin.
In-depth study: the physical examination and the anamnesis
The physical examination consists in the observation of the patient in order to ascertain the symptoms and signs that the latter complains and exhibits
In the case of aphthous stomatitis, the physical examination is often decisive for the diagnosis, as the ulcers have a characteristic appearance and are easily recognizable to an expert eye, such as that of a doctor.
The anamnesis is the critical study of the symptoms observed during the physical examination and of the facts of medical interest collected through specific questions (concerning not only the symptoms, but also the general state of health, habits, recurrent illnesses in the family, etc.). ).
In the case of aphthous stomatitis, the anamnesis can be decisive for diagnostic purposes, as it allows us to understand the possible factors triggered by the formation of canker sores.
How to identify a food responsible for Aphthous Stomatitis
If from the diagnostic investigations it emerges that aphthous stomatitis is linked to some food allergy, the best way to identify the food responsible for the symptoms is to implement an elimination diet: this approach consists in "sequentially eliminating from the daily diet the foods that could trigger the symptoms, so as to identify the food whose suspension coincides with the disappearance of the disorder.
and / or salty, and acidic drinks.When spicy and / or salty foods, and acidic drinks come into contact with aphthous ulcers, the pain associated with the latter becomes acute and becomes even more annoying; with the abolition of these foods until the ulcers disappear , the patient avoids the inconvenience just described;
The oral hygiene guaranteed by the use of chloredixin mouthwash reduces the soreness of ulcers.
Chloredixine mouthwash is a pharmacological preparation; therefore, patients should only use it on the recommendation of the treating physician;
Corticosteroids are anti-inflammatory drugs.
The application of a corticosteroid on the ulcers produced by aphthous stomatitis has the effect of attenuating the inflammation and, consequently, the pain.
The management of aphthous stomatitis through the use of a corticosteroid is reserved for the most severe clinical cases, in which the pain is very intense and the persistence of the ulcers is prolonged.
The use of any corticosteroid must be done only on medical prescription, as it is a pharmacological category full of side effects (especially when its use is improper).
It is important to point out that the majority of people with aphthous stomatitis can control the soreness of the ulcers only through the temporary correction of the diet and the hydration of the oral mucosa, therefore without having to rely on drugs.
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