Aphthous Stomatitis (Aphthosis)

Aphthous stomatitis is a painful disease of the mouth that tends to come and go. It starts with small, red bumps which later develop into tender, white ulcers or sores. The pain may be so pronounced that it interferes with talking or eating. The sores can range in size from 3-10 mm and there may be only one or many. The most common location is inside the cheeks and lips but they can occur on the tongue and palate and even on the genitals and eyes. The ulcers tend to go away over a course of 1-2 weeks and often reoccur.

They may be brought on by trauma like self-biting and dental injuries, foods like hot spices, citrus, fresh pineapple and walnuts, emotional stress, and hormonal changes from pregnancy, menstruation, and menopause. Cases of aphthous stomatitis running in families have also been reported. The true cause of aphthous stomatitis is not known but an infection or an immune reaction has long been thought to play a role.

10-20% of the population is affected by recurrent aphthous stomatitis. The first outbreak typically occurs during the teens or twenties and affected individuals tend to have break outs for decades. Children can also be affected and not uncommonly may exhibit sore throat and fever with the ulcers.

Mouth ulcers can also be associated with Behcet syndrome, anemia, vitamin deficiencies, celiac disease, inflammatory bowel disease and even HIV disease.

There is no permanent cure for aphthous stomatitis and most treatments aim to reduce pain and symptoms. Your doctor may prescribe solutions or gels that can be applied to the sores. But if a trigger is known, it should be avoided.

References:
James WD, Berger TG, Elson DM. Andrews’ diseases of the skin: clinical dermatology, 10th edition. Saunders, 2005.

Angela Leo, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvannia