mouth and dental disorders
Recurrent Aphthous Stomatitis
Introduction
Recurrent aphthous stomatitis (canker sores, or aphthous ulcers) is the presence of small, painful sores (ulcers) inside the mouth that typically begin in childhood and recur frequently. Mouth injury, stress, and some foods may trigger an attack. People feel burning pain, and a day or so later a canker sore develops on the soft tissue of the mouth. Doctors or dentists make the diagnosis based on the pain and the appearance of the canker sores. Treatment is with mouth rinses and sometimes corticosteroids. (See also Mouth Sores and Inflammation .) Recurrent aphthous stomatitis (RAS) is very common. The cause is unclear but probably involves multiple factors, including disorders or abnormal function of the immune system, exposure to preservatives and toothpaste ingredients, and a genetic predisposition. RAS usually begins in childhood, and most people with RAS are<30 years old. People who have RAS get canker sores repeatedly. Some have only one or two canker sores a few times a year. Others have almost continuous outbreaks. Attacks usually decrease in frequency and severity with aging. Many factors seem to predispose to or trigger attacks, but allergic reactions do not seem to be involved. Such factors include injury to the mouth, stress (for example, a college student may get canker sores during final exam week), and certain foods (particularly chocolate, coffee, peanuts, eggs, cereals, almonds, strawberries, cheese, and tomatoes). People with Human Immunodeficiency Virus (HIV) Infection often have large canker sores that persist for weeks. 