Ulcer - aphthous
Key points
- A canker sore is an open sore in the mouth, which appears as a painful white or yellow ulcer surrounded by a bright red area.
- They may occur at any age, but usually first appear between the ages of 10 and 40.
- A diagnosis is based on the distinctive appearance of the lesion.
- In most cases, the condition is self-limited and healing is spontaneous.
Alternative names
Aphthous ulcer; Canker sores
Definition
A canker sore is an open sore in the mouth, which appears as a painful white or yellow ulcer surrounded by a bright red area. A canker sore is benign (not harmful). See also herpes, which can also cause mouth sores.
Causes, incidence, and risk factors
Canker sores are a common form of mouth ulcer. They occur in women more often than men. They may occur at any age, but usually first appear between the ages of 10 and 40.
Canker sores usually appear on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums.
They usually begin with a tingling or burning sensation, followed by a red spot or bump that ulcerates. Pain decreases in 7 to 10 days, with complete healing in 1 to 3 weeks. Particularly large ulcers (greater than 1 cm in diameter) often take longer to heal (2 to 4 weeks). Occasionally, a severe occurrence may be accompanied by nonspecific symptoms of illness, such as fever or malaise. Canker sores often come back again in the future.
There may be an inherited tendency to develop canker sores, as they often run in families. There may also be an immune system link. Ulcers may develop in response to a mouth injury such as dental procedures or aggressive tooth cleaning.
Canker sores may also occur at the site of a bite when the tongue or cheek is bitten. They can be triggered by emotional stress, dietary deficiencies (especially iron, folic acid, or vitamin B12), menstrual periods, hormonal changes, food allergies, and similar situations. They occur most commonly with viral infections. They may occur with no identifiable cause.
Symptoms
- A burning or tingling sensation before other symptoms develop (warning symptom)
- Skin lesion on mucous membranes of the mouth
o Begins as a red spot or bump
o Then develops into an open ulcer
+ Usually small, 1-2 mm to 1 cm
+ Occasionally larger than 1 cm
+ Single or clusters, often appears in groups (crops)
o Painful
o Center appears white or yellow with fibrous texture
o Halo border is bright red (a red halo may not always be present)
o May have gray membrane just prior to healing
Less common symptoms, which may appear at the time of the canker but may or may not be related, include:
- Fever
- General discomfort or uneasiness (malaise)
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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