Apthous ulcers-AKA canker sores.

Most of us have, at one time or another, had rounds with these bothersome spots in our mouths. 

They usually present themselves on the gum tissue either on the lip or tongue side of the teeth-on nonkeratinized (movable) tissue zones.  The etiology is unknown, however elevated antibodies suggest an autoimmune link.  They can occur with other systemic diseases such as Behcets Syndrome, Crohn's disease, ulcerative colitis, or cyclic neutropenia.  Good news-these lesions are not contagious.  They are self-limiting, usually subsiding in 7-10 days.

There are some topical ointments that can be purchased over the counter that can ease the discomfort and slightly shorten the duration of an apthous ulcer.  Many times ulceration occurs as a result of a slight trauma to the tissue.  A slip with the toothbrush or a crispy tortilla chip gone errant can be the culprit.  Eating lots of citrus, elevated stress levels, and hormonal changes add to the possibility of having yet another bout with canker sores.

Above is a description of Minor Apthous Ulcers.  There are two other categories to consider:  Major Apthous Ulcers and Herpetiform Apthous Ulcers.   Major are larger than 1 centimeter, deeper than minor lesions, last several weeks, and can produce scarring.  They present more toward the posterior (back) of the mouth.  Herpetiform are not related to the Herpes virus.  They are very tiny (1-2 millimeters) and occur in clusters.

Hopefully this is a non-topic for most patients.  But it is most helpful information if you suffer often or with Major or Herpetiform.  Knowledge is power!