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Questions and Answers


Q

I am interested in anything you may have with regard to causes, treatments or any suggested research areas concerning apthous (oral) ulcers

A

Acute, distinctive, painful ulcars on the movable oral mucosa, singly or in groups. Those < 1cm. diameter (most common) last 10-14 days; larger last weeks to months. Recurrent attacks are common with 2 or 3 ulcers per each attack - 10 to 15 are common in some individuals. Women are affected more often than men. Cause is unknown but deficiency in iron, vitamin B 12 and folic acid seem to increase susceptibility. Stress and local factors are predominent precipitating factors. The acutely painful phase lasts 3 - 4 days, then the lesions heal by themselves. 2% lidocaine viscous, 1 tbsp as an oral rinse every 3 hours or before meals makes things more tolerable; also a dental protective paste applied 4 x a day prevents irritation of the ulcers. Triamcinolone acetonide dental paste helps too.

For multiple lesions, tetracycline oral suspension is held in the mouth for 2 - 5 minutes before swallowing to coat the ulcers. For severe episodes, corticosteroid therapy, both topical and systemic, may be indicated.

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