Aphthous Ulcer: A Case Report
Anushree Tiwari
Dentist, Mission Hospital Damoh, Madhya Pradesh
ABSTRACT:
Mouth ulcers are quite common in all age groups. They can be linked to several conditions such as
simple injury due to acute trauma or due to a sharp tooth or to an autoimmune disease. There are several
medications available on the market to treat mouth ulcers. But do we need to prescribe a medication
every time? This report presents a case of a 34-year-old male who presented with an ulcer in the palate
and was treated without a prescription.
KEYWORDS: aphthous; ulcer; cankersore
Address for correspondence : Dr Anushree Tiwari, Dentist, Mission Hospital, Rai Chauraha, Damoh-470661, Madhya Pradesh
E-mail: tiwarianushree88@gmail.com
Submitted: 12.06.2023, Accepted: 17.06.2023, Published: 26.06.2023
INTRODUCTION:
An internal sore in the mouth known as a
mouth ulcer can form anywhere. It is possible that a
person can have one or more of these sores, which are
typically red, yellow, or white. They can appear on
gums, tongue, palate, oral mucosa, inner surface of the
lips. They can make eating, drinking, and speaking
very painful. They can occur due to bacterial or viral
infection, sharing food with an infected person,
digestive problems, autoimmune diseases or simply
stress.[1] A few types of ulcers that a dentist may come
across frequently are traumatic ulcers that occur
because of minor trauma, stress, or digestive problems.
Differential diagnoses may also include contact
allergic stomatitis, traumatic fibroma, herpes simplex
virus infection (cold sore), and aphthous stomatitis.[2]
Traumatic ulcers are caused by a sharp tooth, sharp
edges of the appliance within the mouth or cheek
biting.[2] Ulcers can also be caused due to bacterial or
viral infections. Ulcer location can also depict the
reason causing it. For example, ulcer caused by herpes
simplex viral infection occurs in vermilion border,
attached gingiva, hard palate etc.[11]
Oral ulcers usually resolve by themselves in
about a week if the cause is removed. Symptomatic
relief can be achieved with over-the-counter anesthetic
creams/gels and chlorhexidine 0.2% aqueous
mouthwash to maintain good hygiene. However,
mouth ulcers that last more than two weeks and don't
resolve after removing the cause should be referred for
biopsy.[3]
CASE PRESENTATION:
A 34-year-old male came to our clinic with a
complaint of sore in his mouth. He never had similar
sores of such big size before. On clinical examination
we found an ulcer 1 X 2 cm in diameter extending
posterior to the molar area on the palate, not crossing
the midline. The ulcer had a yellowish white
appearance in the center and red erythematous border.
The ulcer had been present for 2 days without causing
any pain, itching or difficulty in eating. The oral
hygiene of the patient was good with mild stains on
some teeth. No signs of bleeding gums or tooth decay
were evident. Further investigations and body vitals
revealed no deviations from the normal. We diagnosed
the case to be of aphthous ulcer major due to its size,
presentation, and location (Figure).
Since the oral hygiene status of the patient was
good and he did not have any signs of pain we
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For reprints contact: editor.pjsr@peoplesuniversity.edu.in
How to cite this article: Tiwari A. Aphthous Ulcer: A Case Report.
PJSR. 2023;16(1):66-68.
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DOI:
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66 People’s Journal of Scientific Research / Volume 16 / Issue 1 / Jan-June 2023
Case Report
Tiwari A. Aphthous Ulcer
Figure : Aphthous ulcer located on the left side of the palate.
prescribed non-alcoholic mouth rinse to prevent
secondary infection, and warm saline rinses two to
three times a day to counter inflammation. The patient
returned after 10 days with a completely healed ulcer.
The patient was scheduled for further follow-up after
three months to check for recurrence.
DISCUSSION:
Break in the oral mucosal lining or erosion is
referred to as mouth ulcer.[9] Even though oral ulcers
are not dangerous; they can pose discomfort to the
patient. Canker sores can affect about 20% of the
population. Since, the etiology is idiopathic, it is
believed that they occur due to the activation of the cell
mediated immune system.[7]
They can occur due to the deficiency of vitamins Vit B,
folate, or iron.[1] Other common causes might be
sensitivity to certain food items. The most frequent
causes include spicy or acidic food, hormonal shifts, or
even genetics.[5] The exact cause of their occurrence is
still unknown.[1] Canker sores can often be painful,
causing difficulty in speaking, eating or drinking but
discomfort. Even non-painful ulcers that do not heal
within 2 weeks should warrant a thorough medical
work up.[6] In most cases anesthetic creams such as
orajel can be prescribed for symptomatic relief.
CONCLUSION:
Ulcers can occur due to a variety of reasons
and might look concerning. But they are very common
and there are a lot of treatment options available for
symptomatic relief while they heal on their own. This
particular case is a good example to show that if there
is no pain or discomfort even a huge ulcer can heal on
its own. Taking proper history can help us rule out the
cause, which in most cases is unknown for aphthous
ulcers.
Financial Support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES:
are not contagious.[4] They do not leave a scar on
healing.
Unlike this case, major aphthous ulcers might
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Herpetiform ulcers, on the other hand, occur in small
clusters of pinpoints 10 to 100 sores fusing together to
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they also heal within one to two weeks without
scarring.[4] Large aphthous ulcer that have slow healing
might also be associated with HIV. Therefore, HIV
testing must be carried out while ruling out the cause.[8]
A visit to a doctor is required when the discomfort is
hindering day-to-day activities due to severe pain or
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