Civitali Dental and Prosthetic Center srl

What a nuisance in my mouth, are they aphthae?


Recurrent aphthous stomatitis

Aphthae often begin with an itching or burning sensation at the site where they will develop.

After some days a red area or a bubble creates, later becoming a little open ulceration. It looks as an oval, white-yellow opening, surrounded by a red inflamed area. Its diameter is usually 3-4 mm, but it may become greater than 1 cm in most severe cases.

It can even be smaller than 1 mm. It causes a stinging pain. Sometimes the lesion is surrounded by a whitish halo.

At least once in his/her life an Italian has suffered from an aphtha, a small painful, burning lesion of the mucosa that heals with difficulty. For one person over five, unrelated to age, aphthae are a recurrent problem. They develop especially under great mental or physical stress, or during the menstrual cycle, or when the immune system is weakened.

Lesions affecting the mouth are hundreds. Also physicians are often greatly uncertain about the diagnosis: for non-experts all are aphthae or oral candidiasis, says Silvio Abati, specialist in Odontostomatologic Diseases at Milano University. “When they are smaller than 1 cm, whitish, with a red halo, painful, and disappear in about ten days, to reappear after one/two months for about six times in a year, especially in people up to 30, then a recurrent aphthous stomatitis may be diagnosed”.

Other lesions are caused by well-known disorders, or by coeliac disease, or by a trauma provoked by teeth broken during restoration at the dentist’s or by accidental bites while chewing food. “Cases of allergy to drugs, some kinds of food, dental materials ulcerations are not aphthae, even if they look quite alike”, Abati explains. Eating can become difficult since “the hole in the mucosa uncovers the connective tissue, and the contact with food and other thermal, mechanical and chemical stimulations activate nerve endings making pain unavoidable” adds Andrea Casasco, Histology Professor at the Medicine and Surgery Faculty at the Pavia University.

Concerning treatment, corticosteroids and rinses may be an option. They all work, in a sense, but do not accelerate the healing time. For sure, healing is faster if bacteria are less.

After a precise diagnosis an antiseptic gel may be applied 2/3 times a day in order to eliminate bacteria infecting the ulceration while a protective gel made of vegetable compounds – working as a protective film - may be applied before meals, Abati suggests.

Recently a therapy based on hyaluronic acid (the same that can be found in the mucosa and in aesthetic fillers) has been developed. Available at the chemist’s in a gel form (a Bracco patent) it should reduce the duration of the sore, accelerating healing and soothing pain.

A randomized double-blind controlled clinical study performed at the Newcastle Dental University Clinic “has shown its effectiveness on pain symptoms, most probably because of the barrier effect provided by the product”, Robin Seymour – professor at the Newcastle University – explains. Comparing the test group with the control one, which was administered a placebo they also observed– after a six days treatment – a smaller number of ulcerations and a diminished recurring frequency.