The lesions of several other oral conditions are sometimes described as aphthae, including Bednars aphthae (infected, traumatic ulcers on the hard palate in infants), oral candidiasis, and foot-and-mouth disease. When used without qualification, aphthae commonly refers to lesions of recurrent aphthous stomatitis. Since the word aphtha is often taken to be synonymous with ulcer, it has been suggested that the term "aphthous ulcer" is redundant, but it remains in common use. Stomatitis is also a non-specific term referring to any inflammatory process in the mouth, with or without oral ulceration. It may describe many different conditions apart from aphthous stomatitis such as angular stomatitis. The current most widely used medical term is "recurrent aphthous stomatitis" or simply "aphthous stomatitis". Historically, many different terms have been used to refer to recurrent aphthous stomatitis or its sub-types, and some are still in use. Mikuliczs aphthae is a synonym of minor RAS, named after Jan Mikulicz-Radecki. Synonyms for major RAS include Suttons ulcers (named after Richard Lightburn Sutton), Suttons disease, Suttons syndrome and periadenitis mucosa necrotica recurrens. Synonyms for aphthous stomatitis as a whole include (recurrent) oral aphthae, (recurrent) aphthous ulceration and (oral) aphthosis.In traditional Chinese medicine, claimed treatments for aphthae focus on clearing heat and nourishing Yin.Rembrandt Gentle White toothpaste did not contain sodium lauryl sulfate, and was specifically marketed as being for the benefit of "canker sore sufferers".
Signs and symptoms
Persons with aphthous stomatitis have no detectable systemic symptoms or signs (i.e., outside the mouth). Generally, symptoms may include prodromal sensations such as burning, itching, or stinging, which may precede the appearance of any lesion by some hours; and pain, which is often out of proportion to the extent of the ulceration and is worsened by physical contact, especially with certain foods and drinks (e.g., if they are acidic or abrasive). Pain is worst in the days immediately following the initial formation of the ulcer, and then recedes as healing progresses. If there are lesions on the tongue, speaking and chewing can be uncomfortable, and ulcers on the soft palate, back of the throat, or esophagus can cause painful swallowing. Signs are limited to the lesions themselves. Ulceration episodes usually occur about 3–6 times per year. However, severe disease is characterized by virtually constant ulceration (new lesions developing before old ones have healed) and may cause debilitating chronic pain and interfere with comfortable eating. In severe cases, this prevents adequate nutrient intake leading to malnutrition and weight loss.Aphthous ulcers typically begin as erythematous macules (reddened, flat area of mucosa) which develop into ulcers that are covered with a yellow-grey fibrinous membrane that can be scraped away. A reddish "halo" surrounds the ulcer. The size, number, location, healing time, and periodicity between episodes of ulcer formation are all dependent upon the subtype of aphthous stomatitis. Causes
The cause is not entirely clear, but is thought to be multifactorial.