Oral Aphthous: Pathophysiology, Clinical Aspects and Medical Treatment

Arch Razi Inst. 2021 Nov 30;76(5):1155-1163. doi: 10.22092/ari.2021.356055.1767. eCollection 2021 Nov.


Oral aphthosis is a painful inflammatory process of the oral mucosa. Oral aphthous can appear alone or secondary to numerous distinct disease processes. If recurrence occurs frequently, it is called recurrent aphthous stomatitis. The pathophysiology of oral aphthous ulcers remains unclear but various bacteria are part of its microbiology. Three morphological types hold great importance in literature because these types help manage the illness properly. Google Scholar and PubMed databases were used to retrieve the relevant data and information. Different keywords including "Aphthous", "Aphthosis", "Canker sores", "Aphthous stomatitis", "Aphthous ulcer causes", "Aphthous ulcer AND Microbiota" and "Aphthous ulcer AND treatment". The causes for oral aphthous ulcerations are widespread and ranges from localized trauma to rare syndromes, underlying intestinal disease, or even malignant disease processes. A detailed history and thorough examination of systems can assist the physician or dermatologist in defining whether it is related to a systemic disease process or truly idiopathic. Management of oral aphthous ulcers is challenging. For oral aphthous or recurrent aphthous ulcers from an underlying disease, topical medications are preferred due to their minimum side effects. Systemic medications are necessary if the disease progresses. Within the limitation of research and literature provided, it is safe to say that topical corticosteroids are the first line of treatment. Herein, the author discusses the pathophysiology, types, causes, diagnosis, and appropriate treatment ladder of oral aphthous stomatitis as described in the literature.

Keywords: Corticosteroids; Diagnosis; Microbiota; Oral aphthosis; Oral aphthous; Recurrent aphthous ulcer.

Publication types

  • Review

MeSH terms

  • Humans
  • Mouth Mucosa / pathology
  • Recurrence
  • Stomatitis, Aphthous* / diagnosis
  • Stomatitis, Aphthous* / pathology
  • Stomatitis, Aphthous* / therapy