December 2, 2023

Aphthae are painful and annoying. We explain how they are created and how you can quickly get rid of those annoying bubbles in your mouth.

A phthae often come out of nowhere and usually disappear without a trace after a few days. Meanwhile, the nasty little spots in your mouth can make eating and everyday life a pain. This is usually not dangerous, but quite annoying. Our experts explain what you can do with an ulcer in the mouth and when you should see a doctor with it.

What is an aphtha?

An aphtha feels like a painful sore in the mouth. “Actually, it is not a blister, but rather a small, deepened crater in the oral mucosa,” explains dentist Dr. Alexander Engel . This damage to the mucous membrane or ulceration causes the nerve endings to be exposed underneath. That’s why the spot hurts so much when you hit it with your tongue. Because there are a lot of bacteria in the mouth, there can also be a so-called superinfection on the spot, in which bacteria attach themselves to the aphtha and inflame.

In addition to the normal aphthous ulcers, there is also the so-called oral rot , also called herpetic gingivostomatitis in technical terms. The herpes infection causes similar blisters in the mouth and is often associated with a fever. Almost everyone carries the virus, but the disease only breaks out in young children.

When do aphthae heal?

An aphtha hurts a lot, especially when eating. But it is not dangerous and usually goes away on its own. “It is said that aphthae usually come 3 days and go 3 days, after 2 weeks at the latest they have completely disappeared”, explains Engel. During this time you can sometimes see a white point on the spot, this is tissue that is healing again over the aphtha. So don’t worry if you suddenly discover a white, rough spot in your mouth, it’s neither bacteria nor a fungal disease, it’s a good sign.

What causes the damage to the oral mucosa?

It is not yet clear why some people get canker sores every now and then. “They are not contagious, and injuries to the oral mucous membrane area do not cause aphthae”, emphasizes the dermatologist Dr. Erik Senger . However, the dermatologist names some favorable circumstances, such as stress or a lack of B vitamins, folic acid, iron or zinc. If you have celiac disease, gluten can also cause the painful areas in your mouth. But just because you have an aphtha does not necessarily mean that you are missing something and vice versa not every deficiency leads to an ulceration in the mouth. 

There are also connections between aphthae and vascular diseases or autoimmune disorders. People with Crohn’s disease, ulcerative colitis, arthritis, or HIV are often prone to painful blisters in their mouth. But don’t panic, having an aphtha every now and then is quite normal and is by no means a sign of a more serious illness.

Are aphthous ulcers contagious?

No, aphthae are not contagious. Unlike herpes, which is triggered by viruses and is therefore highly contagious, aphthae are damage to the oral mucosa and cannot be transmitted.

Are there also dangerous aphthae?

“If you get a canker sore in your mouth a couple of times a year but it goes away after 14 days, you don’t have to worry,” the dermatologist warned. In very rare cases, however, they can indicate another disease. Therefore, pay attention to the following warning signs in the case of aphthae and, if in doubt, have them examined by a dentist or dermatologist:

  • The aphthous ulcers are very large: Usually the area is only a few millimeters in size, but in some cases it can become significantly larger or they do not heal within 14 days. The pain often severely restricts everyday life, which is why many people go to the doctor with it.
  • You very often get aphthous ulcers: If you are constantly struggling with the painful areas in your mouth, you should have a blood count, because you may have a deficiency or another systemic disease.
  • You have ancestors from Asia: “People with roots from the area of ​​the historic Silk Road, that is, the Near and Middle East and East Asia, have a higher risk of what is known as Behçet’s disease,” explains Senger. This is an autoimmune disease of the blood vessels and manifests itself primarily in recurring aphthous ulcers, but can later affect other areas such as the gastric mucosa or the eyes and have dangerous consequences. Behçet’s disease should therefore definitely be treated.
  • The spots are on the gums: A normal aphtha is usually in the front of the mouth, i.e. on the lips, tongue, in the cheeks or sometimes on the roof of the mouth. “However, there are also mucosal necrosis on the gums or between the teeth, which can be a sign of HIV,” says dentist Dr. Angel. So these are not normal canker sores and you should get them tested by a doctor quickly.

What can you do about aphthae?

Since the cause is not really clear, it is difficult to treat, and the healing itself is difficult to accelerate. However, there are some remedies that can alleviate the annoying pain a little. To help alleviate the symptoms of aphthous ulcers, doctors recommend these things:

  1. Leave the area alone: yes, it is tempting to run your tongue over the area every few seconds to see if it really still hurts. However, if it is constantly irritated, the tissue cannot grow back together as quickly. So pull yourself together and leave the ulcer alone, and it will be gone in a few days. 
  2. Pain Relieving Home Remedies: There are some natural medicinal herbs that can relieve pain and soothe sore spots, such as sage, chamomile, and myrrh. There are special tinctures that you can smear on the affected area, or you can slowly drink a (cooled) tea made from these plants.
  3. Cool foods: Cold can numb the pain a bit, so eat a cool yogurt and drink a cold drink, for example. “You shouldn’t suck on ice cubes, they are so cold that afterwards the blood circulation and thus the pain only increase”, warns Engel.
  4. Medicines: In the pharmacy there are numbing pastes, for example with lidocaine, or the anti-inflammatory cortisone. But first talk to your doctor, who can prescribe this for you in an emergency.
  5. Avoid irritation: If you have a canker sore, you will quickly find that acidic, hot or hard food and also alcohol hurts quite a bit because it irritates the area. Therefore, it is better to switch to soft foods such as soup or rice. “Cigarettes are particularly irritating to the damaged mucous membrane and disrupt the body’s healing processes, so be sure to shift down a gear,” advises Engel.  


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