Major Aphthous Ulcers

Major aphthous ulcers, also known as recurrent aphthous stomatitis, are painful and large ulcers that occur on the inside of the mouth or lips. They are usually round or oval in shape and can range in size from 1cm to several centimeters in diameter. These ulcers can be single or multiple, and they typically last for 1-2 weeks before healing on their own.

Major aphthous ulcers are thought to be caused by an immune system reaction to certain foods, medications, or stress. They may also be linked to underlying medical conditions, such as celiac disease, Crohn’s disease, or HIV/AIDS. Some people may have a genetic predisposition to developing these ulcers.


The exact cause of major aphthous ulcer is still unknown, but there are several factors that are believed to contribute to its development. Here are the main causes of major aphthous ulcer:

  1. Genetics: Some people may have a genetic predisposition to developing major aphthous ulcer. Research has shown that the condition is more common in certain families and ethnic groups.
  2. Immune system dysfunction: Major aphthous ulcer is believed to be an autoimmune condition, meaning that the immune system mistakenly attacks the healthy tissues in the mouth, causing inflammation and ulceration.
  3. Nutritional deficiencies: A lack of certain vitamins and minerals, such as vitamin B12, iron, and folic acid, can increase the risk of developing major aphthous ulcer.
  4. Trauma: Injury or irritation to the soft tissues in the mouth can trigger the development of major aphthous ulcer. This can be caused by dental work, biting the inside of the cheek or lip, or using harsh oral hygiene products.
  5. Hormonal changes: Some women may experience an increase in the frequency of major aphthous ulcer during hormonal changes, such as during menstruation or pregnancy.
  6. Stress: Stress can weaken the immune system and make it more susceptible to infections and inflammation, including major aphthous ulcer.

In conclusion, major aphthous ulcer is a complex condition with multiple potential causes. If you experience recurrent mouth ulcers, it is important to see a healthcare professional for an accurate diagnosis and treatment plan.


Major aphthous ulcers, also known as recurrent aphthous stomatitis or canker sores, are common oral conditions characterized by painful, round or oval-shaped ulcers that form on the mucous membranes of the mouth. These ulcers can appear on the lips, tongue, gums, inside the cheeks, and on the roof of the mouth. The main symptoms of major aphthous ulcers include:

  1. Pain: The most common symptom of major aphthous ulcers is pain. The ulcers can be quite painful and can make eating, drinking, and speaking difficult.
  2. Large Size: Major aphthous ulcers are larger than minor aphthous ulcers, which are the most common type of canker sores. Major aphthous ulcers are usually more than 10 mm in diameter and can take longer to heal.
  3. Recurrence: Major aphthous ulcers tend to recur frequently, sometimes several times a year. Recurrence can be triggered by stress, certain foods, hormonal changes, or trauma to the mouth.
  4. Redness: Major aphthous ulcers can cause redness and inflammation in the affected area.
  5. White or Yellow Center: Major aphthous ulcers often have a white or yellow center surrounded by a red border.
  6. Difficulty Eating: Major aphthous ulcers can make it difficult to eat, particularly if the ulcers are located on the tongue or gums.
  7. Fever: In some cases, major aphthous ulcers can cause a low-grade fever.
  8. Fatigue: Major aphthous ulcers can also cause fatigue or a general feeling of malaise.

It is important to note that if you experience any symptoms of major aphthous ulcers, you should see a dentist or doctor for an accurate diagnosis and appropriate treatment.


There is no specific laboratory test or imaging study that can confirm the diagnosis of major aphthous ulcer.

The diagnosis is typically made by an oral health professional, such as a dentist or an oral surgeon, who will examine the ulcer and take a medical history of the patient. The appearance and location of the ulcer, as well as the patient’s medical history, will help the health professional to make a diagnosis.

To confirm the diagnosis, the health professional may perform a biopsy of the ulcer. During the biopsy, a small sample of tissue is removed from the ulcer and examined under a microscope. This can help to rule out other possible causes of the ulcer, such as cancer or infection.

In some cases, blood tests may be ordered to check for underlying medical conditions that may be contributing to the development of ulcers. These may include tests for autoimmune diseases or vitamin deficiencies.

Overall, the diagnosis of major aphthous ulcers is typically based on clinical evaluation, and treatment is focused on managing the symptoms of the ulcer and preventing future outbreaks.


The main medicine treatment of major aphthous ulcer involves the following:

  1. Topical corticosteroids: These are the most commonly used medicines for the treatment of major aphthous ulcers. These corticosteroids help reduce the inflammation and pain associated with the ulcer. Topical corticosteroids can be applied directly to the ulcer and are available in various forms, such as creams, gels, and mouthwashes.
  2. Oral corticosteroids: If the topical corticosteroids do not provide relief, oral corticosteroids may be prescribed. These are more potent than topical corticosteroids and work by reducing the immune system’s response to the ulcer.
  3. Topical anesthetics: These are used to provide temporary relief from the pain associated with the ulcer. These anesthetics are available in the form of gels, sprays, and lozenges.
  4. Systemic immunosuppressants: These are prescribed for severe and persistent cases of major aphthous ulcers. These medicines work by suppressing the immune system, which helps reduce inflammation and promotes healing.
  5. Antibiotics: These are prescribed when the ulcer becomes infected. Antibiotics work by killing the bacteria causing the infection and preventing it from spreading.
  6. Nutritional supplements: Nutritional deficiencies, especially of iron, folate, and vitamin B12, can cause major aphthous ulcers. Nutritional supplements can be prescribed to correct these deficiencies and promote healing.

It is important to consult a healthcare professional before starting any treatment for major aphthous ulcers. The healthcare professional will assess the severity of the ulcer and prescribe the most appropriate medicine treatment for the individual.