Aphthae – You should know this


Various diseases can manifest themselves on the oral mucosa and the tongue. In addition to injuries, for example with toothbrush bristles that are too hard, it is mainly bacterial infections on the surface of the mucous membrane that lead to pathological changes. One of these is the aforementioned aphthae in the mouth. These are painful small wounds in the mouth and throat.

What are aphtae?

Aphtae are small roundish mucous membrane erosions (mucous membrane injuries) preferably on the cheek mucous membrane, but they can also occur on the gums or tongue. The defects, which look like ulcers, have a whitish or yellowish surface with a bright red edge. This typical appearance makes diagnosis easy.

Aphtae in the mouth are extremely painful, especially when sour food and drinks are present. They occur either singly or in groups, then one speaks of stomatitis aphtosa. Unfortunately they can appear again and again.

The exact cause of aphthae has not yet been clarified. However, it is assumed that there may be a lifelong predisposition to the formation of aphthae. A hereditary predisposition to the formation of aphthae is therefore not excluded. In and of itself, aphthae are harmless in the mouth and disappear again on their own after 1 to 2 weeks. What is unpleasant, however, is the severe pain, which is particularly disturbing during meals and when speaking.

Are there different types of aphthae in the mouth?

Basically, two types of aphtae are distinguished, the so-called large aphtae generally require a healing time of several weeks to months until the mucous membrane damage has completely receded. However, the intensity of pain of such a mucosal blister does not necessarily correlate with its size, because it is not the diameter but rather the exact localisation of the aphtae that is decisive for its impairment of the patient. In mechanically highly stressed regions of the oral cavity (e.g. the inner side of the lip or tongue), aphtae are perceived by patients as particularly painful and disturbing.

Affected patients also often report that they experience pain during the corresponding period. – Major form: Aphtae of the major form (large aphtae) exceed a diameter of one centimetre. The healing time of large aphtae usually takes several weeks to months.

Since this type of mucous membrane injury is usually extremely painful, the intake of food is significantly influenced by the disease. – Minor form: Minor form aphtae are small mucous membrane vesicles that do not exceed a diameter of one centimetre. Small aphtae heal within a week without any consequential damage. – Speaking

  • Food intake severe pain
  • Ingestion of saliva or water

Symptoms of aphthae

Aphthae express themselves in the first place by their typical appearance. Often aphthae are described as vesicles, but this does not correspond to reality. Vesicles are a bulge filled with fluid to the outside, whereas aphthae appear on closer inspection as flat mucosal defects (i.e. flat holes), as if the uppermost cell layers are missing.

At the beginning they are rather small yellowish spots with a slightly reddened edge. This is because fibrin is deposited in the wound. Over time, however, a clearly visible bulge develops, which appears whitish or yellow.

The surrounding tissue is normal. Only rarely do small groups of multiple aphtae form in one place. The affected person suffers from severe pain, especially when the aphtae comes into contact with something, such as when eating or speaking normally, where the wound may come in contact with a tooth or touch another part of the mouth.

The pain is very stabbing or burning. It is also often much greater than the area of the mouth would suggest, so that not only the affected tissue seems to hurt, but a much larger area. If aphthae occur on the tongue or also in the throat, i.e. in places that are subject to greater mechanical stress, the disease becomes even more unpleasant, as they cause permanent pain when swallowed, in contact with saliva or when speaking.

The sensation of pain is strongest in the first days. On the tongue it feels like stings or as if you have burned your tongue. Externally they are usually never noticeable unless someone looks directly into the mouth of the person affected.

Most of those affected describe aphthae in the oral cavity as a torture that causes severe pain and restrictions in everyday life. Initially, an aphtha only manifests itself through redness and swelling in the mouth or the oral mucosa. Relatively quickly, the affected areas of the mucous membranes begin to tingle and burn. Within a very short time (usually a few hours after the first symptoms appear), enormously strong pain develops, which becomes even worse when speaking and eating.