Where do aphthae occur?
Aphtae can basically occur on any mucous membrane surface of the body. These are extremely painful mucous membrane damages, which are surrounded by an inflammatory rim and can be seen with the naked eye as small whitish-yellow mucous membrane wounds. Most aphthae are found in the following areas:
- Oral mucosa
- And even in the genital area aphthae are not uncommon.
Aphtae, which develop on and/or under the tongue, the affected patients feel partially strongly limited in their quality of life due to the pain. The formation of aphthae in this form is usually triggered by a herpes simplex infection (so-called oral thrush, (lat. Stomatitis aphthosa) and is characterized by a frequent recurrence after a one-time decay.
Especially stress situations, inner restlessness or feelings of disgust can provoke the reappearance of aphthae in the area of the tongue. In most cases, aphtae of the tongue are counted among the so-called “minor form” (small aphtae), whose size does not exceed a diameter of about one centimetre. Small aphthae usually heal within one to two weeks.
In rare cases, however, the size of aphtae in the area of the tongue, palate or lips can exceed a diameter of one centimetre. In such cases, the medical terminology refers to them as “major form” (large aphtae). Especially small children and infants stop eating and drinking as much as possible when aphtae are present on or under the tongue.
In addition to eating, speaking, touching the mucous membrane region, swallowing water and saliva is extremely painful. However, the pain felt by the respective patient is by no means dependent on the size of the aphtae; rather, the location of the mucous membrane injury plays a decisive role in influencing the patient concerned. For this reason, a single small aphtae, which has a diameter of only half a centimetre, can be perceived as much more painful in the area of the tip of the tongue than a large aphtae (diameter greater than one centimetre) which occurs on the mucous membrane of the cheek.
This fact shows that especially those aphtae which are located in the area of mechanically stressed mucous membranes cause pain particularly frequently. Exactly which food or food components lead to the irritation of aphtae on the tongue seems to be different for each person. Mostly, however, food seems to play a decisive role.
- Sweets (chocolate)
- Raw tomatoes
Also on the lip, the occurrence of inflammatory mucous membrane injuries in the form of aphtae can be perceived as particularly disturbing by the affected patients. Similar to aphthae on and under the tongue, it is assumed that aphthae on the lip can be caused by the Herpes simplex virus. If these mucous membrane injuries occur on the outside of the lip, the affected patients usually feel only slight to moderate pain.
Since aphtae on the outside of the lip can become very large in many cases, patients are particularly disturbed with regard to the aesthetics on them. Particularly painful aphthae of the lip are usually located on the inner side which is subject to high mechanical stress. The degree of pain with aphthae on the gums can be additionally increased during daily oral hygiene.
Contact of the affected mucous membrane areas with the toothbrush, dental floss and/or interdental space brushes can cause irritation of the mucous membrane defect. Aphtae can basically occur on all mucous membranes, including the gums. In most cases, they appear as small roundish erosions with a white or yellow coating on the gums.
Aphthae of the gums can be particularly painful and cause a strong burning sensation in the affected patient. A connection between the frequent occurrence of aphthae of the gums and gingivitis has not been clearly proven. The reason for this is that gingivitis is usually caused by a lack of oral hygiene and food residues that accumulate in the area of the gum line.
The causes of gingival aphthae are not clearly established, but it is assumed that several factors interact. In general, it cannot be assumed that the gums are particularly at risk from an aphtae. In most cases, wounds in the area of the gingiva also heal completely on their own, without the inflammatory processes spreading to the adjacent gums or jawbone.
While an aphtae is present on the gums, the affected patient should proceed particularly gently in daily oral hygiene and exert as little pressure as possible on the mucous membrane blister. An opened mucosal vesicle is usually much more sensitive to certain stimuli and causes much more pain. – In case of a weakened immune system, e.g. a cold or phases of increased stress
- It is now assumed that local gum injuries (for example, caused by mechanical stimuli such as brushing teeth that are too firm) can be provoked.
- In addition, people with severe nutritional deficiencies or deficiencies in vitamin B12, iron or folic acid seem to develop aphtae in the gums much more frequently. – Furthermore, it has been found that smokers generally suffer less often from gum aphthae than non-smokers. In people who smoke regularly, aphtae on the gums occur particularly in phases of nicotine caries.
In addition to the mouth and tongue, aphtae can also be found in the throat and tonsilla palatina (“tonsils”). However, they occur there somewhat less frequently. They are small (0.5mm) oval inflammations that usually occur where the oral mucosa is not directly connected to the underlying bone.
Aphthae can occur once, but in most people they can recur repeatedly and cause unpleasant pain. It usually hurts more if the affected area is subjected to frequent mechanical stress. It is more unpleasant on the tongue than on the cheek.
Aphtae in the throat belong to this category, because their location means that they come into contact with food or saliva every time they swallow, drink or eat, thus causing increased pain. No matter how deliciously prepared the food is, it can become a torture. The pain is usually burning and radiates over a larger area than the size of the aphtae.
The cause for the development of aphthae in the throat area is, as with their other possible places of origin in the oral cavity, to be traced back to many causes and also not yet completely clarified. For example, they can be genetically predisposed, result from a previous injury or be favoured by a deficiency of vitamin B12, iron and/or folic acid. Stress or the intake of highly acidic foods (fruit) can also lead to aphthae in the throat area.
The development of aphthae usually remains hidden from those affected until the first pain occurs when swallowing or even when speaking. From then on, it becomes unpleasant until healing, which can take up to two weeks. The pain is worst in the initial phase, but it slowly subsides over time.
In the case of aphthae in the throat area, in addition to problems with swallowing, there is another problem with treatment, including home remedies. They are located very far back and are therefore difficult to reach and locate. Furthermore, touching them is very unpleasant because the gag reflex is triggered immediately. It is therefore difficult to apply a gel, ointment or a cotton swab soaked in chamomile tea to the affected area. It requires a lot of patience, caution and calm.