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of Oral Pathology, Radiology & Medicine The University of Iowa College of Dentistry Pathophysiology of Aphthous Stomatitis: Immunologic Location: nonkeratinized, unattached mucosal surfaces Typically buccal vestibule, lateral or ventral tongue, floor of mouth Heals in a predictable manner Types: minor, major, herpetiform Treatment not usually necessary for the common minor type Precipitating Factors: Primary Prevention Factors: Relate to maintenance of salivary pellicle or impeding the recognition of antigens to the immune system Pharmacotherapeutic Management Choices: Topical Route - Treatment of choice: triamcinolone acetonide rinse - alters course of disease, increases healing rates - Steroid ointments, pastes Systemic Route - Prednisone - for difficult cases, large +/or multiple ulcerations Over-The-Counter Products Inappropriate Chronic Treatment - Cautery agents - do not affect course of disease (Debacterol, silver nitrate, Negatan, laser) - Tetracycline rinses, oral antibiotics etc

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Bhatta DN, Glantz SA