Intended for healthcare professionals

Practice 10-Minute Consultation

Aphthous ulcers

BMJ 2009; 339 doi: (Published 24 July 2009) Cite this as: BMJ 2009;339:b2382

Aphthous ulcers checklist

Aphthous ulcers (aphthae) are recurrent, exquisitely painful oral ulcers that can
literally dominate and ruin a person's life. Aphthae affect the entire mucosal
surface of the mouth, including the lips and tongue, and can be so painful that
speaking and eating are difficult, and sufferers must resort to topical
anesthetics. As a physician and former aphthous sufferer, I offer the following
checklist of causative and aggravating factors:

A - Amalgams and metal dental work.

P - Poor oral hygiene.

H - Hot spices, such as pepper, cayenne, and cinnamon.

T - Trauma, such as biting your lip, tongue, or cheek.

H - Hunger, especially skipping meals.

A - Addictive substances (alcohol, tobacco, caffeine, sweets).

E - Exhaustion, stress, and anxiety.

Competing interests:
None declared

Competing interests: No competing interests

01 August 2009
Hugh Mann
Eagle Rock, MO 65641 USA