Aphta and Chronic aphtosis
By * Pascal EPPE LSD Dentist Specialize in nutrition therapy
INTRODUCTION
TREATMENT in summary
THE FATIGUE AND STRESS
TISSULAR ACIDOSIS
ALLERGIES, INTOLERANCES AND FOOD SENSIBILITIES
NUTRITIONAL DEFICITS
HORMONE CHANGES RELATED TO THE MENSTRUAL CYCLE
COMPLEMENTARY REMEDIES
CONCLUSION
BIBLIOGRAPHY
Mouth ulcers and aphtosis are recurrent diseases, which leave us confused about their pathogenesis (...) We consider that 17 % of the population is affected by chronic aphthosis.
The classic treatments are very limited and often disappointing.
In a person with no disease which can be questioned, canker sores are usually caused either by nutritional factors, psychological disorders or stress.
Some food allergies are mentioned (nuts, gruyere ,...).
Canker sores may also represent the consequence of certain radiological or medicinal treatments, as radiation therapy and antibiotics treatments with destruction of the intestinal flora.
To treat in depth a chronic aphtosis, the therapist is brought to correct the ground perturbed by the patient and this constitutes a necessary step to obtain the disappearance of the aphta (principle of the functional medicine).
LOCAL TREATMENT SUMMARY
EO oily solution,
Cicatrizes the canker sores and other wounds in the mouth, fights against the loosening of gums, prevents tooth decay.
It is used in case of discomfort or injury due to the pressure of a prosthesis or a dental appliance
DMD DISEASE-MODIFYING DRUG
A remedy like ...
Will be quite indicated and at the top of prescription to rebalance the digestive functions gently and in depth.
Often indicated to allow a good fluidity and a regeneration of cellular membranes, addition of essential fatty acids of the omega 3 family...
The scientific literature and the clinical experience demonstrate daily the remarkable efficiency of the omega 3 in the inflammatory phenomena.
The treatment will be effective because the assimilation will be better and the phenomena of allergies will disappear gradually.
Complementary treatments, according to the etiology and the field to be treated SUMMARY
The fatigue and stress
The patient affected by aphtosis often complains of a loss of physical and mental energy with regular falls of tensions. Indeed, the deep and chronic fatigue is often described as an accompaniment of recurrent aphthosis.
An Irish study (1) clearly shows the role of anxiety and stress in the possible etiology of the chronic aphtosis.
To treat this field, we choose a tonic action and boost the adrenals glands
Boost the adrenal glands. SUMMARY
Indeed, the tired patients often present an hypotension and a deficiency of the cortico-adrenal glands which allow "to moderate" the catabolic effect of catecholamines produced by the adrenal medulla. The stressed patients often have a slowing down of adrenal glands because the management of adrenalin and other catecholamines is often disrupted.
We shall aim at this objective by using remedies such as...
Tissular acidosis SUMMARY
Doctor Kousmine put in evidence the problems of chronic tissue acidosis due to the accumulation of acid waste from the metabolism. To identify this acid ground, it is possible to measure the pH of urines with a strip of pH paper (usually around 6.8) on the second and third urine in the morning and before the noon and evening meals.
One of the symptoms of this acid ground is the cold intolerance associated with the fragility of mucosa and the chronic canker sores appearance. To treat this tissue acidosis, we use alkali carbonates and citrates allowing to buffer the acids.
The lemon is paradoxically active against tissue acidosis because, after digestion, it produces large quantities of alkaline citrates capable of neutralizing these acids accumulated in the body. It is indicated for these patients, to make mouthwashes with the juice of a lemon. We may also suggest to paint the aphta with lemon juice.
To correct the acid ground, the patient can drink water rich in bicarbonate (Vichy-type) which allows to reduce the presence of these acids. To deal in depth the acid ground...
Allergies, intolerances and food sensibilities SUMMARY
Alcohol, chewing gum, citrus, pineapple, dried fruits (especially walnuts), dairy products, gluten, meats, spicy foods, tomatoes, vinegar and other acidic foods are foods that can cause intolerances and disrupt the digestive system.
These food intolerances can be put in evidence by an anamnesis detailed and confirmed by the biology. Many laboratories can henceforth measure immunoglobulins (especially Ig G) produced by the intake of allergenic foods.
Aphtosis and intestinal permeability SUMMARY
Behcet's disease or big aphtosis, fortunately rare immunological disease, cause mouth sores, genital and even eyes. Two studies (3,4) show that subjects suffering from the Behcet's syndrome have a significantly higher intestinal permeability.
On one hand, this intestinal increased permeability (« Leaky Gut Syndrome ») involves an abnormally high permeability of the tight junction of the intestinal mucosa. It has for consequence the passage of antigens, with foods incompletely digested and toxins through the intestinal mucosa, a phenomenon responsible for auto-immune diseases, inflammations and various allergies.
On the other hand, the Leaky Gut Syndrome involves suffering of enterocytes, with a reduced ability to assimilate nutrients actively through the brush border. This may lead to deficiencies in vitamins and minerals by failure to assimilate.
Recent scientific publications puts in relation the inflammations of the bowel (ulcerative colitis and Crohn's disease) with the chronic aphtosis. This relation is now established, seen the close relation between the functioning of the intestinal mucosa and the oral mucosa which share the same embryological origin. In this regard, a Turkish team has just published the results of its research (5).
This Turkish team has correlated aphtosis with celiac disease, a severe allergy to gluten arousing the atrophy of intestinal villosities. The patients reached by this pathology present fat diarrheas, asthenia, anemia, osteoporosis, depression and frequently suffer from auto-immune diseases (thyroiditis or type I diabetes).
In the absence of diagnosis and treatment, the celiac disease can even cause severe neoplastic complications. His diagnosis is crucial, because it allows to prevent these pathologies responsible for an increase of the morbidity and mortality.
This study demonstrates the coexistence more frequent, but far from systematic, between the aphtosis and celiac disease. The dentist may refer patients to their regular doctor or to their gastroenterologist, to diagnose a possible celiac disease.
This diagnosis is achieved by dosages of antibodies IgA and IgG directed against the gliadin and against the endomysium.
The treatment will consist on the eviction of the incriminated foods Lists of foods ; the bowel function often disrupted will be treated in complement : the imbalance of the intestinal flora (dysbiosis) is to be treated with probiotics ;
PROFLORE will be indicated in view of its very high bioavailability. Furthermore, the intestinal mucosa often too permeable (Leaky gut syndrome) is the basis of the phenomena of food intolerance, very important to prescrib...
Aphtosis and toothpastes with lauryl sulfate of sodium SUMMARY
The sodium lauryl sulfate is the most widely used detergent in toothpastes of trading.
This chemical compound might make the oral mucosa more vulnerable by removing the protective coating, constituted of mucin, which coats it (6).
In total, three clinical studies - one preliminary (7), one in simple insu (8) and one to double insu (9) - we concluded that a toothpaste containing this substance causes more relapses of aphta in susceptible individuals that a toothpaste that was devoid.
Nutritional deficits
Iron, Folic acid and vitamins of B group. SUMMARY
Many studies (3, 4, 5, 6) show that by filling the iron deficiencies, in folic acid, in vitamins B1, B2 and B6 and B12 will reduce or eliminate recurrences of mouth ulcers in the most cases.
A Dutch study (6) concludes that, all the cases of chronic aphtosis, should consider the status and the dosage of the vitamin B 12, seen the efficiency of the treatment by the administration of this vitamin.
Treatment:
Hormone changes related to the menstrual cycle SUMMARY
If the oral ulcers are linked to premenstrual syndrome, the licorice will be perfectly indicated (15).
In this treatment, the dried root or an extract not deglycyrrhizinated will be prescribed two weeks before the menstruation.
Rp/ dried licorice roots : 5 g to 12 g per day. Take three times daily after meals, an infusion or decoction of 2 g to 4 g of dried roots in 150 ml of water. Attention, The oral contraceptives can increase the susceptibility to glycyrrhizin. If mouth ulcers occur in period of menopause with hot flashes, the sage has to be chosen.
The sage is one of the components indicated in the troubles of menopause and the premenstrual syndrome. With other natural elements, it composes...
Some complementary remedies SUMMARY
The Aloe vera (Aloe barbadensis) and Clay.
Aloe Vera
A double-blind study (14) demonstrated that the application of a gel-based with acemannan, a constituent of aloe vera was more effective against the aphthous that Orabase Plain®, a conventional treatment based in local anesthetic.
Dosage: As part of the study mentioned above, the product was applied four times daily. It is also possible to make a daily mouthwash with 1 to 3 tablespoons of aloe vera juice.
Clay
Mouthwash in the warm clayey water several times a day until disappearance of the lesions.
Used locally in cataplasms on compresses, the Aloe vera and the clay are the components of the remedy ...
Echinacea (Echinacea angustifolia). SUMMARY
This plant has antiviral and immunostimulatory properties and can cure wounds. It may therefore be useful in treating aphta. Make a mouthwash several times a day with 20 drops of mother tincture diluted in some water. Echinacea is the main component of...
The extraordinary properties of PROPOLIS, the main component of...
Numerous experiments and clinical trials have demonstrated the properties :
- BACTERICIDAL on some staphylococci, salmonella and bacilli...
- FONGICIDES on certain fungi, particularly Candida Albicans and Trichomonas Vaginalis.
- ANAESTHTICS, 3 to 4 times higher than those of cocaine !
- CICATRIZING by the rapid regeneration of tissues.
The PROPOLIS strengthens the defenses of the body and puts it shielded from the attacks generally. Because of its broad antimicrobial properties, powerful anesthetic, significant cicatrizant and not insignificant anti-inflammatory, the propolis, this extraordinary natural product harvested by bees on certain plants, is highly effective in inflammation and oral infections .
For all the oral indications, the propolis is used by internal local way in the form of pieces or chewing pastes, of baths of mouth, tablets or pastilles to be sucked, of sticks for gingival plaster, toothpastes, as well as propolis chewing gum which represents a convenient and pleasant shape to prevent many affections of the mouth and the gums.
Natural substance in the extremely broad scope, propolis has no incompatibility with other medications may be prescribed simultaneously and has no contraindication.
Millennium product and at the same time thoroughly modern, propolis is scientifically studied for some years by the pharmaceutical industry, with results already confirm all empirical data accumulated over centuries and which augur well in the near future with therapeutic perspectives more effective and even broader. Use of propolis : chew for two hours purified propolis in pieces at the rate of 1 g every shot or spray a propolis solution on the lesions.
Chamomile Roman (Chamaemelum nobile All.). SUMMARY
Because of its calming effect on the oral mucosa and its ability to heal wounds, chamomile can be used to relieve canker sores.
Dosage : Gargle several times a day with an infusion of chamomile or with a little tincture diluted with a little water.
Myrrh (Commiphora Myrrha). SUMMARY
This remedy is used since the mists of time to relieve the irritation of the mouth and gums.
Indications of myrrh : treat inflammation of mucous membranes of the mouth and pharynx, minor skin irritations and injuries; adjuvant treatment of pharyngitis and tonsillitis.
Mouthwash several times a day with one or other of the following preparations :
- 200 to 300 mg of extract added to a little water ;
- 4 ml of myrrh tincture in a little water.
Dosage: Although it is possible to find the form of myrrh resin pellets, the most common and most useful medicinal form is the tincture.
Irritations of the mucous membranes of the mouth and throat (mouth ulcers, gingivitis, etc..) Minor skin irritations or injuries.
Researches : The E Commission recognizes the medicinal use of myrrh to treat inflammations of the oral cavity and pharyngeal mucosa. The ESCOP does the same and also includes the treatment of the minor skin irritations and injuries. This organization also recognizes the use of the myrrh tincture as adjuvant treatment of pharyngitis and tonsillitis.
The chronic aphtose is a mild pathology in itself but capable of provoking a discomfort and pains relatively important for the patients.
The effective therapeutic approach of the chronic aphtosis can be made only by approaching the treatment of ground.
We discover one more time the interest of a global vision of the individual and it is the peculiarity of the functional medicine.
The nature provides us with a whole range of effective remedies, not deprive us to learn to use them advisedly for the biggest good of our patients.
1. McCartan BE, Lamey PJ, Wallace AM.Department of Oral Surgery, Oral Medicine and Oral Pathology, School of Dental Science, Trinity College, Dublin, Ireland. Salivary cortisol and anxiety in recurrent aphthous stomatitis. J Oral Pathol Med. 1996 Aug;25(7):357-9.
2. Das SK, Gulati AK, Singh VP. Deglycyrrhizinated licorice in aphthous ulcers. J Assoc Physicians India, 1989; 37:647.
3.Fresko I, et al., "Intestinal permeability in Behçet's syndrome". Ann Rheum Dis, 2001; 60(1):65-6.
4. Shapiro RF, et al., "HLA-B27 and modified bone formation".Lancet, 1976;1(7953):230-1.
5.Aydemir S, et al., Turk J Gastroenterol, 2004 Sep; 15(3):192-5.
6.Health Notes Online. The Natural Pharmacy. Health concerns: Canker Sores.
7.Herlofson BB, Barkvoll P. Department of Oral Surgery and Oral Medicine, Dental Faculty, University of Oslo, Norway. "Sodium lauryl sulfate and recurrent aphthous ulcers: a preliminary study". Acta Odontol Scand, 1994 Oct; 52(5):257-9.
8.Chahine L, Sempson N, Wagoner C, "The effect of sodium lauryl sulfate on recurrent aphthous ulcers: a clinical study". Compend Contin Educ Dent, 1997 Dec; 18(12):1238-40.
9.Herlosfson BB, Barkvoll P, "The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers". Acta Odontol Scand, 1996; 54:150-3.
10. Wray D, Ferguson MM, Mason DK, et al. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron.Br Med J, 1975;2(5969):490-3.
11. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy.J Oral Pathol Med, 1991;20:389-91.
12.Wray D, Ferguson MM, Mason DK, Hutcheon AW, Dagg JH. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron.
13.Weusten BL, van de Wiel A.Department of Internal Medicine, Eemland Hospital, Amersfoort, The Netherlands. Weusten.Schoots@inter.NL.net
Aphthous ulcers and vitamin B12 deficiency; Neth J Med. 1998 Oct;53(4):172-5.
14. Plemons JM, Reps TD, Binnie WH, et al. Evaluation of acemannan in the treatment of recurrent aphthous stomatitis. Wounds, 1994;6:40-5.
15. Das SK, Gulati AK, Singh VP. Deglycyrrhizinated licorice in aphthous ulcers. J Assoc Physicians India, 1989; 37:647.
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