Aphthous mouth ulcers (aphthae) are a common variety of ulcer that form on the mucous membranes, typically in the oral cavity (mouth). Other names for aphthous ulcers include aphthous stomatitis and canker sores.

Aphthous ulcers are generally round in shape and form in the soft areas of the mouth such as inside of the lips, the cheeks or the underside of the tongue. They are benign, non-contagious and can occur as single ulcers or in clusters. In most instances, aphthous ulcers are recurrent  a condition known as recurrent aphthous stomatitis (RAS)  with each episode normally lasting for between 7 and 10 days.The cause of the condition is unclear, and there is no cure, but treatment options are available to treat the pain the ulcers can cause.


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Minor aphthous ulcers

These are the most common variety. They are small in size – usually less than 5 mm in diameter – and can form as a single ulcer or in a cluster. They typically do not cause much pain.

Major aphthous ulcers

These are less common, are generally 5 mm or larger and form singularly or in a pair. They can be painful, especially when eating or drinking, and last anywhere between two weeks and a number of months.

Herpetiform ulcers

These can occur when multiple pinpoint lesions fuse together and form large, irregularly shaped ulcers. Herpetiform ulcers are so called because of their similarity in appearance to herpes, however, herpetiform ulceration is not caused by the herpes simplex virus.


Some tonsil stones don’t cause any symptoms. If you do have symptoms, they may include:

  • Bad breath (halitosis).
  • Cough.
  • Earache.
  • Sore throat.
  • Bad taste in mouth.
  • Small white or yellow stones that one may spit up.

Other symptoms include:

  • Difficulty swallowing.
  • Feeling that something stuck in throat.
  • Small white patches on tonsils.
  • Throat infections that are hard to treat with antibiotics.


The precise cause or causes of aphthous ulcers (canker sores) are unknown, however, it is thought that ulceration is brought about by one or a combination of external triggers.

Possible triggers of aphthous ulcers include:

  • Emotional stress
  • Minor injury inside of the mouth, for example from cuts, burns or bites while eating, dental work, hard brushing or ill-fitting dentures
  • Familial tendency
  • Sodium lauryl sulfate – an active ingredient in some toothpastes and mouthwashes; this compound is not proven as a trigger, but is known to prolong the time needed for ulcers to heal
  • Certain food and drinks, including coffee, chocolate, eggs and cheese, as well as acidic or spicy foods
  • A deficiency of certain vitamins and/or minerals including zinc, B-12, folate and iron that may present with anemia
  • An allergic reaction to oral bacteria
  • Using, as well as quitting, the use of tobacco products
  • Hormonal changes associated with pregnancy
  • Having a weakened immune system, due to certain chronic conditions (Immunodeficiency)

Very rarely recurrent ulceration can be a possible sign of several serious diseases, including:

  • Crohn's disease
  • Celiac disease
  • Behcet’s disease


To diagnose tonsil stones, your provider may:

  • Do a physical exam, looking inside the mouth and throat.
  • Perform an imaging scan if they cannot see the stones easily.
  • Dislodge the stones using a dental pick.


  • Avoiding foods that may trigger ulceration in the individual person
  • Focussing on a healthy, balanced diet containing sufficient amounts of nutrients and vitamins
  • Maintaining good dental hygiene and using a soft toothbrush to avoid irritation
  • Reducing stress and getting plenty of sleep
  • Reducing stress
  • Avoiding hard foods or foods that may scratch the interior of the mouth



Useful for apthous where there is inflamed,burning aphthous ulcers with salivation with a lot of salivation. There is pale mucous membrane( mouth lining) with numerous erosions.There is small, flat ulcers with red, inflamed edges on the tongue and inside of lips and cheeks.Useful for excessive saliva in the mouth and desire for cold water while having .There is foul, metallic taste of the saliva with confluent oral thrush that changes into ulcers, and diffused redness of the whole mucous membrane of the mouth with profuse salivation.


Useful for apthous that have a tendency to bleed easily when touched, or during eating.There is dryness in the mouth with rapid formation of the ulcers in the mouth and on the inner surface of the cheeks. Very useful for mouth ulcers in infants and babies.


Useful for apthous that appear on the soft palate, within the cheeks and on the edges of the tongue.Useful when the whole mouth is ulcerated with severe pain.There is sticking pains in ulcers like that from a splinter. Given where the mucous membrane gets easily bitten, swollen and ulcerated. There is swollen mucous membrane with ulcerated tender gums.


Useful for apthous that develop with oral thrush.There is dryness of the mouth,lips and tongue.Also there is soreness of the mouth with sensitivity to liquids.Given when there is burning pain when food or liquids touch the ulcer.There is small grouped ulcers on the tongue, gums, and cheeks with burning along with profuse watery saliva from the mouth.