Podcast
Questions and Answers
What are the three main types of Recurrent Aphthous Stomatitis (RAS)?
What are the three main types of Recurrent Aphthous Stomatitis (RAS)?
The three main types of RAS are Minor Aphthous Ulcers, Major Aphthous Ulcers, and Herpetiform Ulcers.
What is a possible trigger for RAS that can be found in toothpaste?
What is a possible trigger for RAS that can be found in toothpaste?
Sodium lauryl sulfate (SLS) is a common toothpaste ingredient that can trigger RAS in some individuals.
What are two common local treatments for minor RAS?
What are two common local treatments for minor RAS?
Saltwater rinses and lidocaine gel are two common local treatments for minor RAS, providing soothing and numbing effects.
What type of medication is often prescribed for moderate to severe RAS?
What type of medication is often prescribed for moderate to severe RAS?
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Besides blood count and haematinic levels, what type of tests might be done to investigate the cause of RAS?
Besides blood count and haematinic levels, what type of tests might be done to investigate the cause of RAS?
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What is a key characteristic of Herpetiform Ulcers that distinguishes them from other types of RAS?
What is a key characteristic of Herpetiform Ulcers that distinguishes them from other types of RAS?
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What systemic medication might be prescribed for severe or non-responsive RAS?
What systemic medication might be prescribed for severe or non-responsive RAS?
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Explain the difference between Major Aphthous Ulcers and Minor Aphthous Ulcers.
Explain the difference between Major Aphthous Ulcers and Minor Aphthous Ulcers.
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What is the difference between treating minor RAS versus moderate to severe RAS?
What is the difference between treating minor RAS versus moderate to severe RAS?
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What are two important things to remember about RAS?
What are two important things to remember about RAS?
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What characterizes Recurrent Aphthous Stomatitis (RAS)?
What characterizes Recurrent Aphthous Stomatitis (RAS)?
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What is the estimated prevalence of RAS in the general population?
What is the estimated prevalence of RAS in the general population?
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List at least two potential nutritional deficiencies that may trigger RAS.
List at least two potential nutritional deficiencies that may trigger RAS.
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What type of factors are believed to contribute to the occurrence of RAS?
What type of factors are believed to contribute to the occurrence of RAS?
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What common trigger related to oral hygiene may lead to RAS outbreaks?
What common trigger related to oral hygiene may lead to RAS outbreaks?
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How is RAS primarily diagnosed?
How is RAS primarily diagnosed?
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Why might smoking cessation be considered a trigger for RAS?
Why might smoking cessation be considered a trigger for RAS?
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What demographic is most likely to be affected by RAS?
What demographic is most likely to be affected by RAS?
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Flashcards
Recurrent Aphthous Stomatitis (RAS)
Recurrent Aphthous Stomatitis (RAS)
A type of mouth ulcer that recurs frequently, typically affecting young adults.
Causes of RAS
Causes of RAS
Can be caused by a variety of factors such as genetics, stress, nutritional deficiencies, and certain foods.
Saltwater Rinses
Saltwater Rinses
Commonly used to help soothe minor RAS ulcers.
Sodium Lauryl Sulfate (SLS)
Sodium Lauryl Sulfate (SLS)
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Minor Aphthous Ulcers
Minor Aphthous Ulcers
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Major Aphthous Ulcers
Major Aphthous Ulcers
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Herpetiform Ulcers
Herpetiform Ulcers
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RAS Management Options
RAS Management Options
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Doxycycline
Doxycycline
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RAS is not contagious
RAS is not contagious
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What is Recurrent Aphthous Stomatitis (RAS)?
What is Recurrent Aphthous Stomatitis (RAS)?
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When does RAS typically start and how common is it?
When does RAS typically start and how common is it?
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What are the main causes of RAS?
What are the main causes of RAS?
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What are some genetic and nutritional factors that influence RAS?
What are some genetic and nutritional factors that influence RAS?
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How do certain gastrointestinal disorders relate to RAS?
How do certain gastrointestinal disorders relate to RAS?
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What are some common triggers for RAS?
What are some common triggers for RAS?
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What are some surprising triggers for RAS?
What are some surprising triggers for RAS?
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How do hormonal changes and food allergies relate to RAS?
How do hormonal changes and food allergies relate to RAS?
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Study Notes
Recurrent Aphthous Stomatitis (RAS)
- Definition: Chronic condition causing painful, round or oval mouth ulcers with a yellow-white center and red halo.
- Prevalence: Affects 10–25% of the population, predominantly healthy non-smokers.
- Onset: Often begins in childhood, recurring throughout life.
Causes of RAS
- Multifactorial: The precise cause is unknown.
- Genetics: HLA types may increase susceptibility.
- Nutritional Deficiencies: Low iron, folic acid, or vitamin B12 may be contributing factors.
- Gastrointestinal Disorders: Conditions like celiac disease and inflammatory bowel disease (IBD) are linked to RAS.
Triggers of RAS
- Stress and Emotional Strain
- Minor Trauma (e.g., chewing, dental procedures).
- Sodium Lauryl Sulfate (SLS) Toothpaste: Especially changes in toothpaste.
- Smoking Cessation: Surprisingly, quitting smoking can be a trigger.
- Hormonal Changes: Occurring during menstruation or pregnancy.
- Food Allergens: Certain foods (e.g., citrus, nuts) can trigger outbreaks.
- Immune Deficiencies: Can increase the likelihood of an outbreak (though less common).
Diagnosis of RAS
- Clinical: Based primarily on patient history and physical examination. Questions asked include:
- Ulcer onset timing (childhood/adolescence)
- Frequency of recurrences
- Recent changes in medications or diet(especially toothpaste).
- Symptoms suggesting GI disorders.
- Testing (severe/persistent): Full Blood Count (FBC), haematins levels, and tests for GI diseases.
Differentiating RAS from Other Conditions
- Behçet's Disease: Includes mouth ulcers and systemic symptoms.
- Inflammatory Bowel Disease (IBD): May involve GI symptoms alongside oral ulcers.
- HIV-related Ulcers: Common in immunocompromised patients.
- MAGIC Syndrome: A rare autoimmune disorder.
Types of RAS
- Minor (most common): Small ulcers (2–7 mm), healing in 7–10 days without scarring.
- Major: Larger than 1 cm, more painful, and lasting longer (> 1 month). Can lead to scarring.
- Herpetiform: Clusters of tiny ulcers (1–2 mm), extremely painful, and may consolidate to form larger, irregular lesions.
Management of RAS
Addressing the Cause:
- Identify and address any triggers (stress, diet, underlying GI issues).
- Consider SLS-free toothpaste.
- Supplement deficiencies of iron, B12, or folate.
Local Symptomatic Relief:
- Saltwater rinses.
- Lidocaine gel (5%).
- Chlorhexidine mouthwash (0.2%).
- Difflam Spray (Benzydamine 0.15%).
Medical Treatment (Severity Dependent):
- Mild: Orabase (protective barrier)
- Moderate-Severe: Topical steroids (e.g., hydrocortisone, betamethasone), or beclometasone inhalers for targeted ulcer treatment.
- Doxycycline (100mg dispersible tablet) for herpetiform ulcers (as a rinse)
- Severe/Non-Responsive: Systemic steroids (e.g., Prednisone). Specialist referral.
Key Takeaways
- RAS is common but not contagious.
- Causes are diverse (genetics, diet, GI issues, lifestyle).
- Stress, trauma, and certain dietary adjustments (like the elimination of SLS toothpaste) can be triggers.
- Diagnosis involves a clinical evaluation and potentially blood tests.
- Treatments vary depending on severity, from home remedies to more extensive medical management.
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Description
Explore the chronic condition known as Recurrent Aphthous Stomatitis (RAS), characterized by painful mouth ulcers. This quiz delves into its prevalence, causes, triggers, and the impact on individuals, particularly focusing on nutritional deficiencies and stress factors. Test your knowledge about this common yet often misunderstood condition.