Deshmane Pranav*, Jadhav Siddharth, Wavhal Vinayak, Datkhile Sachin, Lokhande Rahul

Mouth ulcers, also known as aphthous stomatitis, are common, painful lesions that affect the mucosal surfaces of the oral cavity. Their pathophysiology is complex, involving genetic, immunological, and environmental factors. Although the exact cause remains unclear, dysregulation of the immune system plays a central role. Inflammatory responses are triggered by the activation of T lymphocytes, which lead to the release of cytokines, resulting in epithelial cell damage and ulcer formation. Genetic predisposition, stress, trauma, nutritional deficiencies (especially of B vitamins, folic acid, and iron), and microbial factors have all been implicated as contributing factors. The local tissue response is characterized by an imbalance between pro-inflammatory and anti-inflammatory mediators, with the upregulation of cytokines such as interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ). This results in increased vascular permeability, edema, and neutrophil infiltration, which further exacerbate the lesion. Treatment strategies often focus on symptomatic relief, while ongoing research aims to elucidate the precise molecular mechanisms involved to develop more targeted therapies. Understanding the pathophysiology of mouth ulcers is critical for improving treatment outcomes and minimizing recurrence.Treatment options include over-the-counter pain relievers, topical medications, and avoiding irritants. In most cases, mouth ulcers will heal on their own within a week or two. However, if they persist or are accompanied by other symptoms, it is important to seek medical attention. The diagnosis and treatment of oral lesions are often challenging due to the clinician’s limited exposure to the conditions that may cause the lesions and their similar appearances. This review aims at a systematic approach towards the diagnosis of oral ulcers based on their clinical and histopathological features while eliminating unrelated factors. Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases characterized by recurrent and painful ulcerations on the movable or nonkeratinized oral mucosae. Clinically, three types of RAS, namely minor, major, and herpetiform types, can be identified. RAS more commonly affects labial mucosa, buccal mucosa, and tongue. Previous studies indicate that RAS is a multifactorial T cell-mediated immune-dysregulated disease.