MANAGEMENT OF MAJOR TYPE RECURRENT APHTHOUS STOMATITIS

Abstract

Background:  Recurrent aphthous stomatitis (RAS) is a commonly found pathologic soft tissue lesion in the oral cavity. Although the specific etiologic factor remains to be understood, predisposing factors of RAS include diet, stress, genetics, and systemic conditions. Management of RAS involves a variety of pharmacological and non-pharmacological alternatives. First-line therapy of pharmacological modalities consists of the application of a topical corticosteroid. Purpose: This case report intends to describe the findings of a major type of RAS and the subsequent management by topical corticosteroid drug application. Case: A female patient 10 years old came to Dental Clinic Puskesmas Winong II with a chief complaint of non-healing oral ulceration after a week without treatment. The ulcer felt very painful and sometimes bleed. Upon subjective examination, it is noted that the patient’s dietary habits consist of high-sodium and high-sugar foods, and a lack of fruits and vegetables. Clinical examination found loss of mucosal integrity in the form of a solitary ulceration on the lower labial mucosa, oval-shaped with a diameter of 15mm, with elevation in the border of the lesion resembling a crater. The lesion appears more erythematous compared to the surrounding healthy tissue, with a clearly defined border. Case management: RAS management in this case was achieved by application of the topical corticosteroid drug triamcinolone acetonide 0,1% in orabase. The chief complaint and clinical condition improved significantly after a week of drug application. Corticosteroid drugs act as anti-inflammatory and immunosuppressant agents. Conclusion: RAS major type management with topical corticosteroid drug successfully reduced pain and accelerated healing time.