Aphthous stomatitis, commonly known as “thrush on the tongue,” is a disease where a shallow ulcer is formed in the mouth.

Despite an unknown etiology, its occurrence is reportedly associated with the involvement of factors such as viral infection, bacterial infection, malnutrition, immune disorder, stress, trauma, generic factors, hormonal imbalance and other systemic diseases. It is therefore probable that the accumulated fatigue during summer might be one of the causative factors of common mouth ulcers.
When we have thrush on the tongue, we can experience discomfort due to a mild fever and abnormal sensation. We may also be presented with symptoms like malaise and decreased appetite. If we have formed the ulcer arising from thrush on the tongue, we’ll experience severe pain, deglutition disorder (the difficulty in swallowing food) and expressive language disorder (phonation difficulty). But if we have a disease of viral origin, we’ll present with more severe systemic symptoms. 

Viruses that can cause mouth ulcers include herpes simplex virus, cytomegalovirus, varicella zoster virus and Epstein-Barr virus. Causative bacterial strains include Streptococcus.

Natural healing should be promoted and the symptoms should be alleviated to treat ulcers. Good oral hygiene can be maintained by the frequent use of mouthwash. This can also be accompanied by a topical steroid application (e.g., Oramedi). Additional options include chemical cauterization and mucosal protective agents. In severe cases, systemic steroid therapy should be used.

Herpes is an infection caused by the reactivation of the herpes simplex virus by factors as UV light, stress, fever, upper respiratory tract infections, menstruation, pregnancy and immune disorder following the re-activation of latent herpes simplex virus. It might also be brought back by accumulated fatigue during summer.

Because thrush on the tongue is not necessarily caused by a virus, it is unclear whether an ulcer can be transmitted by kissing. But with herpes, the blisters contain the virus and it is thought that herpes can be transmitted by kissing.

Herpes can be treated in a similar manner to mouth ulcers. But this should be accompanied by the additional use of antiviral agents. It is important to maintain good oral hygiene as a preventive measure, for which we should use mouthwash several times a day and brush teeth frequently.

To prevent a recurrence of herpes, it is important to take in sufficient nutrients and pay special attention to avoiding fatigue and stress. If we have other systemic diseases, we should take the appropriate treatments prior to the onset of disease.

By Jeong Han-sin

The author is an associate professor of Otorhinolaryngology ― Head and Neck Surgery at Sungkyunkwan University School of Medicine and doctor at Samsung Medical Center. ― Ed.