What on earth do we have an oral ulcer for? Is this mouthwash really so effective?
Generally speaking, oral ulcer refers to recurrent aphthous ulcer. Recurrent aphthous ulcer is the most common oral mucosal disease in clinic, with a total incidence of 10% ~ 25%.
According to the severity of symptoms, the disease can be divided into three categories.
One is mild aphthous ulcer, accounting for about 80% of all patients. Ulcers are small, few in number and well defined. It is characterized by redness (hyperemia flush zone around 1mm), yellow (yellowish pseudomembrane on the surface), concavity (depression in the center of ulcer) and pain (obvious burning sensation). It usually lasts 1~2 weeks, and it can heal itself even without treatment, but it is easy to relapse.
Severe aphthous ulcers are often single, with a large range and deep degree, with a diameter of 10 ~ 30 mm, which starts at the corners of the mouth and can spread to the back of the mouth, affecting normal speech and swallowing. The attack period can be as long as several months, and there are often systemic symptoms such as low fever and fatigue.
Herpes-like aphthous ulcer, also known as stomatitis aphthous, is small and numerous, reaching dozens. Adjacent ulcers can be fused into pieces, and symptoms such as headache, low fever and general malaise will appear.
As for the etiology, it is traditionally believed that aphtha is related to viral infection, bacterial infection, digestive system diseases and dysfunction, endocrine changes and other factors. The new research of 1 shows that immune and psychological factors may also be the predisposing factors of aphthous ulcer.
Some scholars have tested the cellular immune function of patients, and found that their immune cells such as T cells and NK cells are significantly lower than those of the control group, and their proliferation ability, secretion ability and surface receptor expression are also significantly lower than those of normal people. This suggests that the decline of immune function may not be the result of recurrent aphthous ulcer, but the cause. 2
For another example, some scholars used EPQ scale to test patients' personality, and the results showed that patients with recurrent aphthous ulcer generally had the characteristics of emotional instability. The SCL-90 scale test shows that the scores of interpersonal sensitivity, depression, communication and hostility of patients are obviously increased, suggesting that patients have obvious emotional disorders and their psychological state is worse than that of normal people. three
Generally speaking, although some progress has been made in the etiological study of recurrent aphthous ulcer, the exact pathogenic factors are still unclear. Therefore, the clinical treatment of recurrent aphthous ulcer has been paid attention to. According to the symptoms of patients, we should flexibly choose between anti-inflammatory drugs, painkillers, glucocorticoids, immune enhancers and psychological intervention, so as to cure patients as soon as possible and reduce recurrence.
The main components of compound chlorhexidine gargle are chlorhexidine, metronidazole and concentrated mint water.
Chlorhexidine is a disinfectant, which has quite strong broad-spectrum antibacterial and bactericidal effects. It is a good bactericide with few local irritation and allergic reactions. It is clinically used to treat chronic gingivitis and aphtha.
Nitro group in metronidazole is reduced to amino group in anaerobic environment, which plays an anti-anaerobic role and has good antibacterial effect on some eubacteria, digestive cocci and digestive streptococci.
Mint water has a fragrant smell, which can act on the skin and mucous membrane, produce a cool feeling, make the surface blood vessels contract, thus relieving discomfort and pain, and also promote blood vessel circulation, diminish inflammation and relieve itching. four
According to its composition, compound chlorhexidine gargle can relieve the symptoms of recurrent aphthous ulcer to some extent; As a second-class over-the-counter drug, its safety is relatively guaranteed.
Nevertheless, as mentioned above, the etiology of recurrent aphthous ulcer is complicated, and the emphasis is on symptomatic treatment, which may not be effective at 100%. In addition, if multiple mouthwashes are used at the same time, pay attention to the interval for a period of time to avoid possible drug cross-reactions.
Truth: There are many reasons for oral ulcers. Sterile mouthwash cannot guarantee that 100% is effective.
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refer to
1 Wang, Dai. Etiological status of recurrent oral ulcer [J]. Inner Mongolia Medical Journal, 200 1, 23 (2): 136- 138.
2 Sun, Yu Guangyuan, et al. Study on cellular immune function of patients with recurrent oral ulcer [J]. China Journal of Immunology, 200 1, 17(6): 332-333.
3 Chang, Ni Junzhi. Analysis of psychological related factors in patients with recurrent oral ulcer [J]. Stomatology, 2005,25 (4): 226-227.
4- Xiang Xiang, Ma Yunling, Pan Qingzhuan, et al. Clinical observation on oral care of compound chlorhexidine gargle [J]. Journal of Practical Medical Technology, 2006, 13(23): 4285-4286.
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Author: Zhao Yanchang