Clinical Terminology for Canker Sores at the Gum Line
The clinical name for canker sores is recurrent aphthous ulcers (RAU) or recurrent aphthous stomatitis (RAS), regardless of their location in the mouth. 1, 2, 3
Key Terminology
The terms "canker sores" and "aphthous ulcers" refer to the same clinical entity, with recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU) being the formal medical terminology 1, 2, 4
These ulcers appear as well-demarcated, oval or round lesions with a white or yellow pseudomembrane surrounded by an erythematous (red) halo 5, 6
When aphthous ulcers occur at the gum line specifically, they are still called recurrent aphthous ulcers, though their location on attached gingival tissue is somewhat atypical 3
Important Clinical Distinction
A critical diagnostic feature is that true aphthous ulcers typically occur on unattached (non-keratinized) oral mucosa such as the inside of lips, cheeks, tongue, and soft palate 2, 3
Ulcers appearing on the gum line (attached gingiva) should raise suspicion for alternative diagnoses, as this keratinized tissue is not the typical location for classic aphthous ulcers 3
The primary differential diagnosis for ulcers at the gum line includes herpes simplex virus infection, which preferentially affects keratinized mucosa (gums, hard palate) rather than non-keratinized surfaces 1
Clinical Classification
Minor aphthous ulcers represent 80-90% of all cases and are the most common subtype 3
Major aphthous ulcers and herpetiform variants comprise the remaining subtypes based on size and number of lesions 2, 3
The condition affects 10-25% of the general population with three-month recurrence rates as high as 50% 2, 4