Anant Ghelani asked if I could put this letter up, it was published in the British Dental Journal, Letters page, issue 6, from September 28, 2002, with regards to Aphthous mouth ulcers and carton orange juice. He and his colleagues are researching a possible link between ulcers and ingredients/chemicals to be found in carton orange juice - rather like yours truly, he is in search of funding for his project.

Aphthous ulcers and carton orange juice, a possible link?

Many of us have had the displeasure being afflicted by Aphthous ulcers, which are a common form of mouth ulcers. These ulcers are painful white or yellow sores (ulcers) surrounded by a bright red area. They may occur at any age and usually first appear between the ages of 10 and 40 years (Reichart, 2000 1) in either sex.

Although some of the suggested causes of aphthous ulcers have been a genetic predisposition (Pavelic et al 1998 2), link with natural immunity, mouth injury following dental procedures or aggressive tooth cleaning, when the tongue or cheek is bitten, stress, dietary deficiencies such as iron, folic acid, or vitamin B12, menstrual periods, hormonal changes, food allergies and drug treatment (Boulinguez et al, 2000 3) there have been no suggested preventive measures. Our personal observations over a period covering the last twenty years suggest that there may be a link between the consumption of carton orange juice and aphthous ulcers. We have observed thirty-six subjects of either sex between the age of 18 to 73 years who had recurrent aphthous ulcers. All consumed a quantity of orange juice daily. On being asked to refrain from further orange juice consumption, ulcers resolved in all subjects between one to five days without the use of any medication. Interestingly, the relapse occurred only on the resumption of the use of carton orange juice. Equally, no ulcers occurred on eating fresh oranges, Halib-orange tablets or drinking freshly prepared fruit juice.

Our observations suggests that there may be a link between the aphthous ulcer formation and consumption of carton orange juice, either due to a direct causal link or indirect aggravation of the buccal mucosa in predisposed subjects. The causative agent in the carton orange juice (Anonymous, 2000 4) is not known. Therefore, it would be interesting known if any other readers have made this observation.

Anant Ghelani,  Sarabjit Mastana - Loughborough University
Ash Samanta - Leicester Royal Infirmary, UK.

References

1. Reichart PA. Oral mucosal lesions in a representative cross-sectional study of aging Germans. Community Dent Oral Epidemiol 2000; 28(5):390-8.

2. Pavelic J, Gall-Troselj K, Mravak-Stipetic M, Pavelic K. The p53 and nm23-H1 genes are not deleted in oral benign epithelial lesions. Anticancer Res 1998; 18(5A):3527-31.

3. Boulinguez S, Reix S, Bedane C, Debrock C, Bouyssou-Gauthier ML, Sparsa A, et al. Role of drug exposure in aphthous ulcers: a case-control study. Br J Dermatol 2000; 143(6):1261-5.

4. ANONYMOUS. Citrus: It Only Begins with C. University of California at Berkeley Wellness Letter 2000; 17(1):1-2.

Mr. A. Ghelani,
Department of Human Sciences,
Human Genetics Laboratory,
Loughborough University,
Loughborough,
LE11 3TU

e-mail: A.Ghelani2@lboro.ac.uk

Fax: +44 (0) 01509 223941
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