Digestive System

Updated On: October 07, 2021

What Causes Mouth Ulcers and How to Treat Them?

Written By: Dr. Ahmed Kamal Hussein El Sayed

Dr. Ahmed Kamal Hussein El Sayed completed his B.Sc. degree in oral & dental medicine from the well-known Cairo University in Egypt.

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What is a Mouth Ulcer?

Mouth ulcers are sores that occur due to erosion of the delicate lining of the mouth. They usually appear on & under the tongue & inside of lips & cheeks. They can also appear on the roof of the mouth, but this is unusual. Mouth ulcers can form due to one of several factors, including:

  • Accidental biting while chewing food
  • Poor oral hygiene
  • Dry mouth
  • Cigarette smoking & tobacco chewing
  • Vitamin B-12 deficiency
  • Intestinal problems like acid reflux
  • Spicy & acidic food
  • Extremely hot beverages or food
  • Alcoholic beverages

They are common & uncomfortable but should be cleared up on their own within one to two weeks.  A variety of mouth ulcer treatment brands are available in pharmacy to soothe irritation, as well as natural mouth ulcer remedies. More than one ulcer can appear depending on the case, & they vary in size. If its continuous or recurrent mouth ulcers therefore it might be a signal to another condition or cause that should be investigated by a dentist or doctor.

Symptoms of Mouth Ulcers

Everyone will experience a mouth ulcer at some point, if not several times in their life. Mouth ulcers usually make themselves known when chewing food, speaking or while brushing the teeth. The most common areas are at the soft mouth lining, such as inside the cheeks, lips, on the side of the tongue & some times in the palate areas. Mouth ulcers tend to be elliptical or circular. They are white, yellow, grey or red in colour & inflamed around the edges. They are not contagious & should not be confusing with cold sores, which appear on the mouth & often begin with a tingling or burning sensation.

Mouth ulcer symptoms usually include:

  • Pain or tenderness.
  • One or more painful sores.
  • Irritation by sour, salty or spicy food.
  • Swollen skin around the sores.
  • Problems with chewing or tooth brushing.

Diagnosis: When to see a doctor about Mouth Ulcers

A visit to a doctor or dentist should be scheduled if you get mouth ulcers frequently & they are interfering with your quality of life. Likewise, if mouth ulcers become more red & painful, or if they do not clear up after 14 days & last longer than three weeks you should consult a dentist or doctor. (This is especially important if you use tobacco products & drink alcohol regularly). A doctor or dentist may prescribe a stronger medication to treat severe, recurrent or infected mouth ulcers. In some cases, they may take blood tests to detect an underlying deficiency or an inflammatory condition. If the ulcer didn’t respond to the prescribed medications & mouth remedies for more than 2 weeks, then a biopsy of ulcer & the surrounding tissue may be required for examination & diagnosis.

Persistent mouth ulcers could signify:

  • An infection
  • Oral cancer
  • Underlying gastrointestinal illness such as coeliac or Crohn's disease
  • Autoimmune diseases
  • Vitamin or iron deficiency

Cause of Mouth Ulcers

All of us will suffer from at least one at some point, & seemingly out of nowhere. But what causes mouth ulcers? They can come along at any time &, although mostly small, they often cause significant irritation & considerable discomfort despite their size. That said, the mouth is a busy place, so an ulcer can prove troublesome & painful every time we eat, drink or speak. Mouth ulcers can be triggered by a wound in the mouth that is slow to heal, hot food, irritants in the mouth, smoking & more. Single mouth ulcers are often caused by actions or habits that we can usually prevent through some simple changes. These can include taking a little more care in our oral hygiene routine, being more patient when chewing food, avoiding a certain brand of mouthwash, or simply staying clear of sharp snacks, such as crisps.

Causes of mouth ulcer can include:

  • Biting the tongue or cheek, usually while eating.
  • Ill-fitting braces or dentures.
  • A fractured tooth or rough fillings.
  • Irritation from toothpaste or mouthwash.
  • Cuts or burns from hot beverages.
  • Food intolerance or allergies that include medication.
  • Stress, anxiety or tiredness.
  • Poor oral hygiene.
  • Nutritional deficiencies, including iron or vitamin B12.
  • Hormonal changes during pregnancy.
  • Family genetics.
  • Skin rashes such as Lichen Planus.
  • Longer-term conditions, including inflammatory bowel disease, Behçet's disease or coeliac disease.

Mouth Ulcer Complications

While most mouth ulcers are simply irritating & sometimes cause sharp pain, they are also usually harmless & heal on their own, untreated. Recurring or frequent mouth ulcers can be more of an issue, not least with regards to going about daily life routines, such as eating & speaking.

Mouth Ulcer Treatment

The majority of mouth ulcers will tend to clear up by themselves within 14 days. It is not generally considered that you can speed up recovery. Certain types of mouth ulcers, such as aphthous ulcers or those caused by herpes simplex infection, require topical treatment that includes mouthwash, ointment or gel. In case of sharp & rough fillings & ill-fitting dentures a visit to the dentist is a must to remove the cause of the recurrence. Mouth ulcer treatments often involve good sense - such as avoiding what you think may have caused your mouth ulcer in the first place & occasionally necessitate medical advice. Usually, a visit to a reputable pharmacist will source you a tube of antiseptic gel or a beneficial brand of mouthwash that will ease the discomfort, or prevent a delay in the mouth ulcer healing.

Mouth ulcer treatments to consider include:

  • Applying antiseptic gel.
  • Drinking plenty of non-acidic fluids.
  • Rinsing the mouth with warm, slightly salted water.
  • Using an alcohol-free medicated mouthwash twice daily, preferably containing chlorhexidine gluconate.
  • A topical, usually prescribed, steroid mouthwash or ointment.

Mouth Ulcer Prevention

A mouth ulcer can occur at any time & without warning. & while you may not be able to confirm the reason for a current mouth ulcer appearing, there are a number of known potential causes. With these in mind, there are several actions you can take to either prevent further irritation or inflammation of an existing mouth ulcer. By perhaps changing simple things in your routine such as replacing a toothbrush, avoiding hard or sharp foodstuffs like toast or potato crisps, & maybe not chewing gum, you can reduce the chances of other mouth ulcers forming in the future.

8 tips to prevent mouth ulcers:

  • Taking cool drinks through a straw.
  • Consuming softer foods.
  • Using a soft-bristled toothbrush.
  • Eating a healthy, balanced diet.
  • Cutting out salty, spicy, sour, or acidic food.
  • Not chewing gum.
  • Using toothpaste varieties that do not contain sodium lauryl sulphate.
  • Keeping clear of very hot beverages, fruit juice, & other acidic drinks.

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