Mouth Ulcers

Mouth ulcers are painful, typically small lesions or sores that develop in your mouth or at the base of your gums. They can make eating, drinking, and talking uncomfortable. There are different types of mouth ulcers, including canker sores and those caused by hand, foot, and mouth disease. Mouth ulcers are rarely contagious and usually resolve on their own within 1 to 2 weeks, even without treatment. However, it’s crucial to note that if you develop a mouth ulcer that is large, extremely painful, or persists for a prolonged period without healing, it’s important to seek prompt advice from a doctor or dentist.

What are some misconceptions about mouth ulcers?

Mouth ulcers and cold sores are common oral lesions, but they have distinct characteristics:

Mouth Ulcers:

• Typically appear inside the mouth, such as on the tongue, inside of the cheeks, or gums.
• Not fluid-filled; they are usually small, painful sores with a red or white base.
• Most mouth ulcers are not contagious.

Cold Sores:

• Mainly appear on or around the lips, though they can also spread to the nose or chin.
• Fluid-filled blisters, often grouped together.
• Caused by herpes simplex virus (HSV) and are contagious.
• Can be accompanied by symptoms like fever, fatigue, malaise, and swollen lymph nodes.

What are the causes of mouth ulcers?

There’s no definitive cause behind mouth ulcers, however certain factors and triggers have been identified. Individuals at higher risk include women, children, adolescents, and those with a family history of mouth ulcers.

Common triggers include:

• Minor mouth injury from dental procedures, aggressive brushing, sports accidents, or accidental biting
• Dental braces or other orthodontic appliances
• Use of toothpaste or mouthwash containing sodium lauryl sulfate (SLS)
• Allergic reactions to oral bacteria
• Infections caused by bacteria, viruses, or fungi in the mouth, including conditions like hand, foot, and mouth disease
• Sensitivity to acidic foods and beverages such as strawberries, citrus fruits, pineapple, chocolate, and coffee
• Deficiencies in essential nutrients, particularly vitamin B9 (folate), vitamin B12, zinc, and iron
• Hormonal fluctuations during menstruation or pregnancy
• Emotional stress and inadequate sleep

Additionally, mouth ulcers can signal more serious conditions that require medical attention, such as:

• Celiac disease
• Inflammatory bowel disease (IBD), including ulcerative colitis
• Diabetes
• HIV
• Some autoimmune diseases

What are some symptoms of mouth ulcers?

Symptoms of mouth ulcers can vary depending on their underlying cause, but common signs typically include:

• Painful sores that may appear yellow, white, or red in color.
• Sores located on the inside of the mouth, such as on the tongue, inside of the cheeks, or lips.
• Red areas surrounding the sores.
• Pain that intensifies when eating, drinking, or speaking.

The possibility of having multiple mouth ulcers simultaneously. Generally, mouth ulcers are not contagious unless they stem from an infection like hand, foot, and mouth disease.

What are the types of mouth ulcers?

Canker sores are the most common type of mouth ulcer, with approximately 20% of people experiencing them at least once. There are three primary types of canker sores each with distinct characteristics and healing times, which can help distinguish between them.

• Minor canker sore: Small oval or round ulcers measuring less than 5 millimeters (mm) in diameter. They typically heal within 1 to 2 weeks and do not leave scars.
• Major canker sore: Larger and deeper than minor canker sores, often measuring over 10 mm. They have irregular edges and can take weeks or even months to heal. Major canker sores may result in long-term scarring.
• Herpetiform canker sore: Pinpoint-sized ulcers that occur in clusters, often appearing on the tongue. These clusters may merge to form a single large sore. Herpetiform canker sores also have irregular edges and typically heal within about 1 month without leaving scars. They are named “herpetiform” due to their resemblance to herpes sores, but they are not related to herpes infection.

When do you seek medical attention for mouth ulcers?

Consult a doctor or dentist promptly if you experience any of the following concerning symptoms related to your mouth ulcers:

• Unusually large mouth ulcers
• New mouth ulcers appearing before old ones heal
• Sores that persist for more than 3 weeks
• Painless sores
• Sores that extend to the lips
• Pain that cannot be managed with over-the-counter or natural medications
• Severe difficulties eating and drinking
• High fever or diarrhea coinciding with the appearance of mouth ulcers

Diagnosis of mouth ulcers

Your doctor can diagnose mouth ulcers through a visual examination. If you experience frequent or severe mouth ulcers, your doctor may also test for other underlying medical conditions. Both types of lesions can cause a burning or tingling sensation on the skin that may begin a few days before the lesions appear. However, this sensation is more commonly associated with cold sores. Aphthous ulcers, also known as canker sores, are characterized by small ulcers and are referred to medically as “aphtha.”

What is the treatment for mouth ulcers?

Most mouth ulcers typically resolve on their own without needing treatment. However, if you experience frequent or extremely painful mouth ulcers, there are several treatments and home remedies that can help alleviate pain and speed up healing:

• Applying a paste made from baking soda to the ulcer.
• Using other topical pastes specifically designed for mouth ulcers.
• Applying milk of magnesia directly onto the ulcer.
• Rinsing your mouth with salt water and baking soda solution.
• Using a mouth rinse containing a steroid to reduce pain and swelling.
• Applying ice to the ulcer to numb the area and reduce inflammation.
• Placing a damp tea bag on the ulcer, which may help soothe and promote healing.
• Taking supplements if you have deficiencies in nutrients such as vitamin B9 (folate), vitamin B12, zinc, or iron.
• Using over-the-counter topical products containing benzocaine, such as Orajel or Anbesol, to numb the pain.

How to prevent mouth ulcers?

Here are some tips to help minimize the occurrence of mouth ulcers:

• Avoid foods that can irritate your mouth, such as acidic fruits, nuts, chips, and spicy foods. Opt for whole grains, non-acidic fruits, and vegetables. Maintain a balanced diet and consider taking a daily multivitamin.
• Refrain from talking while chewing to reduce the risk of accidental bites.
• Manage stress levels effectively.
• Maintain good oral hygiene by flossing daily and brushing.
• Use a soft-bristled toothbrush and avoid mouthwashes containing sodium lauryl sulfate (SLS) or alcohol.
• If you use dental or orthodontic devices with sharp edges, ask your dentist for wax to cover them.
• Ensure you get sufficient sleep and rest, which not only helps prevent mouth ulcers but also supports overall health.