Mouth ulcers
Mouth ulcers are an extremely common type of sore found in the mouth, usually on the inside of your lips, your tongue, inside the cheek, or on the sides of your gums.
They can be of various sizes and are often uncomfortable. Most ulcers are harmless and resolve themselves without any treatment. Around 20% of people experience recurrent mouth ulcers, also known as aphthous ulcers. Recurrent ulcers or ulcers that don’t heal may require treatment and could be a sign of an underlying health condition.
Mouth ulcers are not contagious and are sometimes referred to as canker sores.
Types of mouth ulcers:
Minor - Minor ulcers are between 2mm and 8mm across and usually take up to two weeks to heal. They usually only cause minor pain.
Major - These mouth ulcers are larger than 8mm in diameter and the lesions can be raised, deep and irregular in shape. They may also take up to six weeks to heal and may leave some scarring.
Herpetiform ulcers (HU)- These are a subtype of aphthous ulcers which appear as very small or pinpoint mouth ulcers in clusters of 10 – 100. They get their name as they resemble the sores associated with herpes. However, they are not infectious.
They most commonly occur in adults and resolve themselves within a few weeks. They don’t usually leave a scar.
What are the symptoms of mouth ulcers?
Ulcers can be painful when eating, drinking and brushing your teeth. Poor oral hygiene can often make the pain worse. The exact symptoms of the mouth ulcer will depend on what type of ulcer a person has.
Symptoms of minor and major ulcers may include:
one or more sores on the inside of your cheeks, the roof of your mouth, gums or tongue
round lesions with red edges that are yellow, grey or white in the middle
fever, sluggishness or swollen glands, if the outbreak is extreme
Signs of HU may include:
mouth lesions that are extremely painful and can appear anywhere in the mouth
ulcers that recur quickly which gives the impression that the infection is continuous
ulcers that increase in size to eventually form one large ulcer
lesions that take more than 10 days to heal
What causes mouth ulcers?
While there is no one specific cause for mouth ulcers, there are certain factors that can lead to their development, which include:
biting the inside of your cheek
injury or trauma to the mouth, including slipping with your toothbrush when brushing your teeth
rubbing against braces or dental apparatus
rubbing against broken or misaligned teeth
burns from hot food
spicy or acidic foods
sensitivity to toothpaste or mouth wash
reactions to medications such as pain relief or beta-blockers
deficiency in vitamins B-12, folate, iron, and zinc
hormonal changes such as those during puberty, pregnancy and menopause
stress, anxiety or extreme fatigue
skin rashes in the mouth, such as lichen planus
other bacterial, fungus or viral infections, including the herpes simplex viral infection (cold sores)
Mouth ulcers can also be the sign of underlying health conditions, including:
coeliac disease
Crohn’s disease
inflammatory bowel disease
HIV/AIDS
diabetes
Behcet’s disease
oral cancer
What are the complications of mouth ulcers?
Most mouth ulcers heal on their own and only cause temporary pain or difficulty while eating and drinking. However, some ulcers may heal with scarring, while others can lead to bacterial infections, or even increase the risk of developing oral cancer.10
How to treat and heal mouth ulcers
Most mouth ulcers will usually heal on their own within 10 to 14 days, and won’t require any treatment, although over-the-counter (OTC) pain relief medication or an anaesthetic mouth gel may be needed to relieve pain. Your MediADVICE pharmacist will be able to advise you on what products may be suitable.
However, recurrent ulcers or those caused by the herpes simplex infection may require a topical treatment such as a mouthwash, ointment or gel. In severe cases, it may be necessary for immunosuppressant medication.
To help heal ulcers, we suggest the following:
avoid touching the ulcer where possible and if you have to, make sure you wash your hands before and after
use a soft toothbrush when cleaning your teeth, or mouthwash if ulcers are too painful for a toothbrush
rinse your mouth with salt water (one teaspoon to one cup of water) several times a day, holding the water in your mouth for two minutes and then spitting out
eat soft food
avoid acidic or spicy foods
drink through a straw
drink cool water to ease pain
take over-the-counter (OTC) pain relief medication, when needed
To help heal ulcers, we suggest the following:
avoid touching the ulcer where possible and if you have to, make sure you wash your hands before and after
use a soft toothbrush when cleaning your teeth, or mouthwash if ulcers are too painful for a toothbrush
rinse your mouth with salt water (one teaspoon to one cup of water) several times a day, holding the water in your mouth for two minutes and then spitting out
eat soft food
avoid acidic or spicy foods
drink through a straw
drink cool water to ease pain
take over-the-counter (OTC) pain relief medication, when needed
When should you see your doctor for mouth ulcers?
If your mouth ulcers do not heal within two weeks, or they interfere with your daily living you should see your doctor. You should also seek medical advice if you experience any of the following:
mouth ulcers that extend to your lips
unusually large ulcers
painless ulcers
painful ulcers that can’t be managed with OTC pain medication
new ulcers appear before the old ones have healed
problems eating or drinking
weight loss
high fever and diarrhea
Your local MediADVICE pharmacist is available to help you manage your health. Speak to your MediADVICE pharmacist about your mouth ulcers so we can recommend products and medications that may be suitable for you.
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Disclaimer
General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.
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