Description

Mouth ulcers are a very common problem and can appear for many reasons. Usually they last only one to two weeks and disappear by themselves, often caused by biting the cheek or damage from tooth brushing or food. Occasionally mouth ulcers last longer or are repeated frequently and can be caused by more serious conditions. If an ulcer remains for more than three weeks or it looks abnormal and causes notable discomfort or pain, it is recommended you see your GP or dentist as soon as possible.

Mouth Ulcers


Mouth ulcers are a very common problem and can appear for many reasons. Usually they last only one to two weeks and disappear by themselves, often caused by biting the cheek or damage from tooth brushing or food. Occasionally mouth ulcers last longer or are repeated frequently and can be caused by more serious conditions. If an ulcer remains for more than three weeks or it looks abnormal and causes notable discomfort or pain, it is recommended you see your GP or dentist as soon as possible.


What are mouth ulcers?


Mouth ulcers are a very common problem and these round or oval sores most often form inside of the cheeks or lips. Occasionally they can appear on the tongue, gums and even on the roof of the mouth. Ulcers are different from cold sores (“herpes simplex”), which are blisters that appear on the outside of the lips or mouth.


Mouth ulcers are usually white, red, yellow or grey in colour, with a red and swollen inflammation around the edge. Depending on the size of the ulcer and the location, they can be very painful and this pain can be irritated by eating, drinking, swallowing or while brushing your teeth. However, they are usually harmless and will heal without the need for any treatment.


What are the causes of mouth ulcers?


In most cases, a mouth ulcer is caused by inadvertently biting the cheek or tongue, or by damage caused by tooth brushing, from eating a sharp piece of food or by poorly fitting dentures. These are known as “traumatic ulcers” and, asides from causing some discomfort, should clear up within a couple of weeks.


Occasionally, ulcers can be a result of “aphthous stomatitis”, a common condition that sees mouth ulcers recurring in repeated bouts. These recurrent ulcers can appear in a cluster of four to six at once, a large ulcer (which could be 10mm or larger) or even up to 100 very small (about 1-2mm across), painful ulcers.


At least 1 in 5 people can develop aphthous mouth ulcers at some stage in their life, but it is not always clear what the cause of them might be.


Although these ulcers are not infectious and can appear for no apparent reason in otherwise healthy people, they can sometimes be related to other factors or diseases. These triggers can include changes in hormone levels, when women may experience ulcers just before their menstrual period, those who have recently quit smoking, as a result of food allergies, or through stress and anxiety. They can also be triggered by certain medication, such as ibuprofen or oral nicotine replacement therapies.


Ulcers may also be a sign that you have a lack of iron, vitamin B12 or folic acid. They may also be a sign of an underlying health condition, including Crohn’s disease, coeliac disease, foot and mouth disease, Behçet's disease, lichen planus or HIV.


Mouth cancer can also first appear as mouth ulcer that does not heal, or as a red or white patch on the tongue, under the tongue or elsewhere in the mouth.


If you have any ulcer that lasts for more than two weeks, if it causes you to feel unwell or the ulcers keep coming back, it is strongly recommended that you see your doctor or dentist.  If you are a smoker or heavy drinker it is particularly important that you seek medical advice to eliminate a link between your mouth ulcers and a potential cancer.


How can I treat mouth ulcers?


Most mouth ulcers will heal with 10-14 days without causing any lasting effects. Which treatment is appropriate depends on the cause. If your ulcer is the result of a sharp tooth or poorly adjusted dentures, you may need to visit a dentist to solve the problem.


In order to ease the symptoms of a mouth ulcer, using an antimicrobial chlorhexidine mouthwash (such as Corsodyl) or steroid lozenges (such as Corlan tablets) may encourage ulcers to heal more quickly. Corticosteroid (which come in forms of mouthwashes and sprays) can help reduce inflammation and the pain associated with ulcers.


The pain of mouth ulcers can also be eased in the short term with painkilling gels, such as Bonjela. If the ulcer is particularly painful, your GP or dentist may be able to prescribe you a form of benzydamine that will help reduce pain and inflammation.


You should always check with a GP or dentist before using any of these treatments for those under the age of 12.


How can I prevent mouth ulcers?


There are a few general measures that you can take to reduce your likelihood of developing mouth ulcers, or at least to reduce aggravating existing ones. This can include a change of diet (avoiding spicy or salty food and acidic drinks), using a soft toothbrush, or avoiding the food or medication (with medical advice) that you think might be triggering the ulcers.


If your mouth ulcers have been brought on by stress, you may want to consider relaxation techniques or exercise. However maintaining good oral hygiene, increasing your intake of vitamins A, C and E, as well as making regular visits to your dentist should help you keep ulcers at bay.


When should I visit a doctor or dentist?


Most mouth ulcers heal on their own within 10-14 days. If you have had a mouth ulcer for more than three weeks, or the ulcer looks abnormal, often bleeds or is excessively painful, it is recommended that you see your GP or dentist.


If you are getting mouth ulcers regularly, you should also seek advice from your doctor or dentist.


You may be referred to the hospital to see a specialist and a blood test or biopsy (cell tissue sample) might be taken to diagnose see what could be causing your symptoms.



During a check-up your dentist will always check for any ulcers or white patches inside your mouth. If these are persistent (lasting more than 14 days) you may be referred to see a specialist in oral medicine.

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