Mouth ulcers, also known as canker sores, are painful sores that can occur on the tongue, inside of lips or cheeks or anywhere inside the mouth.
Symptoms of a mouth ulcer include:
One or more painful sores on different parts of the mucosal lining the mouth.
Swelling skin around the sores.
Pain when chewing or tooth brushing because of inflammation.
Irritation of the sores by salty, spicy or sour foods.
Loss of appetite.
Recurring aphthous ulcers generally occur on the softer mouth lining of the lips, cheeks, sides of the tongue, floor of the mouth, back of the roof of the mouth and around the tonsil area. These ulcers, which normally appear yellowish white, are usually no larger than 5mm. More than one aphthous ulcer may develop at a time, and sometimes these ulcers are joined together. Aphthous ulceration affects about 20% of the population.
Common causes of mouth ulcers
The most common cause is injury from accidental biting the inside of cheeks or tongue, or constant rubbing from dentures, braces, sharp teeth etc. A diet comprising of excessive “heaty” foods such as deep-fried foods, durian, red meat, chocolate, nuts, and spicy foods may also lead to mouth ulcers. These acute mouth ulcers would normally heal by itself within 1-2 weeks.
Other causes of mouth ulcers may be due to certain medications, skin rashes in the mouth, viral, bacterial and fungal infections, autoimmune diseases, chemicals, deficiency in Vitamin B, folate or iron or some medical conditions such as gastrointestinal diseases, mouth cancer. Mouth ulcers of such nature may occur frequently until the root cause is treated.
When do you need to seek medical attention for mouth ulcers?
See your dentist or doctor if your mouth ulcers do not clear up within two weeks, or if you get them frequently. It is important not to ignore an ulcer that you have had for more than two weeks, especially if you use tobacco products and drink alcohol regularly. This is because tobacco use and drinking alcohol increase your risk of mouth cancer.
Treating mouth ulcers
While most ulcers heal by itself within 1-2 weeks, you may also try some home remedies that will help in the healing process:
Avoid spicy, sour, “heaty” foods until the ulcers heal.
Drink plenty of fluids.
Keep your mouth clean.
Apply topical oral gel/ paste to the ulcers.
Regularly rinse your mouth out with warm salt water, holding it in your mouth for up to 5 minutes at a time
Recurring mouth ulcers or aphthous ulcers may require medical attention. Common treatments include:
Use antiseptic (such as chlorhexidine gluconate) mouthwash two times a day
Use a topical steroid gel, mouthwash or paste.
In severe cases, immunosuppressants may be prescribed by your oral health professional.
If the ulcers do not respond to the normal treatments prescribed by your medical or oral health professional, you may need to consult an oral health specialist trained in oral pathology, oral medicine and oral surgery to have a biopsy done for the ulcer. A biopsy is a procedure where a tissue sample is taken for examination under microscope and diagnosis.
Preventing mouth ulcers
Mouth ulcers can be avoided in some cases by brushing your teeth with gentle brush strokes with a soft toothbrush, eating a well-balanced and nutritious diet and/ or making sure that underlying medical conditions are diagnosed and well-controlled.
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