What could be a food lover’s second greatest fear? Yes. Mouth ulcers. Otherwise known as canker sores, they are painful round or oval sores that form in the mouth, often on the inside of the cheeks. Mouth ulcers could be painful, annoying, and embarrassing. Although mouth ulcers can be uncomfortable, especially when you eat, drink or brush your teeth, they are harmless.
Most mouth ulcers clear up by themselves within a couple of weeks. You only need to see a doctor if the ulcer gets worse or lasts for longer than three weeks.
Mouth ulcers, also known as aphthous ulcers, are small shallow ulcers that appear in the mouth and often make eating and talking uncomfortable. They are very common, with around one in five adults and 5%-10% of children.
Simple mouth ulcers may appear 3 or 4 times a year and last up to a week. They typically occur in people between 10 and 20 years of age. Complex mouth ulcers are less common and occur more often in people who have previously had them.
What causes mouth ulcers?
The exact cause of most mouth ulcers is unknown. Stress or tissue injury is thought to be the cause of simple mouth ulcers. Certain foods, including citrus or acidic fruits and vegetables (such as lemons, oranges, pineapples, apples, figs, tomatoes, and strawberries), can trigger a mouth ulcer or make the problem worse. Sometimes a sharp tooth surface or dental appliance such as braces or ill-fitting dentures, might also trigger mouth ulcers.
Some cases of complex mouth ulcers are caused by an underlying health condition, such as an impaired immune system; nutritional problems, such as vitamin B-12, zinc, folic acid, or iron deficiency and gastrointestinal tract disease, such as celiac disease and Crohn’s disease.
When you first quit smoking, you may develop more mouth ulcers than normal, but this is temporary. Some medications, including common pain killers, beta-blockers and some chest pain medicines may cause a reaction that leads to mouth ulcers. Accidental bites in the mouth or any other form of oral trauma is likely to result in mouth ulcers. But ulcers could also be a reason of vitamin deficiency; nutritional deficiencies such as those of iron, vitamin B 12 and/or vitamin C could cause mouth ulcers.
Mouth ulcers can also be caused by a wide range of factors including:
- Injury from a toothbrush (such as slipping while brushing)
- Constant rubbing against misaligned or sharp teeth
- Constant rubbing against dentures or braces
- Poor oral hygiene
- Burns from eating hot food
- Irritation from strong antiseptics, such as a mouthwash
- Oral thrush infection
- Herpes simplex viral infection (cold sore)
- Reaction to certain drugs, such as chemotherapeutic agents
- Autoimmune diseases (for example, lichen planus)
- Syphilis infection
- A range of other infections including hand-foot-mouth syndrome
- Certain diseases including tuberculosis, AIDS, diabetes mellitus and inflammatory bowel disease
- Cancer of the lip.
Symptoms of Mouth Ulcers
The symptoms of a mouth ulcer depend on the cause, but may include:
- A round sore or sores inside the mouth
- Swollen skin around the sores
- Problems with chewing or brushing teeth because of the tenderness
- Irritation of the sores by salty, spicy or sour foods
- Loss of appetite
- Complications of mouth ulcers
Untreated, mouth ulcers can occasionally lead to complications, including bacterial infection, inflammation of the mouth (cellulitis), tooth abscess.
Diagnosis of Mouth Ulcers
It is important to establish the cause of the mouth ulcers. Some of the investigations may include:
Physical examination – Mouth ulcers look different depending on their cause. For example, if the ulcer is large and yellow, it was most likely caused by trauma. Cold sores inside the mouth tend to be very numerous and spread around the gums, tongue, throat, and inside of the cheeks. A fever also suggests the ulcers may be caused by a herpes simplex infection.
Blood tests – Check for signs of infection.
Skin biopsy – A small tag of tissue from the ulcer is taken and examined in a laboratory.
Tips for Management
- Avoid spicy and sour foods until the ulcers heal.
- Drink plenty of fluids.
- Regularly rinse your mouth out with warm, slightly salted water.
- Keep your mouth clean.
- Use a medicated mouthwash.
- Brush your teeth at least twice every day.
- Floss regularly.
- Visit your dentist regularly.
- Brush your teeth very gently, taking care not to slip with the brush.
- Eat a well-balanced and nutritious diet.
- Chew 4 to 5 leaves of holy basil (tulsi) and drink water.
- Boil fenugreek (methi) leaves in some water. Take out the leaves and gargle the mouth with this water two to three times a day.
- Eating raw tomatoes is another remedy for ulcers. Also, gargle using tomato juice.
- Mix a pinch of turmeric along with a teaspoon of glycerin. Apply this paste on the sores.
- Take some coconut milk and gently massage the mouth ulcers.
- Gargle with mouthwash every day before bedtime and preferably after lunch and dinner. It will not only prevent formation of mouth ulcers but also bad breath.
- Apply toothpaste over the sores to treat them.
- Avoid drinking hot liquids like tea, coffee and avoid oily, spicy food. This will only aggravate the condition of the mouth ulcers.
- Consume a diet that is rich in calcium and vitamin C, for e.g., foods like yogurt, milk, cottage cheese and orange juice.
- Avoid eating non-vegetarian foods as they increase the level of acidity in the body.
- Apply a paste of baking soda with water on the sores.
- Eat raw salad with lots of onion, this will make the ulcer disappear.
- Use plain yogurt.
- Make a paste of Indian gooseberry and apply it on the sores directly. Repeat this process at least twice a day.
- Coconut milk is a good medicine for ulcers. Extract milk by grating fresh coconut. Now gargle with this for about four times a day.
- Gargle with one glass of cold chilled water and one glass of lukewarm water alternatively. This process will cure the mouth ulcer.
- Take at least two tablespoons of aloe vera gel thrice daily for quick results.
- Eat banana with curds first thing in the morning for better results.
[sws_green_box box_size=”600″] Article by,
Dr. NS Rajesh Kumar, BHMS, CFN MSc (DFSM)