Mouth Ulcers : Symptoms, Causes, Diagnosis and Treatments

September 6, 2018

Table of Content

Overview and Statistics
Types and Symptoms
Risk Factors For Mouth Ulcers
Do I have Mouth Ulcers?
Causes and Prevention of Mouth Ulcers
Diagnosis and Tests for Mouth Ulcers
Treatment and Care for Mouth Ulcers
OTC or Self-management of Mouth Ulcers
Natural Ways to Cure Mouth Ulcers
Health Tip by Experts

Overview and Statistics:

Mouth ulcers or aphthous ulcers are commonly called canker sores. These are generally small and painful lesions that develop at the base of your gums or in your mouth. Mouth ulcers are relatively common and may clear up without any treatment within one to two weeks. They are rarely a symptoms of a serious health condition but might become a bit uncomfortable to live with. Mouth ulcers can cause difficulties in drinking, eating and even talking. Females, adolescents, and people who have a family history of mouth ulcers have a higher risk for developing these ulcers.

Mouth ulcers are not contagious and usually resolve within two weeks. However, if you have developed a canker sore that is relatively large or extremely painful, or one that lasts for a longer time, you must seek medical attention

Mouth ulcers vary in size and the symptoms primarily depend upon what type of mouth ulcer you have developed.

Oral ulceration is indeed a common complaint in the medical centers and hospitals. The estimated prevalence of oral ulcers globally is 4%, while aphthous, ulcers affect as many as 25% of the worldwide population ^[1].

Types and Symptoms:

Standard mouth ulcers generally appear on an individual’s inner cheeks and may last for around 1 week. Most of these mouth ulcers are harmless and resolve without any medical intervention.

Mouth ulcers or canker sores can be further classified into three main types. These types are:

1. Herpetiform Ulcers (HU):

Herpetiform ulcers are usually a subset of aphthous ulcers. These ulcers resemble sores associated with herpes and thus are called herpetiform ulcers. These are not contagious. These ulcers may recur rather quickly, and it might apparently feel that this condition never improves.

Herpetiform ulcers are just a pinpoint size and occur in clusters containing 10 to 100. These ulcers usually affect adults only. Herpetiform ulcers have irregular edges and normally heal without leaving any scars, in one to two weeks.

2. Minor Ulcers :

Minor ulcer size can be between 2 millimeters (mm) to around 8 mm. These types of ulcers generally take two weeks to improve and may cause only minor pain. Minor ulcers are generally small, oval or round ulcers that heal within one to two weeks with no scarring.

3. Major Ulcers :

Major ulcers are generally bigger than the minor ulcers. These ulcers are usually irregular in shape, might appeared raised, and may penetrate deeper into the tissues. These ulcers may take several weeks to resolve and might leave a scar tissue when they resolve. And, this could be a long-term scarring.

With this let’s learn the signs and symptoms of mouth ulcers.

Signs And Symptoms of Mouth Ulcers :

Ulcers could be mildly painful and the pain might aggravate by eating, drinking, and a poor oral hygiene. The general signs and symptoms of mouth ulcers are as follows:

Herpetiform Ulcers might:

be extremely painful ulcers in your mouth
recur rather quickly, so the infection seems continuous
get enlarged in size, eventually they come together to form a larger, ragged mouth ulcer
take around 10 to 14 days to heal
appear anywhere in your mouth

These ulcers are more observed in the females than males and are much more common in the older adults.

Symptoms of major and minor ulcers include:

one or more sores that might appear on your cheeks, roof of your mouth, or tongue
round lesions with red edges and can be white, yellow or gray in the middle

During more severe outbreaks of canker sores, few people may also experience sluggishness, fever and swollen glands.

You must immediately see your doctor if you observe any of the following signs:

relatively large mouth ulcers
newer canker sores before the older sores heal
sores that have been there for more than three weeks
sores which don’t cause pain
mouth ulcers that extend out to your lips
pain that isn’t reduced with any over the counter (OTC) or any natural medication
severe problems while drinking and eating
persistent high fever or diarrhea when these mouth ulcers appear.

It is important to seek immediate medical help, if you have any of the above-mentioned warning symptoms as they might indicate a serious underlying health condition. Let’s discuss the factors that may increase your risk of developing mouth ulcers.

Risk Factors For Mouth Ulcers :

The exact risk factors for mouth ulcers are yet not known and may vary from person to person. There are few common risk factors that might surely aggravate your risk of developing mouth ulcers, these are:

Quitting smoking
Regular consumption of citrus fruits and other foods that are high in acidity or are spiced up
Braces, ill-fitting dentures, and other dental apparatus that is constantly rubbing against your mouth and gums
Constant stress or anxiety
Hormonal changes that occur during puberty, pregnancy and menopause
Certain medications including pain killers and beta-blockers
Certain genetic factors might contribute to mouth ulcers
Medical conditions such as Crohn’s disease and celiac disease
Nutritional deficiency like vitamin B12 or iron deficiency
Weakened immune system

All these risk factors may lead to mouth ulcers. Learn whether you have mouth ulcers or not?

Do I have Mouth Ulcers?:

If you notice ulcers in your mouth, they might be the harmless canker sores or cold sores. Mouth ulcers are not contagious and must not be mistaken for cold sores. Cold sores appear especially on the lips or around the mouth. These sores generally begin with itching, tingling or burning sensation. Mouth ulcers might also be a sign of health conditions that are serious and require immediate medical treatment, such as:

Hand, foot and mouth disease, that might also cause a rash on your hands and feet
Oral lichen planus, that can lead to a white, lacy ulcer pattern inside your cheeks
Celiac disease (a condition wherein the body is intolerant to the gluten)
Inflammatory bowel disease
Diabetes mellitus
Bechet’s disease (that causes inflammation throughout a person’s body)
An autoimmune disease
HIV/AIDS

Let’s learn about the causes and prevention of mouth ulcers.

Causes and Prevention of Mouth Ulcers :

Causes of Mouth Ulcers :

There are no specific causes behind mouth ulcers. However, various factors and triggers might lead to the development of mouth ulcers. These causes include:

Any mouth injury due to some dental work, hard brushing, injury due to sports, or an accidental bite
Using toothpastes and mouth washes that have sodium lauryl sulfate
Food sensitivity to any acidic foods such as pineapples, strawberries, citrus fruits and other foods trigger including coffee and chocolate
Deficiency of certain essential vitamins including vitamin B12, folate, zinc, and iron
Allergic responses to certain mouth bacteria
Ill-fitting dental braces
Hormonal changes especially during menstruation
Improper dental fillings
Emotional stress, anxiety or being sleep deprived
Bacterial, fungal or viral infections
Your canker sores might be due to family history of mouth ulcers
Hormonal fluctuation during puberty and menopause
Immune system issues might also lead to canker sores
Taking non-steroidal anti inflammatory drugs (NSAIDs) like ibuprofen
Using nicorandil, a medication which is prescribed for angina
Taking beta-blockers that are used to treat angina, abnormal heart beats or high blood pressure
Side effects of cancer treatment includin chemotherapy or radiation therapy.

In certain cases, causes of mouth ulcers cannot be determined.

With knowing the causes, let’s discuss how to prevent mouth ulcers.

Prevention of Mouth Ulcers :

Mouth ulcers have no specific cure and generally recur. However, they can be partly prevented.

Development of a mouth ulcer is inevitable, there are few things you can do to reduce the risk of developing canker sores and also to reduce their severity.

You may take the following a few steps to reduce your risk of developing mouth ulcers.

Avoid foods that may irritate your mouth. That involves eliminating various acidic fruits such as grapefruit, pineapple, lemon, oranges, and chips, nuts, or anything that is spicy.
Consume whole grains and alkaline fruits, vegetables.
Always adhere to a well-balanced, healthy diet and also take a multivitamin capsule daily.
You should avoid talking when you are eating your food to reduce those accidental bites.
Having control of your stress levels and maintaining great oral hygiene by using mouthwash daily and also brushing after you had your meal may also help
Most people have experienced that avoiding soft bristle toothbrushes and not using mouthwashes that has sodium lauryl sulfate has helped in preventing the mouth ulcers.
Your dentist may give you wax to properly cover any dental or orthodontic mouth devices with any sharp edges.
Consult your doctor about changing or prescribing new medications if older ones are resulting in canker sores.
Keep your mouth clean through daily brushing and also flossing
Avoid the triggers that previously led mouth ulcers
Let’s now learn how mouth ulcers are diagnosed.

Diagnosis and Tests for Mouth Ulcers :

Generally, your doctor will easily diagnose a canker sore through visual examination. They might recommend several other tests including blood tests or a biopsy of the affected area if you have a severe breakout. Your doctor or dentist might also recommend few tests if he or she believes you have:

A viral infection
A mineral or vitamin deficiency
Hormonal fluctuations or a disorder
Issues with your immune system
A severe canker sores breakout

It is important to note that a malign lesion (cancer causing) might initially look like a canker sore, but this lesion would not heal without a treatment. Certain symptoms of mouth (oral) cancer are like those of mouth ulcers, such as painful ulcers and significant swelling in the neck area. But, oral cancer is generally also marked by presence of unique symptoms, as mentioned below:

Bleeding from the gums or mouth
Loose teeth
Difficulty in swallowing
Pain in your ears

If you observe these symptoms besides normal canker sore signs, you must visit your doctor immediately to check out for oral cancer as the primary cause.

Treatment And Care for Mouth Ulcers :

Treatment for Mouth Ulcers :

Mouth ulcers generally heal without any treatment. Nevertheless, there are various important lifestyle changes that can help in treating these ulcers. You should brush and floss your teeth regularly to keep viral and bacterial infection at bay. Avoid consuming spicy foods to help the ulcers heal quickly. Consume milk or have yogurt or an ice cream to help ease the pain.

This pain can be severe at times. You may reduce this discomfort by gargling with either a mouthwash or lukewarm salt water. This might feel uncomfortable initially, but this will help in reducing the pain.

Certain ingredients present in easily available topical products may also help in relieving and healing canker sores, including:

benzocaine
rinses that have hydrogen peroxide
fluocinonide

Your dentist or doctor may also prescribe the following depending upon your symptoms:

An antimicrobial mouth wash or mouth washes that contain chlorhexidine
An antibiotic including mouth rinses or pills that have doxycycline
A corticosteroid cream or ointment, that includes beclomethasone or hydrocortisone hemi succinate
Any of prescription mouth washes, particularly one that has lidocaine or dexamethasone for combating inflammation and reducing pain

Let’s see how you can take care of people who are suffering from mouth ulcers.

Care for People With Mouth Ulcers :

Generally, when a person is suffering from mouth ulcers, he or she is capable enough of taking care of themselves. But, if he or she is not able to; you can do the following.

Remind them to take their prescribed medicines at the recommended time.
Make sure they properly brush and floss.
Ask them to use the prescribed mouth wash only.
Consult the doctor or physician if their symptoms exacerbate.
Don’t let them eat citrus fruits such as pineapples, strawberries and oranges.
Make sure they are not consuming spicy foods such as chips or any other curries.
Learn about the normal and warning symptoms associated with mouth ulcers, so that you may take prompt action if that is necessary at all.

Let’s know about the OTC medications and the self-management methods.

OTC or Self Management of Mouth Ulcers :

Certain ingredients present in easily available over the counter (OTC) topical products could heal and relieve the pain due to sores. These include the below-mentioned drugs:

benzocaine
mouth washes and rinses that have hydrogen peroxide
fluocinonide

Other drugs either in the form of mouthwashes or pills, can only be used after your doctor or physician recommends so.

Self-Management of Mouth Ulcers :

Self-management of canker sores includes the following:

Apply the prescribed paste as directed by your physician or pharmacist
Use a soft toothbrush for brushing your teeth
Avoid hard, salty, spicy, acidic or extremely hot food or beverages until your mouth ulcers heal.
Use a straw to consume any cold beverages.
Avoid anything or cause that might be triggering the canker sores.
Consume plenty of fluids.
Rinse your mouth using lukewarm, slightly salted water regularly.
Make sure your mouth is clean.
You can consider taking pain-relieving medications including paracetamol.
You may also apply a prescribed antiseptic gel to the mouth ulcers.
Use an alcohol-free prescribed mouthwash that contains chlorhexidine gluconate.
You may also use a topical steroid mouth rinse or ointment that is prescribed by your doctor or dentist.

Let’s learn how to treat mouth ulcers naturally.

Natural Ways to Cure Mouth Ulcers:

Mouth ulcers can be easily treated using certain natural ways. You can use these natural home remedies for relieving the pain and symptoms. All of these are really easy to do and are really effective.

1) Gargle with Salt water:

Salt water acts as a natural disinfectant. It is an excellent natural remedy for treating canker sores. Whenever you begin noticing the initial signs of a canker sore, you should start swishing with salt water. This would help in relieving your pain and would support the healing process.

Dissolve one teaspoon sea salt or natural salt in one cup lukewarm water. Swish this water for a minimum of 30 seconds. Spit it out, and then use fresh water to rinse your mouth.

2) Consume Fenugreek leaves:

Fenugreek is long used kitchen ingredient in preparing many curries. However, fenugreek leaves have multiple healing benefits. Moreover, fenugreek can also boost your immune system. It contains lots of vitamins and minerals including vitamin C, riboflavin, zinc, iron, calcium, carotene, phosphorous and various others.

3) Add Basil to Your Diet:

Basil has multiple anti-microbial and anti-inflammatory properties. Basil leaves may also prevent certain mouth infections and relieve canker sores. You may add a few fresh basil leaves to your dishes. Chew a few leaves in between your meals. You may also soak basil leaves in boiling, hot water. This can be used as a mouth wash.

4) Rinse Your Mouth with Baking Soda:

Baking soda provides an alkaline base. It can effectively neutralize acids that are present in your mouth and may irritate your canker sores. Baking soda can also inhibit the bacteria in your mouth. This can help in healing of sores rapidly. Mix one teaspoon baking soda in one cup warm water. Swish your mouth with it and use it as a mouth rinse. In the end, rinse with clean water.

5) Eat Probiotic Yogurt:

Probiotic yogurt is super packed with good bacteria. These beneficial bacteria help in replenishing your oral flora and may treat mouth ulcers. The friendly bacteria present in the probiotic yogurt can improve your stomach health. This, would in-turn help in improving your oral health. The natural coolness of yogurt will also calm and soothe the associated pain.

6) Consume Chamomile Tea:

Chamomile is great for your overall health. It can help in making your feel relaxed and can support healthy digestion. It also contains various chemical compounds that have excellent antiseptic properties.

Chamomile might help in easily relieving your canker sores. It may also speed up the healing process. You can consume chamomile by sipping on warm tea.

7) Have Zinc Supplements:

If you develop canker regularly, you might be suffering from a zinc deficiency. Consuming zinc supplements may give you some relief. It may reduce the occurrence of mouth ulcers by around 50 to 100 %.

8) Use Clove Oil :

Clove oil is a great natural remedy for treating mouth ulcers. Clove’s active ingredient is known as eugenol, that acts as a painkiller ^[2]. Dentists have long recommended clove oil for relieving the pain and discomfort. Clove oil may be applied directly over the mouth ulcers for instant relief. You can also prepare an effective mouth wash from clove oil.

Health Tip by Expert:

It is very important to keep your mouth clean and have great oral hygiene. With proper alkaline diet and good oral hygiene, it is possible to both prevent and treat mouth ulcers.