Introduction
Mouth ulcers appear as small reddish-white painful lesions inside the mouth. Many factors like trauma, friction, health status, accidental cheek or lip biting, and nutritional deficiencies trigger the formation of mouth ulcers. They are not transmissible (contagious); sharing the food, kissing, or touching the ulcer does not transmit the disease. They do not cause any harm, but the patient can feel the pain and discomfort, which usually subsides once healing occurs.
What Are the Different Types of Mouth Ulcers?
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Canker Sore: This is the most common mouth ulcer with unknown causative factors.
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Oral Lichen Planus: This condition results in itchy rashes and white sores inside the mouth.
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Leukoplakia: This condition results in white or gray patches inside the mouth.
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Erythroplakia: This condition causes red patches in the mouth, which is caused due to smoking and chewing tobacco.
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Oral Thrush: It is a fungal infection that develops inside the mouth.
What Are the Symptoms Associated With Mouth Ulcers?
Some common symptoms are:
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The ulcer will be red at the edges and white, gray, or yellow in the center.
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Presence of swelling around the ulcers.
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Enhanced soreness while brushing.
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Aggravated pain while eating spicy food.
What Are the Causes of Mouth Ulcers?
The definite cause of mouth ulcers is not known, however, the predicted causes include:
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Vitamin deficiencies including iron and vitamin B12 deficiency.
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Autoimmune diseases such as systemic lupus erythematosus.
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Bechets’s disease (inflammation of the blood vessels throughout the body).
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Oral cancers (squamous cell carcinoma).
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Gastrointestinal diseases include Crohn’s (inflammation of the gut) and celiac disease (immune disease of the small intestine).
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Oral ulcers occur as side effects of certain drugs (medications). An example of a cytotoxic drug is Nicorandil (a drug used in relieving chest pain caused due to decreased blood flow).
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Accidental biting of lip, tongue, and cheek.
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Minor lacerations from toothbrushes, dental fillings, and any dental procedures.
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Orthodontic treatments are known to cause ulcers. This can be either from braces or aligners.
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When eating hot and spicy foods, some may experience ulcers due to excessive intake of acidic foods such as lemons, pineapples, and gooseberries.
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During the menstrual cycle, women experience ulcers due to hormonal changes.
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Stress, insufficient sleep.
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Friction caused due to fractured teeth, crowns, and dentures.
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Infections are caused by bacteria and viruses (herpes simplex).
What Does the Mouth Ulcer Look Like?
Oral ulcers are easy to identify. They appear as red, swollen, painful lesions occurring on the lips (upper and lower), tongue, buccal cheeks, floor of the mouth, and on the palate (roof of the oral cavity). The borders of the ulcers appear as red margins; the inner part of the ulcer looks whitish yellow in color. The central portion of the ulcer appears to have risen from the surface. The symptoms of the ulcers are:
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People with oral ulcers find difficulty in chewing food, and the pain intensity increases especially while taking hot and spicy foods.
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Due to the pain, the patient starts avoiding the food.
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Discomfort can be felt during brushing and gargling, as the chemicals from toothpaste and mouthwashes irritate the ulcer.
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Sometimes, ulcers present as a single lesion or occur in groups of two to three, depending upon the cause.
How to Diagnose Mouth Ulcers?
Diagnosis is simple and is done by:
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Visual Checkup: The doctor checks for any outbreaks in the lining of the oral cavity.
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Blood Investigations: If the doctor suspects that mouth ulcers are due to vitamin deficiencies, then a patient's vitamin profile is advised.
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Biopsy: In cases of delayed healing and recurrent ulcers, the doctor advises for biopsy. The biopsy is a procedure in which a small part of the suspicious tissue is detached from the site and sent to the laboratory. The pathologist checks for cancerous cells in the laboratory and gives the report.
What Are the Treatment Methods?
Usually, mouth ulcers come and go away independently; generally, no treatment is advised. However, the medications are given to subside the pain and discomfort caused by the ulcer. Topical steroid gels and ointments would provide relief from the pain. In some cases, antiseptic ointments are advised to prevent further spread. Patients are advised to avoid hot and spicy foods and maintain oral hygiene. It is strictly advised to terminate smoking, alcohol, and pan chewing as these will cause delays in ulcer healing.
What Are the Home Remedies to Prevent Mouth Ulcers?
By following simple tips, mouth ulcers can be prevented. The following are the remedies for the prevention of mouth ulcers:
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Maintaining Oral Hygiene: Brushing twice daily, followed by flossing and gargling, helps eliminate microbes from the oral cavity.
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Reducing the Stress: Oral ulcers are the common manifestations of stress. When the person is undergoing stress, hormonal changes take place in the body leading to ulcer formation.
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Eating Healthy Food: Eating a balanced diet helps to prevent nutritional deficiencies, as deficiency of vitamins (vitamin B12, vitamin C, etc) and minerals are known to cause ulcers.
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Maintaining Health: Sometimes ulcer formation gets triggered by underlying diseases. In such conditions, the underlying health conditions must be medically managed and kept under control.
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Dental Visits: Regular visits to the dentist twice a year help in the oral assessment. If required, the dentist performs cleaning procedures to maintain good oral hygiene.
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Keep Hydrating: Sufficient fluid intake must be done to prevent the dryness of the oral cavity, as dry mouth can lead to friction which can cause ulcers.
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Mouth Rinsing: Saltwater rising is advised to flush out the oral bacteria and help maintain fresh breath. However, salt water rinsing is only advised once the ulcer subsides since the salt causes a burning sensation in the ulcer.
When to Make a Doctor Appointment?
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Prolonged Healing Time: Mouth ulcers heal within one or two weeks, but if the ulcers persist for over three weeks, it is better to consult the doctor.
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Recurrent Ulcers: If the ulcers are repeatedly occurring in the oral cavity, it is not a good sign, and one must seek the doctor's advice to know about the cause.
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Ulcer Turning Into Infectious Wound: Ulcers, if left untreated, may turn into infectious wounds that hamper the chewing of food, and these must be addressed with the utmost care.
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Large Ulcers: If the ulcers seem to be increasing, a doctor's consultation must be done without any delay. Sometimes, ulcers are considered the symptom of underlying cancerous conditions.
Conclusion
Mouth ulcers are not life-threatening and dangerous. But they cause pain and discomfort to the patient. The inconvenience can be felt, especially during the chewing of food. Generally, mouth ulcers do not require any treatment; they heal by themselves. Many over-the-counter analgesic (pain relieving) topical medications are available, which help treat the irritation, soreness, and tenderness caused by ulcers.
