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How do I tell if I have traumatic ulcers or canker sores?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have multiple painful sores in my mouth that appeared two days ago.

One is large, what I think is a canker sore (kind of grey flesh with a bunch of swollen gums below it), one small sore (just two little dots in my mouth), and the other I have not looked at. I have had poor oral hygiene for the past few months.

I am just wondering if it is most likely gum disease, like periodontitis, or what it could be?

Kindly assist.

Hello,

Welcome to icliniq.com.

I have read your query. Please be calm.

They can be ANUG (acute necrotizing ulcerative gingivitis), lichen planus, canker sores (the grey color indicates necrosis), or noma. So, I suggest you please share pictures for confirmation of the diagnosis. I would also suggest you do a biopsy or FNAC (fine needle aspiration cytology).

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.

Patient's Query

Hello doctor,

Thank you. There are two sores. One is the bigger one (it looks like a cut almost on my gums), and the other is some small white dots. There is another sore that is smaller than both of these on my upper left molar, but I cannot get an image of it.

Pain has been there for around two days. And the color may be more white than grey. It is hard for me to tell. They are very painful and hard to eat. If something touches the big one, it causes really bad pain, and if something touches the small white dot ones, it hurts but is bearable. I have attached the pictures for your reference.

Kindly give your opinion.

Hello,

Welcome back to icliniq.com.

I have seen two pictures (attachments removed to protect the patient's identity). One is a traumatic ulcer below the premolar. In contrast, the other is a recurrent aphthous ulcer.

Please apply Dologel (Choline Salicylate and Lidocaine) or Orajel (Benzocaine) thrice a day over the painful and bigger traumatic ulcer. Take a multivitamin (that contains Lycopene and Folic acid). You can take an analgesic like Voveran-SR (Diclofenac) 100 mg if the pain is unbearable.

Please do not use any mouthwash as it can irritate the mucosa. Avoid eating hot and spicy food. Have fruits like papaya and musk melon. Please follow the steps and get back to me if you have further queries.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.

Answered byDr. Bharat Joshi

Medically reviewed byDr. K. Shobana

Published At July 8, 2021
Reviewed AtMay 7, 2026

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