My mouth ulcer is not getting better. What can be done?

Hi,

Welcome to icliniq.com.

I have read your queries and can understand your concern regarding your condition.

Based on the history and the photo (attachments hidden to protect patient identity), this does not look like a simple vitamin-deficiency mouth ulcer. A mouth ulcer persisting for more than 2 months despite taking folic acid and B-complex tablets needs proper evaluation.

I think the possible causes in your case are

1. Traumatic ulcer - This ulcer appears on the inner lower lip, very commonly caused by sharp teeth, irregular bite, or repeated friction. I assessed your photo, and it appears it is possible with this tooth alignment.

2. Contact or allergic stomatitis – Artificial sweeteners, flavored toothpaste, chewing gum, mouth fresheners, or certain foods can trigger chronic irritation or allergy.

3. Recurrent aphthous ulcer – non-vitamin causes – Stress, sleep deprivation, smoking or tobacco exposure, acidity, or immune-related factors.

4. Oral lichen planus, or chronic inflammatory lesion – Can present as long-standing ulcers or erosions.

5. Gastrointestinal issues (less common but possible) – Gastritis, Helicobacter pylori infection, iron deficiency, or malabsorption can contribute, but they do not usually cause a single persistent ulcer.

It is important to rule out any non-healing ulcer more than two weeks must be examined to exclude precancerous or malignant lesions, especially if there is pain, induration, or bleeding. What you should do now :

1. Ear, nose, throat (ENT) or dental consultation urgently for a local oral examination. Check for sharp tooth edges or chronic trauma.

2. Stop possible triggers – Avoid artificial sweeteners, spicy foods, acidic foods, tobacco, alcohol, and strong mouthwashes.

3. Medications commonly advised (doctor-guided): Topical steroid oral gel (like triamcinolone oral paste), antiseptic mouthwash (chlorhexidine for short term), local anesthetic gel for pain relief

I suggest the investigations if the ulcer persists: complete blood count, iron profile, and Vitamin B12 level. If still not healing, you must proceed with a biopsy of the ulcer (a very important step), and if there are any key red flags, seek care immediately. Signs like an ulcer not healing for more than two to three weeks with a hard base or raised margins, which bleed on touch, along with weight loss or difficulty eating, must be taken seriously.

I hope my answer is clear to you, and if you need any details at any time, I am here and at your service.

Thank you.

Hi,Welcome back to icliniq.com.

Thank you for your appreciative words.