Mouth Ulcers: types, causes, symptoms, and treatments

Mouth ulcers are a common and painful ailment that can affect people of any age. These are tiny, round, or oval sores that can develop inside the mouth, on the lips, or the gums. Stress, wounds, infections, and problems with the immune system are some of the possible causes. In addition to causing discomfort and anguish, mouth ulcers can interfere with regular speech and eating patterns.

It can take various forms, and the underlying cause can affect both the severity and duration of the condition. This guide will provide a comprehensive overview of the different types of mouth ulcers, their causes, symptoms, and potential treatments.

Types Of Mouth Ulcers:

Minor Aphthous Ulcers: These common ulcers appear as small, round, or oval sores with a red border, measuring less than 10 millimeters in diameter. They heal within 7 to 10 days without scarring.

Major Aphthous Ulcers: Major ulcers, also known as large ulcers, are less common but more severe. They are typically larger than 10 millimeters in diameter, deeper, and can be extremely painful. They may take several weeks or even months to heal and often leave scarring.

Herpetiform Ulcers: This rare type presents as multiple small, clustered ulcers that can merge into larger, irregular shapes. They are often more painful than other types and may take several weeks to heal.

Causes of Mouth Ulcers:

Mouth ulcers can develop due to various reasons, including physical trauma, dietary factors, stress, hormonal changes, medications, and underlying health conditions.

Physical Trauma: Soft tissue injuries in the mouth, like accidental biting or rubbing against sharp teeth or dental appliances, can cause them. Aggressive tooth brushing or dental procedures can also lead to trauma and ulceration.

Dietary Factors: Certain foods and drinks can irritate the mouth lining, leading to ulcers. Examples include acidic fruits, spicy foods, and nutrient deficiencies like vitamin B12, iron, and folate.

Stress: Anxiety and emotional stress can impair immunity and increase a person’s risk of developing mouth ulcers. Mouth ulcers can form due to the hormones released during stress, impairing the body’s capacity to fend off infections and cure itself.

Hormonal Changes: Hormonal fluctuations during menstrual cycles, pregnancy, or hormonal contraceptive use can increase the likelihood of developing mouth ulcers in some individuals.

Medications: Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), chemotherapy drugs, and medications used to treat autoimmune disorders, can cause mouth ulcers as a side effect.

Symptoms of Mouth Ulcers:

Mouth ulcers can cause discomfort and pain. They appear as round or oval-shaped sores with a yellow-gray center and a red, inflamed border inside the mouth.

Pain: Ulcers can cause intense pain, especially when eating, drinking, or accidentally biting the affected area. The pain can range from mild discomfort to a severe, burning sensation, depending on the size and severity of the ulcer.

Redness and Swelling: The area around the mouth ulcer is frequently red and swollen due to inflammation. It may be difficult to open your mouth wide or speak comfortably because of the redness and swelling that may extend beyond the ulcer’s immediate vicinity.

Trouble Eating and Drinking: Mouth ulcers can make eating & drinking difficult. Chewing and swallowing can cause more pain and irritation. Some people may lose their appetite temporarily or have trouble eating certain foods, especially acidic, spicy, or hard-to-chew items.

Fever: In severe cases, especially when mouth ulcers are accompanied by an underlying condition or infection, a fever may develop. However, fever is not a common symptom of simple mouth ulcers.

Risk Factors for Mouth Ulcers:

Certain factors can increase the likelihood of developing mouth ulcers, including:

Family History: Mouth ulcers tend to run in families, suggesting a genetic predisposition. If your parents or siblings frequently experience mouth ulcers, you may be at a higher risk.

Nutritional Deficiencies: Certain nutrient deficiencies, like iron, vitamin B12, folate, and zinc, can increase susceptibility to mouth ulcers by weakening the immune system and impairing the healing process.

Weakened Immune System: Individuals with compromised immune system, due to medical conditions or immune-suppressing medications, are more prone to developing mouth ulcers. A weakened immune system makes it harder for the body to fight off infections and heal properly.

Certain Medical Conditions: Certain medical conditions can increase the risk of mouth ulcers, including:

• Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis
• Celiac disease, an autoimmune disorder triggered by gluten
• Behcet’s disease, a rare inflammatory disorder
• HIV/AIDS
• Certain types of anemia
• Chronic kidney disease

These conditions can affect the immune system, cause inflammation, or lead to nutritional deficiencies, all of which can contribute to the development of mouth ulcers.

Diagnosis of Mouth Ulcers:

Diagnosing mouth ulcers typically involves a physical examination and a review of your medical history. During the physical examination, your dentist or doctor will carefully examine the ulcers in your mouth, noting their appearance, size, location, and any associated symptoms.

The dentist or doctor may use a tongue depressor or a small mirror to get a better view of the ulcers, especially those located at the back of the mouth or on the tonsils. They may also gently palpate (feel) the ulcers and the surrounding area to check for any abnormalities or signs of infection.

In addition to the physical examination, your dentist or doctor will ask you questions about your medical history, including:

• When the ulcers first appeared and how long they have been present
• Any recent illnesses, injuries, or changes in your overall health
• Medications you are currently taking (prescription, over-the-counter, or supplements)
• Dietary habits and any recent changes in your diet
• Stress levels or any significant life events that may have contributed to the ulcers
• Family history of mouth ulcers or other oral conditions

In some cases, further testing may be recommended to rule out underlying conditions or identify potential causes. These tests may include:

Blood tests: Your doctor may order blood tests to check for nutrient deficiencies, such as iron, folate, or vitamin B12, which can contribute to the development of mouth ulcers.

Biopsy: If the ulcers appear suspicious or do not heal within a reasonable time frame, your doctor may recommend a biopsy. During a biopsy, a small sample of tissue is taken from the ulcer and sent to a laboratory for analysis to rule out more serious conditions, such as oral cancer.

Allergy testing: If your doctor suspects that an allergic reaction to certain foods or substances may be causing mouth ulcers, they may recommend allergy testing to identify potential triggers.

By thoroughly examining you, your dentist or doctor can accurately diagnose and treat your mouth ulcers.

Home Remedies for Ulcers in mouth:

• Salt Water Rinses: Rinsing your mouth with warm salt water is an effective home remedy for mouth ulcers. Dissolve 1/2 teaspoon of salt in a cup of warm water, swish it in your mouth for 30 seconds to a minute, then spit it out.
• Over-the-counterPain Relievers: Mouth ulcers can be very painful, especially when eating or drinking. Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce the discomfort.
• Avoiding Irritants: Avoid spicy, acidic, or crunchy foods, alcohol, tobacco, toothpaste, or mouthwashes containing sodium lauryl sulfate, as they can worsen mouth ulcers.
• Maintaining Oral Hygiene: It’s important to maintain good oral hygiene while you have mouth ulcers to prevent infection and promote healing. Use a soft-bristled toothbrush and mild, non-irritating toothpaste to gently brush your teeth. After meals, rinse your mouth with an antiseptic mouthwash to keep the area clean and free from food debris.

Medical Treatment for Mouth Ulcers:

• Topical Medications: For minor ulcers, topical medications are often prescribed to provide relief from pain and promote healing. These include antimicrobial mouthwashes, pain-relieving gels, or creams containing ingredients like benzydamine, lidocaine, or benzocaine. Corticosteroid ointments or pastes may also be used to reduce inflammation and speed up healing.
• Oral Medications: In cases of severe or recurring ulcers, oral medications may be necessary. Anti-inflammatory medicines such as ibuprofen or naproxen can help decrease inflammation and pain. Immunosuppressant medications, such as thalidomide or dapsone, may be prescribed for severe cases to suppress the immune system’s overreaction that causes mouth ulcers.

Treatment for Underlying Causes

Treating the underlying illness is essential if ulcers are the result of it. For example, supplements such as vitamin B12, folic acid, or iron may be advised if ulcers are associated with nutritional inadequacies. It could be necessary to change the dosage or look into other drugs if ulcers in mouth are a side effect of a certain medication. When diseases like Crohn’s disease or celiac disease are managed with the right care, mouth ulcers brought on by those ailments can be avoided or less frequent.

Complications of Mouth Ulcers:

Mouth ulcers, usually harmless, can sometimes lead to complications if left untreated or persistent. Potential complications include:

Infection: These are open sores in the mouth that can lead to infections, fever, swollen lymph nodes, and increased pain. In severe cases, the infection can spread to other parts of the body.

Difficulty Eating and Drinking: They can make eating and drinking challenging and painful, especially if they are on the tongue, inner cheeks, or lips. This can lead to dehydration, malnutrition, and weight loss, especially in children or those with pre-existing medical conditions.

Weight Loss: Persistent or severe ulcers can make eating and drinking difficult, leading to unintentional weight loss, especially in children, which can affect their growth and development.

Impact on Quality of Life: Mouth ulcers can greatly impact a person’s quality of life, causing pain and discomfort that make it difficult to talk, eat, drink, and sleep. This can lead to irritability, anxiety, and decreased well-being, especially with recurring or chronic ulcers.

If mouth ulcers worsen, last longer than two weeks, or are accompanied by other worrisome symptoms, it’s critical to consult a doctor. In addition to preventing these issues, proper management and treatment can lessen the agony brought on by ulcers.

Prevention of Ulcers in mouth:

• Remember to maintain good oral hygiene to prevent mouth ulcers. This includes brushing your teeth twice a day, flossing daily, and using an antibacterial mouthwash.
• Consider dietary changes to prevent ulcers in mouth. Avoid spicy, acidic, or salty foods. Increase intake of vitamin C-rich fruits and vegetables like citrus fruits, bell peppers, and broccoli for healing and to prevent infections.
• Since stress can impair immunity and increase the risk of mouth ulcers, it’s critical to manage stress. To lower your stress levels, try deep breathing exercises, yoga, or meditation.
• Quit smoking and limit alcohol consumption, as both can irritate the mouth lining and increase the risk of mouth ulcers.