Mouth Ulcers: Causes, Symptoms, Treatment & Prevention

Mouth Ulcer Causes, Symptoms and treatment

Mouth ulcers, also called canker sores are one of the most common oral health conditions. Mouth ulcers are painful sores that appear inside the mouth. You may have one or more than one canker sore at a time. Teenagers and young adults are more likely to develop mouth ulcers, but it can happen to people of any age.

There are many different types of mouth ulcers. Some can develop around and others in the mouth. Some are painful whiles others may be unsightly. They are usually harmless but some may be a sign of something more serious. If your mouth sore does not go away within 10 days, you should consult your dentist.

They are different from cold sores, which appear on the outer lips and are caused by a virus. Cold sores often begin with a tingling, itching or burning sensation around your mouth. Mouth ulcers can usually be managed at home, without seeing your doctor. But if your ulcer has lasted longer than three weeks you should seek medical attention.

What Does a Mouth Ulcer Look Like?

Mouth ulcers are usually round or oval sores that commonly appear inside the mouth on the:

  • cheeks
  • lips
  • tongue

They can be white, red, yellow or grey in colour and swollen. It’s possible to have more than one mouth ulcer at a time and they may spread or grow.

What are The Common Causes of Mouth Ulcers?

The exact cause of canker sores is still unknown. One theory is that oral ulcers appear when the body’s white blood cells attack the cells that line the inside of the mouth instead of healthy cells. This is due to an immune system malfunction.

Also, people with recurring canker sores often have family members with the same condition. This means the sores may also be hereditary, explains the Mayo Clinic. The family connection may also be due to a shared environmental factors rather than genes, however, so more research is needed in this area.

Usually a single mouth ulcer is due to damage caused by biting the cheek or tongue. It can also be due to a sharp teeth, brushing or poorly fitting  dentures. Mouth damage can also occur from using a toothbrush incorrectly, or from a sharp tooth or filling. These ulcers are called ‘traumatic’ ulcers. If you have a number of mouth ulcers, and they keep coming back, this is called ‘recurrent aphthous stomatitis’

In most cases, mouth ulcers are not caused by an infection. This means you cannot catch it from another person. For example, in most cases it is not possible to get a mouth ulcer from kissing someone who has a mouth ulcer. You can’t even get it by sharing drinking glasses or cutlery with them.

Potential Triggers of Recurrent Mouth Ulcers

The cause of recurrent (returning) mouth ulcers is often unknown. However, a number of factors may increase your chances of getting recurrent ulcers. These are listed below.

1. Stress and anxiety

Although stress does not directly cause mouth ulcers, it does increase the chances of developing them. Also, it can affect their healing process as well. Mouth ulcers in return can also cause stress by affecting how and what you can eat and drink.

2. Oral trauma

This can be in situations such as excessive tooth brushing, or chewing sharp or hard foods. It can also occur when you accidentally bite the inside of your cheek. A poorly fitting dentures and a defective filling increases your risk.

3. Hormonal changes

Some women develop mouth ulcers during their period. This is due to changes in the hormone levels in your body during your menstrual cycle.

4. Sodium lauryl sulfate (SLS)

This is another potential cause for canker sores. SLS is a foaming agent used in many toothpastes, cosmetics and cleaners. According to Environmental Health Insights, this ingredient doesn’t pose a danger to human health when it’s properly formulated. While the ingredient is considered safe, it can increase irritation inside the mouth if you have mouth ulcers.

5. Certain Foods

Eating certain foods can also increases your likelihood of developing mouth ulcers. Eating foods that you are allergic to may cause you to get a canker sore. Eat or drink food or juice that has a lot of acid, such as orange juice. Other foods that increases your risk of mouth ulcers include:

  • chocolate
  • coffee
  • peanuts
  • almonds
  • strawberries
  • cheese
  • tomatoes
  • wheat flour

6. Quitting smoking

When you first stop smoking, you may find that you develop more mouth ulcers than usual. This is a normal reaction. Your body is dealing with the change in chemicals in your body.

After giving up smoking, any increase in mouth ulcers will be temporary. But this should not deter you from stopping smoking. The long-term health benefits of not smoking are far greater than the short-term discomfort of mouth ulcers.
Not smoking will significantly lower your risk of developing serious health conditions, such as heart disease and lung cancer. Your overall level of fitness will also improve greatly.

7. Underlying conditions

If you have recurrent mouth ulcers, they may be caused by an underlying medical condition, such as:

  • Vitamin B12 deficiency. Vitamin B12 helps to make red blood cells and keeps your body’s nervous system healthy. A lack of vitamin B12 can cause tiredness, shortness of breath and mouth ulcers.
  • Iron deficiency. If you lack iron in your diet, your red blood cells will not be able to carry as much oxygen. This can make you feel tired and dizzy. Sometimes, an iron deficiency can also cause mouth ulcers.
  • Coeliac disease. This is due to the intolerance to a protein called gluten, which is found in wheat, rye and barley. The condition causes inflammation in the small intestine. Mouth ulcers are also a common symptom in adults with the coeliac disease.
  • Crohn’s disease. This is also another condition that causes inflammation of the gut, leading to ulcers developing in both your stomach and mouth.
  • Reactive arthritis. A reaction to another infection within your body. It can cause inflammation, which sometimes spreads to your mouth.
  • Immunodeficiency. This involves any condition that attacks or suppresses the body’s natural defence against infection and illness such as HIV. This can cause you to develop mouth ulcers.

8. Certain Medications

Occasionally, mouth ulcers are caused by a reaction to a medicine that you are taking. Some of the medicines that can cause mouth ulcers includes:

  • Non-steroidal anti-inflammatory drugs (NSAIDs). A painkilling medication, such as ibuprofen and aspirin.
  • Beta-blockers medications to treat a variety of conditions that affect the heart and blood flow, such as angina, heart failure, high blood pressure and abnormal heart rhythms.
  • Some medicines used to treat angina (chest pain caused by reduced blood flow to the heart).

You may notice that you start to get mouth ulcers when you begin taking the medicine, or when you increase the dosage. However, this is often only a temporary effect of the medication.

Speak to your doctor if you find that you are having more mouth ulcers due to your medication. They may be able to prescribe an alternative medicine for you. However, never stop taking your medication unless your doctor advises you to do so.

Less common causes

There are also a number of other less common causes of mouth ulcers such as:

  • Herpes simplex infection. It is a highly contagious virus and can cause cold sores on the mouth and the genitals.
  • Anaemia. A condition that occurs when there is a low number of red blood cells or haemoglobin (a protein found in red blood cells that transports oxygen around the body).
  • Skin conditions, such as angina bullosa haemorrhagica (blood-filled blisters that turn to ulcers if they burst).
  • Gastrointestinal disease such as irritable bowel syndrome (IBS) and gastro-oesophageal reflux disease (GORD).
  • Pharyngitis thus a sore throat.
  • Chickenpox. A mild but highly infectious condition that causes an itchy rash, which blisters and becomes crusty.
  • Hand, foot and mouth disease. A common, mild illness that occurs due to a virus.
  • Less common bacterial and viral infections can also sometimes cause mouth ulcers, although this is rare.

What are The Symptoms of Mouth Ulcers?

The symptoms of a mouth ulcer depend on the cause, but may include: 

  • one or more painful sores on part of the skin lining the mouth
  • swollen skin around the sores
  • problems with chewing or tooth brushing because of the tenderness
  • irritation of the sores by salty, spicy or sour foods 
  • loss of appetite.

Can Cancer Cause Mouth Ulcers?

Cancer of the mouth can first appear as a mouth ulcer. The ulcers caused by mouth cancer are usually single and last a long time without any obvious nearby cause (for example a sharp tooth). See your dentist if you have any ulcer that lasts longer than three weeks.

Ulcers caused by cancer usually appear on or under the tongue. But they may occasionally appear somewhere else in the mouth. Cancer of the mouth is usually linked to heavy smoking and drinking. Doing both together greatly increases the risk.

How is it treated?

You do not need to see a doctor for most canker sores. They will get better on their own. There are many things you can try at home to relieve the pain caused by your canker sores:

  • Eat soft, bland foods that are easy to swallow, such as yogurt or cream soup. Cut your food into small pieces or mash or puree it. Avoid coffee, chocolate, spicy or salty foods, citrus fruits or juices, nuts, seeds, and tomatoes.
  • Drink cold fluids, such as water or iced tea, or eat Popsicles. Sometimes fluid touching the canker sore can cause a stinging pain. Use a straw so the fluid doesn’t touch the canker sore. Hold ice on the canker sore until it is numb.
  • Carefully brush your teeth so you don’t touch the sore with the toothbrush bristles.
  • Rinse your mouth with salt water. To make a salt water rinse, dissolve 5 g (1 tsp) of salt in 250 mL (1 cup) of warm water.
  • Buy an over-the-counter medicine, such as Anbesol, Milk of Magnesia, or Oragel, to put on your canker sores. Use a cotton swab to apply the medicine. Put it on your sores 3 to 4 times a day. If your child is under 2 years of age, ask your doctor if you can give your child numbing medicines.
  • Take a pain reliever, such as non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen (such as Advil), or naproxen (such as Aleve). Do not give aspirin to anyone younger than 18 because of the risk of Reye syndrome. Be safe with medicines. Read and follow all instruction on the label.

If your canker sores do not feel better after trying these steps at home for 2 weeks, you may need to see your doctor or dentist. 

How Can You Prevent Mouth Ulcers?

It may not be possible to prevent mouth ulcers. Unless you know what causes your canker sores. If you do know what causes your mouth ulcers, you can help prevent them by avoiding what you know causes them.

However, the following may help to reduce your risk of developing mouth ulcers:

  • Avoiding certain foods – such as chocolate, spicy foods, coffee, peanuts, almonds, strawberries, cheese, tomatoes and wheat flour. Thus if any cause you to have an ulcer.
  • Chewing your food slowly and carefully, trying not to talk and chew at the same time.
  • Not chewing gum.
  • Brushing your teeth with a soft-bristled brush, which may reduce irritation in your mouth.
  • Reducing stress and anxiety – which may be a trigger for some people.
  • Limiting your use of alcohol and tobacco.

In general, it is important to get enough vitamins and minerals in your diet, like folic acid, vitamin B12, zinc, and iron.

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