Mouth Ulcer - Causes, Types, Treatment, Prevention

A mouth sore can be painful and make a lot of normal activities more difficult, like eating and speaking. Mouth ulcers often present as white and red painful sore in the mouth. Mouth ulcers commonly arise as a result of trauma, infection, underlying health conditions, dental appliances like braces or dentures, or from acidic or hot foods for instance. However, sometimes the cause is unknown.

Fortunately, mouth ulcers typically resolve on their own after a week or so, and there are many things that can be done at home to help ease the symptoms. In cases where any mouth sore persists for long periods of time, your dental professional should be informed for proper diagnosis and treatment. This article will give complete information about symptoms, causes, treatments, and prevention tips for Mouth Ulcers.

• In a study analyzing 1,134 students, approximately 33% of students reported experiencing recurrent oral ulcers.
• Of the 33% of students with recurrent oral ulcer history, greater than 27% of students were under some form of stress.

What is Mouth Ulcer?

Mouth ulcers are lesions that can form anywhere inside the mouth, including the gums, lips, cheeks, tongue, and roof of the mouth. They are often painful and appear as a round shaped lesion with red inflamed borders and a red, yellow or white center. You may experience a single ulcer or multiple ulcers at a time. These sores can make chewing and speaking very uncomfortable. Some mouth ulcers go away without treatment, whereas others may require treatment.

What are the Symptoms of Mouth Ulcers?

Pain while Brushing Teeth

As mentioned, mouth ulcers can be painful, which can make doing daily activities like tooth brushing challenging. These sores are typically very sensitive to touch, and the toothbrush may aggravate the lesion causing pain.

Sore Irritation from Acidic Foods

Acidic, spicy, and sharp foods can irritate the mouth when a mouth ulcer is present. Do your best to avoid foods like nuts, chips, acidic fruits, and sodas for instance which can increase irritation and inflammation worsening mouth ulcers.

Swelling around the Sores

Mouth ulcers tend to have defined borders that are red in color and swollen around the edges.

Reduced Appetite

If you have a mouth ulcer you may experience loss of appetite due to mouth pain.

Painful Sores in Yellow, White, or Red Colors

Mouth ulcers commonly appear yellow, white, or red in color in the shape of a small circle or oval. A red outer border typically encircles the ulcer.

Mouth Sores on Tongue, Cheeks, or Lips

Oral sores can appear on your tongue, inner cheeks, or inner lips for a variety of reasons. Mouth ulcers are not typically located on the outside of the mouth, as these may be classified as a separate condition.

Constant Recurring Sores leading to Ongoing Infections

Oral sores may reoccur due to certain triggers like stress or certain foods. Sometimes the cause of their reoccurrence is unknown. If you experience persistent mouth ulcers that do not go away, speak with your healthcare providers immediately.

Sores Merging and Growing into a Large, Uneven Ulcer

In some cases, oral sores may merge and form a larger sore. This can be painful and lead to oral scarring.

Sores Appearing Anywhere in the Mouth

Mouth ulcers may appear anywhere inside the mouth, and you may experience more than one at a time.

What Causes Mouth Ulcers?

Cheek or Tongue Bites

Accidentally biting your cheek or tongue may cause mouth ulcers to develop.

Allergy to Certain Bacteria

Allergic reactions to certain oral bacteria, foods or ingredients may lead to mouth ulcers.

Braces or Retainers Hurt

Braces or other orthodontic appliances such as ill-fitting retainers may cause traumatic mouth ulcers to develop.

Vitamin Deficiency

Certain vitamin deficiencies have been linked to the presence of mouth ulcers, including a lack of iron, vitamin B3, vitamin C, folic acid, or vitamin B12.

Harsh or Abrasive Toothpaste

Sodium lauryl sulfate (SLS), a well-known ingredient found in toothpaste, has been associated with mouth ulcers.

Acidic Foods

Sensitivity to acidic foods like coffee, citrus fruits, and sodas can cause oral tissue irritation and cause mouth ulcers.

Hormonal Changes

Hormonal changes, such as those during pregnancy, menstruation, and menopause may result in the appearance of mouth ulcers.

Burning

Burning your mouth with hot foods or drinks can cause mouth ulcers to form.

Stress

Research has found a potential link between emotional stress and the development of mouth ulcers.

Digestive Diseases

Digestive conditions including inflammatory bowel disease (IBD), Crohn's disease, and ulcerative colitis may potentially result in mouth ulcer formation as a complication of the condition.

Autoimmune Conditions

Autoimmune conditions like lupus or pemphigus can cause mouth ulcers to develop more easily.

Lack of Sleep

Sleep is necessary for normal body functioning, and when adequate sleep is not had the body’s hormones become altered. This change in hormones can trigger the formation of mouth ulcers.

Viral Infections

Viral infections, such as Herpes Simplex Virus (HSV) are known to cause recurring small, painful, fluid-filled blisters on the skin, mouth, and outer lips.

Toothbrush Injuries

Oral trauma such as toothbrush injuries can irritate your tissue and lead to mouth ulcers.

Misaligned Teeth

Misaligned teeth and an improper bite can cause mouth ulcers, as the teeth may be rubbing against your oral tissue and creating tissue injury.

Genetics Factors

Genetics may play a role in the formation of mouth ulcers, according to research.

Blood Disorders

Blood disorders including Behcet's disease, leukemia, and anemia may trigger the formation of mouth ulcers.

Dental Work Causes Tissue Injury

Dental work such as a filling or crown procedure may result in accidental tissue injury that can lead to the development of a mouth sore.

Types of Mouth Ulcers

Herpetiform Ulceration (HU)

Herpetiform ulcers are a type of canker sore that is typically very small in size and appear in clusters of about 10 to 100 sores. They dent to heal without scarring in approximately 2 weeks.

Canker Sores

Canker sores are small oval or round shaped ulcers with a white, gray, or yellow appearance surrounded by red inflammation. They are painful but tend to heal on their own in a couple of weeks.

Cold Sores

Cold sores are fluid-filled blisters that are located on the outside of the mouth and lips. They are generally white or red in color. Oral cold sores are caused by a viral infection with herpes simplex type 1 virus (HSV-1). Initial outbreaks may include mild flu-like symptoms. Cold sores can be spread through kissing, sharing utensils, and other forms of contact.

Traumatic Ulcers

Traumatic ulcers can occur due to accidents like cheek or tongue biting, teeth clenching or grinding, dental appliances, or injury to the mouth. Other dental problems like tooth fracture, tooth decay, or dental crowding may also cause traumatic ulcers.

Minor Ulcers

Minor ulcers are small and round shaped encircled with red inflammation. These ulcers heal without scarring in approximately two weeks.

Major Ulcers

Major ulcers are larger in size than minor ulcers, and often take longer to heal. Major ulcers tend to leave scarring once healed.

Aphthous Ulcers

An aphthous ulcer, also known as a canker sore, is a painful non-contagious oral lesion. They are located on the inside of the mouth, and tend to last no longer than two weeks.

How to Treat Mouth Ulcers?

Antiseptic Gels

There are many over-the-counter antiseptic gels designed to help alleviate oral pain from mouth ulcers and promote their healing.

Steroid Ointments

Steroid ointments are commonly prescribed to reduce oral pain and increase healing of oral ulcers.

Medicated Mouth Rinses

Medicated mouth rinses may be recommended to help alleviate mouth ulcer pain and improve the healing process.

Nicorandil

Your medical professional may recommend Nicorandil for treatment of mouth ulcers, which is a medication sometimes also used to treat chest pain.

Beta-Blockers

Beta-Blockers, commonly used to treat high blood pressure, may also be recommended for treatment of mouth ulcers.

Laser Treatment

In severe cases of recurring mouth ulcers, laser treatment may be recommended by your dental professional for relieving pain and preventing reinfection.

Corticosteroid Lozenges

Corticosteroid lozenges may help alleviate mouth ulcer pain and speed up their healing.

How to Prevent Mouth Ulcers?

Brush Twice, Floss Once Daily

Be sure to brush your teeth at least twice a day and floss daily to avoid oral infection and prevent mouth ulcers.

Rinse with Salt Water

Warm saltwater rinses a few times a day can help soothe pain and aid in the healing process of a mouth ulcer.

Use Medicated Mouthwash

Your medical or dental professional may recommend using a prescription mouthwash to help your mouth ulcer heal. These mouthwashes often contain antimicrobial ingredients to help prevent oral infection and worsening of the ulcer.

Use a Soft brush

The American Dental Association (ADA) recommends using a soft-bristled toothbrush to minimize irritating your oral cavity. Avoid using hard-bristled toothbrushes and mouthwashes that contain irritants such as sodium lauryl sulfate (SLS) or alcohol.

Stay Hydrated

Drinking water is essential to keep yourself healthy and avoid dehydration. It can also help alleviate painful mouth sores.

Eat a Fresh, Healthy Diet

Implement a nutritious and well-balanced diet to keep your smile and body healthy. Be sure you are consuming adequate amounts of fruits and vegetables, and are having the correct amount of vitamins and minerals in your diet.

Avoid Spicy, Sour Foods

Avoid consuming spicy or sour foods, as they can irritate your mouth. Limit spices, hot sauce, lemon, limes, and carbonated or caffeinated drinks for instance.

Reduce Stress

Stress plays a major role in our health, including oral health. Adequate sleep, and stress-reducing activities like exercise and mindfulness practices may help lower your risk of developing mouth ulcers.

What is the Difference between Mouth Ulcer and Cancer?

Mouth ulcers and cancer can present differently and there are certain signs and symptoms to look for when deciphering between the two. Mouth ulcers are typically painful, whereas cancer is often asymptomatic. Mouth ulcers tend to be flat with white and yellow discoloration and often disappears after approximately two weeks. On the other hand, oral cancer can appear flat or raised with a white or red appearance that tends to persist indefinitely.

How Long do Mouth Ulcers Last?

Most mouth ulcers disappear after one to two weeks. In cases where a mouth sore is lasting longer than 3 weeks, it is important to schedule a visit with your healthcare providers immediately.

Are Mouth Ulcers Contagious?

Mouth ulcers are not contagious and cannot be spread through saliva. However, cold sores, also known as fever blisters, are caused by herpes simplex virus and the fluid within them is contagious. Cold sores develop in a different location than mouth ulcers, being normally found on the outside of the mouth, lips, and facial skin.

When Is It Necessary to Schedule an Appointment with Healthcare Provider?

Mouth ulcers are very common and typically can be resolved without intervention. However, severe symptoms warrant the attention of your healthcare providers including:

• Ulcers lasting more than 3 weeks
• Fever
• Diarrhea
• Asymptomatic mouth sores
• Abnormally large motu ulcers
• Pain that is not eased by medication
• Mouth ulcers on the outer part of the lips
• New sores that appear before old ones heal

Conclusion

Mouth ulcers can be an uncomfortable experience. Luckily, mouth ulcers and its symptoms tend to disappear with little to no treatment. Be on the lookout for symptoms of mouth ulcers and speak with your healthcare professionals for guidance and treatment if your mouth sores persist longer than 3 weeks.