Mouth ulcers, also known as canker sores or aphthous ulcers are common and painful lesions found in the oral cavity. A lesion is an abnormal area of tissue inside or outside your body that may get bigger or change it's appearance gradually. It may or may not be cancerous. 

Mouth ulcers generally develop inside or at the base of your mouth and are painful. They are mostly seen in women and adolescents (individuals between ages 10 and 24 years). Mouth ulcers usually go away within one to two weeks. 

Causes of Mouth Ulcers

The exact cause of mouth ulcers are not known. However, certain triggers and factors that can cause mouth ulcers include:

1. Stomach disorder/digestion problems. Crohn's disease is a chronic inflammatory disease of the digestive tract. It can lead to redness, swelling, or sores anywhere in your digestive system, including your mouth. 

2. Vitamin deficiency. A lack of essential vitamins, especially iron, folic acid, zinc, and vitamin B 12 can cause ulcers in the mouth. 

3. Stress. Too much stress can cause problems with your mouth, teeth, and gums. Stress likely raises your chances of getting mouth ulcers.

4. Auto-immune disorders. Auto-immune conditions (where your immune system mistakenly attacks your healthy body cells) can be a rare cause of mouth ulcers. This could be aided by genetic, emotional, nutritional, or hormonal factors.

5. Other factors. A number of other factors that can cause mouth ulcers include:

  • Acidic foods. Foods such as strawberries, pineapples, and citrus fruits increases the risk of mouth ulcers.

  • Oral thrush. This is a yeast infection that develops in your mouth. It causes white or yellowish bumps to form on the inner cheeks and tongue. Oral thrush considerably increases your risk of mouth ulcers.

  • Diabetes mellitus. Diabetes is associated with an increased risk for thrush. Additionally, people with diabetes are likely to have a dry mouth, which has been associated with an increased risk for mouth ulcers.

  • Dental braces. These are used to align and straighten your teeth. Mouth ulcers are common during the initial days of wearing braces. It occurs as the result of your inner cheeks rubbing against the braces. 

Types of Mouth Ulcers

1. Minor aphthous ulcers. They are small, about 2 to 8 mm in size and accounts for 85% of the mouth ulcers. They occur on the floor of your mouth, lateral and ventral tongue. These are usually not serious and heal without scarring in 7 to10 days.

2. Major aphthous ulcers. These ulcers are larger, more than 10 mm in size. They involve deeper ulceration and are thus, very painful. Major aphthous ulcers usually appear on the anterior (inside) pillar of your tonsil (two oval-shaped pads of tissue on either side at the back of the throat). 

3. Herpetiform ulcers. Herpetiform ulcers are small (1-2 mm in size ),and forms on the lateral margins and ventral surface of the tongue. They also can occur on the floor of the mouth. They are painful and can cause difficulty in eating and speaking. 

Symptoms of Mouth Ulcers

  • Painful sores in the mouth.
  • A tingling or burning sensation before the sores appear.

  • The sores appear round and are white or grey in colour.
  • Severe cases can result in fever and swollen lymph nodes.

Diagnosis of Mouth Ulcers

Mouth ulcers are usually easy to diagnose, through a visual examination. They're usually white or grey and surrounded by red, inflamed soft tissues. 

Treatment and Management of Mouth Ulcers

Mouth ulcers usually resolve on their own without treatment. The treatment is usually symptomatic if you get mouth ulcers often or if they’re extremely painful. Various treatment options include:

  • Pain-relieving gels and medications to provide instant relief from pain. 

  • Warm salt water gargles to help prevent the growth of bacteria in your mouth and relieves pain and discomfort.

  • Mouth rinses with steroids to reduce pain and swelling.

  • Nutritional supplements to treat deficiencies of iron, folic acid, zinc, and vitamin B 12.

Mouth ulcers can be prevented with certain steps such as:

  • Avoiding very hot foods and drinks. Quite often patients confuse oral ulcers with pharyngitis (pain or irritation in your throat) and try to consume hot food or drinks. This should be avoided in the case of ulcers.

  • Avoiding acidic foods. Choose whole grains and alkaline (non-acidic) food such as beans, lentils, soybeans, tofu, herbal teas, potatoes, unsweetened yogurt, and milk.

  • Chewing food slowly. When you chew your food slowly and consciously, you can avoid accidental biting of your lips or tongue and can help prevent mouth ulcers.

  • Maintaining good oral hygiene is an easy way to stay away from ulcers in the mouth. Brush your teeth at least twice a day with an appropriate toothbrush and toothpaste. Floss regularly for healthy gums.

If your mouth ulcers are recurrent or if the symptoms do not go away for more than 10 days, make sure to consult your doctor without any further delay.

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.