A mouth ulcer is a painful sore in the mouth on either the cheeks or gums. They usually appear red or yellow in colour. Mouth ulcers occur either singly or in clusters, causing a lot of discomfort or pain. They heal within 7 to 10 days. Mouth ulcers are different from cold sores that appear on the outer lips and are due to a viral infection.
There are different types of mouth ulcers. A single mouth ulcer is usually caused by damage to the mouth, like biting the cheek, or damage to the gum with a toothbrush or a sharp tooth or filling. They usually go away once the source of the problem is treated.
A recurrent ulcer is one that comes and goes, sometimes every few weeks. There are three types:
Minor ulcers are the most common. They can appear inside the cheeks, on the lips, tongue, gums and more rarely on the roof of the mouth. Most of these ulcers are the size of the top of a pencil and can sometimes come in clusters. You can get four to six at any one time.
Large ulcers (major type) are more severe and can last for five to ten weeks. They may appear near the tonsils and can be very painful, especially when swallowing. You usually only get one at a time.
It is also possible to have up to 100 very small painful ulcers (herpetiform type), which last for one to two weeks.
The last two varieties are very rare.
Ulcers are very common. Most people will suffer from single ulcers at one time or another. Over 20% of the population have recurrent mouth ulcers at some time in their lives. Often they begin in childhood, but most people grow out of them by their late twenties. In many cases, several members of the family may suffer from these ulcers, which is due to a family tendency and not infection.
Recurrent mouth ulcers may be due to:
too little iron or a lack of vitamins in the diet, especially B12 and C,
hormonal changes – many women get ulcers at the time of their periods,
stress,· infections, particularly herpes simplex in children and some adults,
Behcet’s disease, an auto-immune disease caused by the body attacking the cells lining the mouth,
bowel disease such as Chron’s disease or ulcerative colitis, coeliac disease (gluten sensitivity), and
skin diseases such as Lichen Planus, Herpes Simplex or Pemphigus.
Some medicines can also cause mouth ulcers.
Recurrent mouth ulcers cannot be caught by kissing, or by sharing drinks and utensils, because they are not caused by an infection.
Mouth ulcers may be round or oval with shallow, white, grey or yellow spots with an inflamed border. They cause discomfort or pain, particularly with certain foods. The most painful stage lasts for three or four days and then the symptoms settle until the ulcers heal, usually without scarring, in seven to ten days.
In severe attacks you may feel sick and be slightly fevered. You may also have painful, enlarged lymph glands around your jaw in the upper part of your neck.
You can normally diagnose mouth ulcers yourself from their appearance and the typical symptoms.
You should ask your dentist for advice if:
it is your first ulcer,
the ulcer has an uneven discolouration and is deep,
it is not causing you any pain or discomfort,
you have had the ulcer for more than three weeks,
it is bigger than 1 cm in diameter and is a single ulcer,
you are taking any other medication, or
you are pregnant.
If you also get ulcers in other parts of your body, such as the eyes or genital area, it is important that you tell your dentist about this.
The exact treatment will depend on the cause of the ulcer. Sometimes all that is required is to remove the cause of the ulcer, such as a sharp tooth.
The following self-care measures may help to reduce pain from mouth ulcers:
keep your mouth clean at all times,
avoid foods that are spicy, acidic, salty or particularly hot or cold, which can make the symptoms worse,
eat a healthy diet that includes fresh fruit and vegetables,
gargle with warm salt water,
use a diluted chlorhexidine mouthwash once a day to help reduce the length of time the ulcers last.
sprays and rinses are also available for pain relief.
You can also use special products that are available from your pharmacist:
Adcortyl in Orabase. Dry the area first with a cotton wool bud and then use a wet finger or the back of a spoon to put the cream on the sore area. You can use it up to four times a day after meals. However, it is most effective to use this cream late at night as it stays there for longer. You may find it has a gritty feel in your mouth
Corlan Pellets are small bitter tasting tablets that dissolve in your mouth releasing a drug that acts on the ulcer. Place them near the ulcer. You can use them four times a day.
There are many preparations that you can buy without prescription. However, you should consult your dentist in case you need additional medications or if the ulcers persist.
Try to avoid getting run down by making sure you eat a balanced diet, take regular exercise and learn to manage stress. Make sure your teeth are in good order by regular visits to your dentist.
Most ulcers heal on their own. However, if the ulcer doesn’t heal within three weeks you should visit your dentist. Your dentist will be able to examine your mouth to check that the problem is an ulcer and not something more serious.
If you suffer from ulcers that come and go frequently, you should visit your dentist to check that there is not an underlying medical cause.
source NHSDirect 151204