Mouth ulcers (or apthous ulcers) are common, with as many as one in two of the population suffering from them, but the cause in many cases is unknown. They may occur on your tongue, on your soft palate, inside your cheeks or lips, and at the base of your gums. They differ from cold sores in that they occur in the soft tissues of your mouth and aren’t contagious. Conversely, cold sores rarely develop in the soft tissues of your mouth and are extremely contagious because they’re caused by the herpes virus.
The cause of mouth ulcers in many people cannot be explained, but others may have caused by the following:-
Trauma or damage
- A minor injury may trigger a mouth ulcer for example, over-zealous tooth-brushing, or eating or drinking something that is very hot as well as biting the inside of the mouth.
- Normally mouth ulcers occurring as a symptom of a disease are associated with other symptoms.
Tingling or burning
- This sensation may occur before the development of an ulcer.
A painful lesion(s)
- Most mouth ulcers occur in crops of one to five with common being on the sides of the tongue and inside the lips and cheeks. They may be up to 5mm in diameter and have a white or yellowish centre with an inflamed, red outer edge.
- Minor injuries to the mucous membranes occur commonly in people who wear dentures (they may not fit properly) and people who wear braces or other orthodontic devices.
Food and Nutrition
- A deficiency of vitamin B12, zinc, folic acid or iron may cause mouth ulcers and also lead to other symptoms involving the lips, tongue and oral mucosa. These kinds of deficiences are more likely to occur in people with diseases of the gastrointestinal tract which affect absorption of nutrients (e.g. ulcerative colitis). Mouth ulcers may also be caused by allergies to some foods.
Age, sex and family history
- Mouth ulcers occur more between the ages of ten and forty and it is estimated that in one in three people suffering from mouth ulcers there is a family history of mouth ulcers. Women more commonly suffer from them and they often occur before the start of the menstrual period. Ulcers often occur less or even not at all during pregnancy, which indicates a hormonal involvement.
Reduced immune system function
- People who are taking drugs which lower the effectiveness of their immune system (for example after transplantation, for the treatment of cancer or for auto-immune conditions such as rheumatoid arthritis or colitis) and people with HIV are more likely to get mouth ulcers. This is because the mouth normally contains a large number of micro-organisms, which provide a healthy environment in the mouth. But if the immune system is not functioning properly, the balance of these micro-organisms can change and this can cause problems, such as the development of mouth ulcers.
- Rarely, mouth ulcers may be associated with disorders of the blood including anaemia and the abnormally low white cell count of leukaemia.
- Oral cancers are more common in smokers. Oral cancer more commonly affects the lips but can affect the tongue.
These mainly occur when a mouth ulcer that is left untreated is infected by bacteria and this can lead to infection of the whole mouth or teeth.
See your doctor if you experience mouth ulcers with any of the following.
Unusually large sores
Unusually large sores
- Persistent sores, lasting three weeks or more
- Pain that you can’t control with self-care measures
- Difficulty drinking enough fluids
- High fever with mouth ulcers
- Weight loss
- Involvement of other mucous membranes (e.g. genitalia)
Most ulcers usually heal within seven to ten days. Preparations on sale in pharmacies for the treatment of mouth ulcers can help to relieve the discomfort and pain and also reduce the risk of a bacterial infection. Many over-the-counter preparations are not suitable for those who are pregnant or for children under two years of age and may not be suitable for other individuals, so it is always important to talk to your local Haven pharmacist when buying preparation for mouth ulcers over-the-counter.
Because mouth ulcers can recur, you may be able to reduce their frequency by addressing factors that seem to trigger them, so:-
- Avoid foods that seem to irritate your mouth. These may include acidic foods, nuts and certain spices.
- Don’t chew and talk at the same time, you could cause minor trauma to the delicate lining of your mouth, triggering a mouth ulcer.
- Regular brushing of teeth after meals and using floss once a day can keep your mouth clean and free of foods that might trigger an ulcer. Using a soft brush may help you avoid irritation of mouth tissues.
Use ice to help relieve the pain of a mouth ulcer and rinse your mouth with salt water to help the ulcers heal.
Find out more about mouth ulcers from your local Haven Pharmacist.