Mouth Ulcers

Mouth ulcers are a common yet painful infliction. They usually present as round or oval sores that are found inside the mouth, developing on the lips, cheeks or tongue. Their appearance can vary; mouth ulcers can be red, white, yellow or grey in colour and are usually swollen. It is possible for a sufferer to experience multiple mouth ulcers at a time, which unfortunately may spread and grow.  Although very uncomfortable, mouth ulcers are in most cases harmless. Without treatment, the majority of mouth ulcers will clear up within a fortnight.

In some cases, the causes of mouth ulcers are still unclear. However, most single ulcers are the result of damage to the lining inside of the mouth. This damage can be the result of:

• Accidently biting the inside of the cheek or lips.
• Eating hard or sharp-edged food.
• Having dentures that do not fit properly.
• Having a defective filling.

It is not always clear what causes recurrent mouth ulcers to develop, though triggers are thought to include:

• Hormonal changes, such as a woman’s monthly period.
• Anxiety or stress.
• Certain foods, such as spicy foods, chocolate, cheese, tomatoes, strawberries, almonds, peanuts, wheat flour and coffee. 
• Smoking cessation, which has been known to cause mouth ulcers in its initial stages.

Genetics can also be a contributing factor as around 40% of recurrent mouth ulcer sufferers report that the condition runs in their family. Certain medical conditions can also cause mouth ulcers, these include:

• Crohn’s disease.
• Coeliac disease.
• Hand, foot and mouth disease.
• The cold sore virus.
• Chickenpox.
• Reactive arthritis.
• Behcet’s disease.

Mouth ulcers will present as round or oval sores that commonly appear inside the mouth. They can develop on the lips, inner cheeks or tongue. These swollen sore will be either red, white, yellow or grey in colour. Mouth ulcers are normally 2 - 8mm in diameter and may have a raised or defined border.

It is possible to present with multiple mouth ulcers at any given time. These sores can be painful and, depending on location, can make eating, drinking, talking and brushing teeth extremely uncomfortable.

In most cases, mouth ulcers can be treated at home; there is no need for an official diagnosis. It is only recommended you visit your doctor should any of the following apply:

• Your mouth ulcers are recurrent and frequent.
• Your mouth ulcers have persisted for longer than three weeks.
• Your mouth ulcers have become inflamed and painful, which may suggest a bacterial infection that will require treatment with antibiotics.
• You also have a fever, swollen glands or other signs of illness.

Mouth ulcers can also be a symptom of hand, foot and mouth disease, which is a viral infection that mainly affects young children. If you are worried or unsure about your mouth ulcers, it is advised to speak to a pharmacist, GP or dentist for an informed diagnosis.

Mouth ulcers will usually heal by themselves within one to two weeks. There are treatments available that will help reduce the swelling and ease the discomfort. Treatments that are available without prescription include:

• Antimicrobial mouthwashes, such as Corsodyl or Chlorhexidine Gluconate. These may help to speed up healing and also prevent the ulcer from becoming infected. 
• Corticosteroid treatments, such as hydrocortisone buccal tablets, help to reduce the discomfort as well as speeding up the healing process. Corticosteroid treatments are not suitable for children under 12 years. 
• Pain-killing mouthwashes, lozenges, pastilles, gels or sprays are available to help reduce the associated pain and discomfort. Examples of such treatments include; Iglu Gel, Iglu Pastilles, Bonjela Adult Gel, Difflam Oral Rinse, Difflam Spray and Dequadin Lozenges. These treatments normally include a local anaesthetic to numb the area.

In some cases, it may be necessary to seek stronger treatment options if your ulcers are severe or numerous. Your GP or dentist can issue stronger steroid treatments to help reduce the pain and swelling as well as speed up healing.

In many cases, it is impossible to prevent mouth ulcers, as they are often the result of things that are out of our control (such as genetics or medical conditions). However, there are steps that can be taken that may help to reduce the risk of developing mouth ulcers. These include:

• Avoiding foods that are known to be triggers, such as chocolate or spicy foods.
• Using a soft-bristled toothbrush that will help to reduce irritation in the mouth.
• Avoid using toothpaste that contains Sodium Lauryl Sulphate.
• Avoid excessively chewing gum.
• Reducing your stress and anxiety levels.
• Try to avoid chewing or biting the inside of your mouth.