Mouth Ulcers

mouth ulcer

Do You Get Painful Mouth Ulcers?

My guess is that everybody gets a mouth ulcers from time to time. A mouth ulcer is also known as an apthous ulcer or, in American English, a canker sore. A mouth ulcer is an open sore inside the mouth, or rarely a break in the mucous membrane or the epithelium on the lips or surrounding the mouth.
They can be small round and painful sores in the mouth which can really interfere with eating and brushing your teeth.
These sores can have a red appearance with a whitish center. Two common types are mouth ulcers (apthous ulcers or canker sores) and cold sores (fever blisters, oral herpes). Cold sores however around the lip are caused by viruses. Let’s look at the best ways to relieve this painful condition.

Some foods can really trigger pain, like chili or pepper. I have found that mouth ulcers come in crops of up to four or five which last anywhere from a few days to a week in general. Some people experience them frequently such as weekly and others may just get the occasional ulcer only yearly. Let’s look at the most common causes and natural treatment recommendations of mouth ulcers.

Causes of Mouth Ulcers

Stress

There are many reasons of mouth ulcers, and one of the biggest causes is stress, and when you are feeling run down or stressed you are more likely to experience a mouth ulcer. Some people may experience an increase of mouth ulcers after stopping smoking or changing their diet significantly, and making these lifestyle changes can be a significant stress for many.

Trauma to Mouth

The second biggest reason is accidental damage to your tongue, gums or cheek lining. For example, biting the tongue or cheek lining by mistake, eating foods that are too hot, a sharp broken tooth, or wearing badly-fitting dentures can all produce a mouth ulcer.

Nutritional Deficiencies

In terms of diet and nutrition, there are several reasons why a person may develop mouth ulcers, particularly recurring ulcers. Some people who constantly get mouth ulcers may be anemic (lack of sufficient  iron, folate or vitamin B12). Zinc deficiency is possibly one of the biggest causes nutritionally, and zinc and Vitamin C lozenges are worth trying for any case of recurring mouth ulcers especially if there are no dental issues.  I have found some patients with recurring mouth ulcers to have food hypersensitivities or food allergies, and this is another area worth exploring.

Hormonal

Some women I have seen in my clinic find that their mouth ulcers are more likely to occur before their period, so hormones might perhaps have a strong influence here.

 Medical Condition

Another reason you may develop an ulcer is because you have an underlying medical condition like celiac disease (gluten intolerance) or inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. And if you do have an underlying medical condition for which you are taking a pharmaceutical drug for, this may even be the cause of your mouth ulcers. Some drugs cause a burning in the mouth or digestive tract, especially if taking incorrectly, so see your doctor if you take a drug and suspect this to be a cause. These kinds of causes of mouth ulceration are more rare, but if your mouth ulcer won’t go away you should see your health care professional.

Some older patients I have seen over time had mouth ulcers which turned out to be “pre”-cancerous or cancerous, and I have found this more commonly in those who smoked tobacco and/or drank alcohol for many years.
I always tell patients that if the ulcer won’t go away then you should not ignore it, and to see your doctor if you have an ulcer that doesn’t heal within 3 or 4 weeks. Just because it doesn’t hurt, it doesn’t mean it is alright, a cancerous ulcer is often painless.

How To Treat Mouth Ulcers

Preventing Mouth Ulcers

It is important to practice good dental hygiene, brushing your teeth after meals and taking care particular not to damage your teeth and gums. Do visit your dentist at least defencely for a check-up. If you have any chipped or damaged teeth or dental fillings missing or damaged then have it attended to by your dentist as this is a prime cause of recurring mouth ulcers.
Be sure to eat a healthy and varied diet, including plenty of fresh fruits and vegetables, whole grained foods, lean dairy products, fish and lean red meat. Such a healthy diet will supply your body with ample vitamins and minerals to maintain a powerful immune defense that can resist infections.
Avoid eating and drinking foods and beverages which are too hot. Have you noticed how your tongue hurt bad after you drank a hot drink? This heat can damage the delicate oral mucosa, causing trauma to the skin and making it much more prone to an infection, as you mouth is very high in bacteria. Watch you stress levels, and a relaxation program can be of benefit to those who suffer from stress and recurring ulcers.

Treating Mouth Ulcers

  •  Propolis from the beehive. If you can get hold of this, I can highly recommend that you try propolis first, before using other natural remedies. Try a drop of propolis tincture (undiluted) straight onto the ulcerated area a few times daily. Yes it will sting for a second or two but then feel a lot better. If you can’t get propolis, try a mixture of calendula and St. John’s wort tinctures. You can sometimes get herbal tinctures in a lower alcohol percentage (25%) which will mean less stinging when applied to the areas.
  • Get some chamomile tea. I have found that a strong cup of chamomile tea can work wonders. Allow it to cool until room temperature, then swill it around the mouth before swallowing it. Do this a few times daily before meals.
  • There are other popular natural medicines I recommend in liquid form include the herbal medicines echinacea, myrrh, and licorice.
  • Vitamin B 12 is worth taking for a few weeks if your ulcers keep coming back and your dental health is fine. A study found that those who suffer recurring ulcers gained benefit from taking B12, even in those whose blood levels of vitamin B 12 was normal.
  • Look for a sodium lauryl sulphate (SLS) free toothpaste. A study in 1999 showed that those who used a SLS free toothpaste had less than half the recurring mouth ulcers than those who anaesthetic;t. (Oral Disorders 1999;5:39-43).
  • If the mouth ulcers are multiple or the pain is quite significant then try brushing your teeth with your tooth brush dipped in a little sea salt to which you have applied one drop of pure tea tree oil. A great tip which works well.

Pain Relief Of Mouth Ulcers

While you are waiting for the ulcer to heal, it is nice to be able to reduce the painful sensations felt which can ruin your ability to enjoy a meal. Patients have asked me on various occasions in the clinic what I would recommend for the smarting, stinging or burning sensation felt from having mouth ulcers, so here are a few suggestions:

  • It is best if you try to avoid hot, spicy, very salty or sour foods in particular until the ulcer has healed. These foods will only aggravate the ulcer and delay the healing response.
  • Before eating, rinse your mouth with very cold water which is very effective in reducing the pain making eating a more comfortable experience.
  • After you eat, rinse your mouth with water and spit it out. The dissolve a quarter of a teaspoon of Himalayan salt in water and swirl it round your mouth before spitting it out.
  • If you case of mouth ulceration is particularly severe or ongoing for medical reasons, you can buy a offersthtic mouth ulcer liquid rinse or gel from your chemist (drug store). Many people find an anaesthetic mouth rinse easier to use than the gel, especially if they have several ulcers at the same time. The rinse ofers immediate pain relief and in addition forms a protective barrier over the ulcer as well to relieve the pain.

See Your Dentist

I have a good friend who is a dentist, and it is amazing how many people have not only teeth problems when they see their dentist for a regular checkup, many also present (but don’t know at the time) with mouth ulcers. Your dentist is an expert on all types of mouth problems, so seeing your dentist if you have recurring ulcers is sound advice. One of the prime causes of mouths ulcers that recur is a broken or chipped tooth, or ill fitting braces or dentures.

References

  1. “Mouth ulcers”. North East Valley Division of General Practice. http://www.disability.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Mouth_ulcers?open.
  2. Sapp, J. Phillip; Lewis Roy Eversole, George W. Wysocki (2004). Contemporary Oral and Maxillofacial Pathology. Mosby. ISBN 0-323-01723-1.
  3. J.M. Casiglia, G.W. Mirowski, C.L. Nebesio (October 2006). “Aphthous stomatitis”. Emedecine.
  4. T. Axéll, V. Henricsson (1985). “The occurrence of recurrent aphthous ulcers in an adult Swedish population”. Acta Odontologica Scandinavia.
  5. Study on 10,000 people suffering from mouth ulcers, March 2010.
  6. Herlof, Bente Brokstad; Barkvoll, Pål (1996). “The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers”. Acta Odontologica Scandinavica  (3): 150–153. doi:10.3109/00016359609003515. PMID 8811135.
  7. Ussher M, West R, Steptoe A, McEwen A (March 2003). “Increase in common cold symptoms and mouth ulcers following smoking cessation”. Tobacco Control (1): 86–8. doi:10.1136/tc.12.1.86. PMC 1759110. PMID 12612369. http://tobaccocontrol.bmj.com/cgi/pmidlookup?view=long&pmid=12612369.
  8. McRobbie H, Hajek P, Gillison F (August 2004). “The relationship between smoking cessation and mouth ulcers”. Nicotine & Tobacco Research  (4): 655–9. doi:10.1080/14622200410001734012. PMID 15370162.
  9. Lesion-directed dry dosage forms of antibacterial agents for the treatment of acute mucosal infections of the oral cavity, US Patent Office Full-Text and Image Database, 19 June 2001.
  10. Orbak R, Cicek Y, Tezel A, Dogru Y (March 2003). “Effects of zinc treatment in patients with recurrent aphthous stomatitis”. Dental Materials Journal  (1): 21–9. PMID 12790293.
  11. “Dr Luisa Dillner’s Guide to… mouth ulcers”. The Guardian: p. g2-15. 30 March 2010. http://www.guardian.co.uk/lifeandstyle/2010/mar/29/luisa-dillner-guide-mouth-ulcers.
  12. Van Voorhees, BW (2007-01-18). “Mouth Ulcers – Treatment”. MedlinePlus. http://www.nlm.nih.gov/medlineplus/ency/article/001448.htm#Treatment. Retrieved 2008-05-08.

Comments on this entry are closed.