Know the Types of Mouth Ulcers before Treatment

Mouth Ulcer

Tiny white or yellow colour mouth ulcers can be extremely annoying. They can give a jitter of sharp shooting pain while you are eating something, especially salty or spicy food. You may face trouble in speaking or talking too.

Irrespective of age group, mouth ulcers can affect a small child to an elderly person. Mouth ulcers usually occur on the inner surface of the cheeks and lips, sides or underneath tongue, roof of the mouth and sometimes at the base of the gums.

In some cases a mouth ulcer may be precipitated or indicate underlying disease or disorder.

Types of Recurrent Ulcers

There are two types of recurrent mouth ulcers:

  • Canker sore or apthous ulcer or recurrent apthous minor
  • Cold sore or fever blister

The most common type of mouth ulcer is canker sore. Medical term for canker sore is called recurrent aphthous stomati They are not contagious and are found inside the mouth on cheeks, gums or lips. Canker sore do not involve the roof of mouth.

Canker sores may recur at intervals of a few days or up to 2–3 months. The peak age of recurrent apthous minor onset is during childhood, with a tendency to decrease in severity and frequency with age.

Minor canker sores heal completely in one to three weeks, but major canker sores can take up to six weeks to heal.

Fever blister or cold sore caused by Herpes simplex virus Type 1. Blisters or sores on the lips and around the outside of the mouth are usually cold sores. They are contagious.

Cold sore occurs in the individual with dormant or latent herpes simplex virus, which gets reactivated  in the case of acute stress or trauma.

Mouth Ulcers due to Systemic Involvement

Mouth ulcers can also occur due to some diseases, disorders and conditions that can be serious, even life-threatening. These include oral cancer and leukoplakia.

Reasons Why you have Mouth Ulcers Frequently

1. Most common cause : stress or tissue injury (aggressive tooth brushing or ill fitting denture, braces, rough dental fillings or sharp edges on teeth, sudden bite or chewing the inside of the cheek)

2. Consumption of very hot food or drinks

3. Allergy or adverse reactions of food (e.g., caffeine, tangy cheese,chocolate, coffee, peanuts, almonds, strawberries, cheese and tomatoes, chocolate acidic, spicy or salty food) drinks or oral health care products (toothpastes and mouth rinses) and certain medicines. Irritation by a few chemicals, tobacco and alcohol.

4. Xerostomia or dry mouth (which may be due to medicines or medical conditions)

5. Some nutritional deficiencies (e.g., low iron, folic acid, zinc, B-group vitamins) , Anemia

6. Poor diet and digestive problems like constipation

7. Hormonal imbalances, particularly during puberty in girls and menstruation

8. Cessation of smoking

9. Systemic causes of mouth ulcers

Blood disease: Anaemia, Leukaemias, myelodysplastic syndromes, Neutropenias

Skin diseases
Lichen planus, Pemphigus,  Pemphigoid,   Erythema multiforme, Dermatitis herpetiformis

Infections
Viral- HSV, VZV, EBV, CMV, HIV, Coxsackie viruses
Bacterial- Mycobacteria, Treponema pallidum

Gastrointestinal diseases
Coeliac disease, Crohn’s disease, Ulcerative colitis

Malignancy
Oral carcinoma, Antral carcinoma
Lymphomas, Kaposi’s sarcoma, Salivary neoplasms

Sign & Symptoms of Mouth Ulcers 

You may feel tingling or burning sensation the inside of Lips or cheek 1 to 2 days prior to appearance of an ulcer.

Prevention from Mouth Ulcers

  • Maintain good oral hygiene by brushing twice daily, flossing and rinsing your mouth after every meals
  • Avoid too much spicy or acidic foodstuffs or any food you are allergic.
  • Use soft toothbrushes, chew slowly to avoid undue trauma
  • Try a sodium lauryl sulfate-free toothpaste, most notorious ingredient to cause mouth irritations.
  • Drink a minimum of 8 glasses of water a day.
  • Have good sleep for 7 hours in the night.
  • Take less stress, do meditation and yoga.
  • Have regular check-ups with dentist, dentist may point out problem such as sharp teeth or fillings, that could damage your mouth.

  • Eat healthy, balanced diet rich in vitamin

Treatment of Mouth Ulcer

No treatment- around 80% the mouth ulcers healing 1 to 2 weeks without scarring and are not contagious.

Rule out etiology.Treatment plans
for mouth ulcers are individualized based on the underlying cause, the presence of coexisting diseases, the age and medical history of the patient

Seek medical advice if they last longer than 2 weeks or keep coming back.

Treatment is symptomatic , medications are given to decrease the discomfort and faster healing of ulcers. If the cause is known, then treatment of that condition is also recommended.

  1. Maintain adequate oral hygiene and avoid spicy or hot foods
  2. Dissolve half a teaspoon of salt in a glassful of warm water. Use warm saline gargle thrice a day for removing the infection and heal faster.
  3. Antiseptic mouthwash is indicated in the case of secondary bacterial infection, ulcer due to denture related irritation, immunocompromised  patient. Chlorhexidinehwash of choice for aphthous ulcers.
  4. Apply local anesthetic gel  which contain local anaesthetics as benzocaine or lignocaine eg – mucopain or oragel
    Anabel gel – contains choline salicylate benzalkonium chloride and lignocaine
  5. If mouth sores occurs frequently and there is more than one sore, then it can be due to vitamin B deficiency. Take Vitamin B complex capsule once daily for 15 days.
  6. If your mouth ulcer does not respond to over-the-counter or at-home treatments, your doctor may prescribe a topical medication containing a steroid for the inflammation.
  7. Taking steroids are reserved for serious conditions and should be taken under medical supervision only.

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