About
Mouth ulcers, also known as canker sores, are small and painful sores that can form inside the mouth, on the lips, tongue, or cheeks. The cause of mouth ulcers is still unclear, but may be caused by a variety of factors including stress, hormonal changes, acidic or spicy foods, or a deficiency of certain vitamins or iron. Mouth ulcers are generally round and white, but can sometimes be yellow or gray. Symptoms of mouth ulcers can include pain, tenderness, swelling, and irritation. Treatment for mouth ulcers is typically topical medications, medications taken orally, or home remedies such as salt water rinses or cold teabags.
Symptoms
The most common symptom of a mouth ulcer is a small, round, white or yellow spot on the inside of the mouth. Other symptoms include a burning sensation in the mouth, redness or swelling in the affected area, pain or tenderness in the mouth, and a decreased appetite. In some cases, a person may also experience difficulty speaking or eating, and the mouth ulcer may be accompanied by a fever.
Causes
The exact cause of mouth ulcers is often hard to identify. However, possible known causes of mouth ulcers include local irritation from sharp or rough food, stress, nutritional deficiencies, hormonal imbalances, certain medications, fungal or bacterial infections, autoimmune disorders, and a weakened immune system. Some people may be genetically predisposed to mouth ulcer formation.
Risk factors
There are numerous risk factors associated with mouth ulcers, including:
- Poor dental hygiene: Poor oral hygiene increases your risk of developing an ulcer due to bacteria or irritation of the gums and teeth.
- Stress: Stress can cause the body to produce more cortisol, leading to inflammation and weakened immunity, which can increase your risk of mouth ulcers.
- Food allergies: Certain foods may cause an allergic reaction, leading to an ulcer.
- Certain medications: Certain medications may cause mouth ulcers as a side effect.
- Nutrient deficiencies: Nutrient deficiencies may cause or worsen ulcers.
- Smoking: Smoking increases the risk of mouth ulcers due to exposure to harmful substances that can irritate the mouth.
- Hormonal changes: Hormonal changes during puberty, pregnancy, and menopause can increase the risk of mouth ulcers.
- Diabetes: Diabetes may increase the risk of mouth ulcers due to a weakened immune system or poor blood sugar control.
- Certain medical conditions: Certain medical conditions, such as Crohn’s disease, inflammatory bowel disease, and celiac disease, may increase the risk of mouth ulcers.
- 0. Age: Ulcers are more common in older adults due to weakened immune systems and decreased saliva production.
Diagnosis
Mouth ulcers can generally be diagnosed during a physical examination. The doctor may ask you questions to help determine the cause. If the cause of the mouth ulcer is unknown, they may perform a biopsy, a laboratory test to examine the tissue under a microscope. Other tests may include blood tests to check for anemia, vitamin deficiencies, or any underlying diseases. Blood tests may also be used to look for infections such as HIV and herpes. They may also perform an x-ray to rule out any underlying dental problems.
Sub-types
Mouth ulcers can be divided into several subtypes, depending on the cause and the underlying medical condition.
- Aphthous ulcers (canker sores): These are the most common type of mouth ulcers, and they can appear as either single or multiple lesions. They are usually oval-shaped and appear on the inside of the cheeks, lips, or tongue.
- Traumatic ulcers: These occur as a result of physical injury to the mouth, such as biting or burning the tongue or lip with hot food.
- Geographic ulcers: These consist of ulcers that form a specific pattern on the mouth, such as a line around the edges of the tongue.
- Hormonal ulcers: These ulcers can occur in women during pregnancy or during menstruation.
- Systemic ulcers: These are caused by an underlying medical condition, such as Crohn’s disease, Behcet’s disease, or HIV/AIDS.
- Chemical ulcers: These are caused by exposure to certain chemicals, such as medicated toothpaste or mouthwash.
- Autoimmune ulcers: These are caused by an abnormal immune response, such as lupus or pemphigus.
Treatments
Treatment options for mouth ulcers vary depending on the underlying cause and severity. Generally, the primary goal of treatment is to reduce pain and inflammation.
Self-care treatments include:
- Taking OTC pain medications such as ibuprofen or acetaminophen
- Consuming a diet high in fruits, vegetables, and dairy products
- Avoiding acidic, spicy, and caffeinated foods
- Gargling with warm salt water or mouthwash
Prescription medications may also be prescribed to treat mouth ulcers, such as:
- Steroid medications to reduce inflammation
- Antiseptic solutions or gels to speed up healing
- Medications to treat underlying conditions, such as viral or fungal infections
In cases of recurrent or severe mouth ulcers, your doctor may recommend other treatments such as laser therapy, cryotherapy, or topical medications.
Prevention
Mouth ulcers can be prevented by making sure to maintain proper oral hygiene. Brushing and flossing twice a day, avoiding acidic and spicy foods, reducing stress, drinking plenty of water, avoiding tobacco and alcohol use, and avoiding foods that are difficult to chew can all help prevent mouth ulcers. Additionally, eating a balanced diet and taking a daily multivitamin can help strengthen the immune system and reduce the risk of mouth ulcers.
Gender differences?
Yes, there are gender-specific differences in the presentation and management of Mouth ulcer. The prevalence of mouth ulcer is higher among females than males, with prevalence rates of 3.2 – 12.7% and 0.8 – 4.9%, respectively. Additionally, mouth ulcers among females are more likely to be recurrent and chronic. As a result, females typically present with more severe symptoms, including an increased intensity of pain, longer healing time, and more frequent recurrences. The management of mouth ulcers is also different in males and females. Females are more likely to receive aggressive treatment strategies, such as topical medications, systemic medications, and lifestyle modifications. Furthermore, for females, stress-reduction techniques may be used to reduce the frequency of recurrences. On the other hand, males are more likely to rely on self-care measures such as rinsing with salt water and topical analgesics.
Nutrition
Good nutrition can play an important role in the management of mouth ulcers. Eating a balanced diet with plenty of fruits and vegetables, lean proteins, and complex carbohydrates helps support the body’s natural healing process. Additionally, vitamin and mineral supplements may be beneficial, such as vitamin C to strengthen the immune system and increase collagen production, and zinc to promote healing. Eating foods rich in lysine, such as fish, may help reduce the severity of mouth ulcers. Finally, avoiding foods that are known to irritate mouth ulcers, such as acidic, spicy, or salty foods, is also important.
Physical Activity
Physical activity can have both positive and negative effects on mouth ulcers. Regular physical activity can help to reduce stress and anxiety, which can help to reduce the occurrence of mouth ulcers. On the other hand, strenuous physical activity can cause trauma to the mouth such as injuries to the cheek and lips, which can make existing mouth ulcers worse and cause new ones to form. Thus, if you have mouth ulcers, it is best to engage in moderate physical activity and avoid any activity that could cause trauma to the mouth.
Further Reading
- https://www.healthline.com/health/mouth-ulcers
- https://www.ncbi.nlm.nih.gov/books/NBK546251/
- https://www.medicalnewstoday.com/articles/317984
- https://patient.info/oral-dental-care/mouth-ulcers-leaflet
- https://www.nhsinform.scot/illnesses-and-conditions/mouth/mouth-ulcer
- https://www.nature.com/articles/bdj.2007.82