One of the most typical oral health problems everyone encounters is the mouth ulcer, often called an aphthous ulcer. They are clearly visible in the mouth and distributed across the whole oral cavity. They begin as white to yellowish sores, and as they grow a red rim forms around them. They are tiny, flat ulcers, typically 0.5 to 1 mm across. They can appear in anyone at any time, regardless of age — even in toddlers of two, although they often only appear in puberty.
Although these ulcers can hurt, many people do not worry much beyond the discomfort. They are frequently discovered by dentists or other specialists at a routine examination. They heal by themselves and often clear up within one to two weeks. There are various kinds, among them herpetiform ulcers, minor ulcers, major ulcers and simple ones. Most are simple and mild and occur three or four times a year, mainly between the ages of 10 and 20, and often last a week. Less common mouth ulcers are complex and herpetiform. In patients who have had them before, recurrence is more likely. Major mouth ulcers are larger and last longer than two weeks, and scarring usually occurs after healing.
Symptoms and causes
It is still unclear exactly where mouth ulcers come from. They can be triggered by stress, small injuries and certain foods such as citrus or acidic fruit and vegetables — lemons, oranges, pineapple, apples, tomatoes and strawberries. Taking non-steroidal anti-inflammatory medication such as ibuprofen can also encourage them. Sharp toothbrushes, sharp tooth surfaces, dental appliances and loose dentures can likewise lead to ulcers. Conditions such as lupus, Behçet’s disease, coeliac disease, ulcerative colitis, Crohn’s disease and AIDS can also show themselves as mouth ulcers.
Itching and discomfort are two of the most common symptoms. A tingling or burning sensation can also occur before the ulcer appears. In more severe cases patients can also have a temperature, physical sluggishness and swollen lymph nodes.
Prevention and treatment
There are two ways of treating mouth ulcers: over-the-counter medicines and home remedies. All of them help ease the discomfort and the inflammation and speed up healing. The most important thing to do before turning to home remedies is to control the possible triggers.
Treatment can involve oral medication such as sucralfate or oral steroids, supplements and addressing the underlying condition, as well as mouth rinses and topical products such as tubes and gels. If these problems occur frequently, they can be avoided by avoiding the triggers, preventing irritation from chewing gum, using a soft-bristled brush, flossing daily and avoiding oral care products containing sodium lauryl sulphate.
Home remedies and habits: rinse your mouth regularly with water or bicarbonate of soda — mix one tablespoon in half a cup of warm water. Dab on a small amount of magnesium several times a day. Avoid hot, abrasive and acidic meals for the time being. You can also try putting ice on the ulcer. Until it has healed, brush as gently as possible. Over-the-counter therapies include oral care products such as antiseptic mouthwashes that help reduce germs, and oral gels to ease the discomfort.
It is time to see a dentist if your ulcer does not heal even after trying all these remedies. If an aphthous ulcer lasts longer than 14 days or even longer, if it seems to be getting worse, if it grows unusually large, if you notice frequent outbreaks, if they become very painful over time or if they are accompanied by a high temperature, you should see your dentist straight away. Early examination and detection can spare you discomfort and distress.
