Mouth ulcer treatment
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Mouth ulcer treatment
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If a mouth ulcer won’t heal or keeps causing you pain, the first step is to find out why, then take whatever treatment is needed.
About mouth ulcer treatment
A mouth ulcer can have many causes — fatigue, your general condition, nutrition, a habit of biting your cheek, irritation from teeth or an orthodontic appliance, or infection. Ulcers that look alike can need different treatment, so rather than relying on an over-the-counter medicine and watching it for a long time, you should have the healing and the surrounding tissue checked.
Types and causes of mouth ulcers
There are several types of mouth ulcer, and the features and course differ depending on the cause.
Aphthous ulcers
This is the most common type. A white ulcer with redness and swelling around it, round or oval and around 2-10mm across. It causes severe pain when touched and most often appears on the inside of the cheek, the inside of the lip, the tongue or the gums. The exact cause is not known, but it is thought to happen more often when fatigue, stress, poor sleep or poor nutrition lower your immunity, or when the cheek is bitten or an orthodontic appliance or denture rubs the mucosa.
Catarrhal ulcers
This type comes from physical irritation — a denture or orthodontic appliance rubbing the mucosa, a burn from hot food, biting the inside of the cheek — or from a bacterial infection. Tooth decay, periodontal disease or a crown that no longer fits well can also be a trigger. The mucosa turns red and swollen with an eroded appearance, and unlike an aphthous ulcer the edges are usually poorly defined and the area can spread. It improves once the source of irritation is removed.
Viral ulcers
This type is caused by an infection such as the herpes virus or coxsackievirus. Herpes causes small blisters on the lips and around the mouth; once these burst they form painful ulcers, sometimes with a fever or general fatigue. Hand, foot and mouth disease is another viral illness with mouth ulcers — besides the mouth, a rash can appear on the palms and soles. It is more common in children, but adults can catch it too.
Candidal ulcers
This type comes from an overgrowth of Candida, a type of fungus. It happens more easily when your immunity is low, after long-term antibiotic use, or with steroid medication, and Candida can also build up under a denture worn for long periods without being removed. A white, coating-like film forms, and forcing it off can cause bleeding; there may also be a burning sensation or a change in taste.
Who is more likely to get mouth ulcers
Fatigue and stress build-up
Fatigue and stress that build up can lower your immunity, making mouth ulcers more likely. Take extra care during busy spells at work, a change in your surroundings, or a stretch of poor sleep.
An unbalanced diet
An unbalanced diet also makes mouth ulcers more likely. A shortage of B vitamins, iron or zinc in particular makes it harder for the mucosa to stay healthy, so take extra care if you eat out often or have a limited diet.
Wearing an orthodontic appliance or a denture
An orthodontic appliance or denture can rub against the mucosa and damage it. Mouth ulcers are more likely while you are getting used to a new appliance, or once a denture stops fitting well, so if rubbing is causing you pain, have it adjusted as soon as possible.
A habit of biting the inside of your mouth
If you tend to bite the inside of your cheek or your lip, repeated damage to the same spot makes mouth ulcers more likely. The same applies if crooked teeth or a sharp tooth press against the mucosa.
Smoking or a dry mouth
Smoking irritates the mucosa and can lower your immunity, raising the risk of mouth ulcers. Saliva has an antibacterial effect, so if your mouth tends to dry out, bacteria can build up more easily too, which also makes mouth ulcers more likely.
Mouth ulcers that need a dentist’s opinion
Not healing after a long time
This means it shows no improvement after around 2 weeks, or it keeps growing.
Recurring ulcers
This means one keeps appearing in the same spot, or a denture or the edge of a tooth keeps rubbing against it.
Severe symptoms
This means symptoms such as a fever, a large area of erosion, or difficulty eating or drinking.
Treatment process
Discussing your symptoms
We ask when it started, how it has developed, and whether it keeps recurring.
Oral examination
We check the condition of the wound, whether a tooth or an appliance is in contact with it, and how well the mouth is being kept clean.
Treatment based on the cause
Depending on the situation, we suggest removing the source of irritation, guidance on cleaning, medication, or another approach.
Follow-up visit
We check how it is healing, and if needed arrange further tests or a referral to a partner medical institution.
How to prevent mouth ulcers
Enough sleep and managing stress
Getting enough sleep and not letting fatigue build up is the basic principle. The busier you are, the more you should look after your rest, and moderate exercise or time spent on a hobby to release stress can also help.
A balanced diet
Aim for a nutritionally balanced diet and eat plenty of food rich in B vitamins. Alongside pork, liver, eggs, natto, spinach and bananas, iron and zinc also help keep the mucosa healthy.
Careful oral care
Brush after meals and before bed to keep your mouth clean. Scrubbing hard with a hard-bristled brush can damage the mucosa, so a soft-bristled brush and a gentle touch are best.
Looking after your appliance or denture properly
If an orthodontic appliance or denture is rubbing and causing pain, do not put up with it — have it adjusted as soon as possible. It also matters that you clean a denture daily, take it out at night, and have its fit checked regularly by your dentist.
Stopping smoking and cutting down on irritants
Smoking is linked not only to mouth ulcers but also to the risk of periodontal disease and oral cancer, so consider giving it up. Drink alcohol in moderation, and go easy on strongly spiced food too.
Don’t leave it untreated based on your own judgment
What looks like a mouth ulcer can sometimes be hiding another condition. Do not squeeze the affected area or repeatedly use a harsh medication, and see a dentist promptly if it will not heal. If you develop severe swelling, or difficulty breathing or swallowing, go to a medical institution right away.
FAQ
Q1. Will a mouth ulcer heal on its own if left alone?
Most mouth ulcers heal naturally in around 1 week to 10 days. That said, if the pain is severe or eating is difficult, treatment can help ease the discomfort. If it has not healed after 2 weeks or more, another condition may be behind it, so we recommend having it checked at a dental clinic.
Q2. Is there anything I should watch in my diet when I have a mouth ulcer?
Strongly spiced, sour, salty or very hot food can sting the area and make the pain worse. Soft, mild food such as rice porridge, udon, tofu or yogurt is a good choice.
Q3. Do over-the-counter medicines work?
An over-the-counter ointment for mouth ulcers can be expected to have some effect. However, it may not suit a viral or candidal ulcer and can sometimes prolong it instead, so if it is slow to heal, please consider asking a dentist.
Q4. Can a mouth ulcer be passed on to someone else?
An aphthous ulcer is not generally thought to be contagious. A viral ulcer, however — such as one from herpes or hand, foot and mouth disease — can be passed on, so avoid sharing towels or cups and wash your hands often.
Q5. How can I tell a mouth ulcer from cancer?
An ordinary mouth ulcer usually heals within about 1-2 weeks, but be alert to a hard lump that will not go away, or a lesion with poorly defined edges that persists. If it has not healed after 2 weeks or more, is growing, or starts bleeding easily, we recommend having it checked at a dental clinic as soon as possible.
Q6. What can I do if my child can’t eat because of a mouth ulcer?
When the pain is severe, try something cold, soft and mild — ice cream, jelly, or udon that has cooled down. You can also ask a dentist about an ointment to ease the pain.
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