Mouth Ulcers: Causes, Symptoms, and Treatment Options

What Is a Mouth Ulcer?

Mouth ulcer is a painful sore that develops inside the mouth, appearing as a round or oval lesion with a red edge and white, yellow or grey center. These ulcers, also called canker sores or aphthous ulcers, can make eating, drinking and talking uncomfortable.

An estimated 20% of the general population is affected by recurring mouth ulcers. While they are not contagious, these sores can be annoying and painful. Mouth ulcers usually heal on their own within 1-2 weeks, but some types can last longer and cause more severe symptoms.

What Are the Types of Mouth Ulcers?

There are three main mouth ulcer types:

• Minor Aphthous Ulcers: These are the most common, accounting for 80% of cases. Minor ulcers are small (less than 5 mm), shallow, and heal within 1-2 weeks without scarring.
• Major Aphthous Ulcers: Larger and deeper than minor ulcers, major sores are often very painful. They can take up to 6 weeks to heal and may leave extensive scarring. About 15% of patients suffer from major ulcers.
• Herpetiform Ulcers: These sores appear in clusters of tiny ulcers (1-2 mm) that merge to form larger irregular areas. Despite their name, herpetiform ulcers are not caused by the herpes virus. They typically heal within 1-2 weeks.

Other less common types include traumatic ulcers caused by injury and ulcers linked to systemic conditions like celiac disease or HIV/AIDS. Rarely, a persistent mouth sore may indicate oral cancer.

What Are the Symptoms of a Mouth Ulcer?

The main symptom is a sore on the soft tissues of the mouth, such as the tongue, inside of the cheeks, gums, or palate. Mouth ulcer symptoms include:

• Pain and discomfort, especially when eating, drinking or brushing teeth
• A burning, stinging sensation a few days before the sore appears
• Swelling and redness around the sore
• Increased sensitivity to hot, salty, sour or spicy foods

In severe cases, mouth ulcers may also lead to fever, swollen lymph nodes and general feelings of illness or fatigue. Contact your doctor if you have a mouth sore that doesn't improve after three weeks for mouth ulcer treatment.

What Causes Mouth Ulcers?

Exact mouth ulcer causes are unknown. However, certain factors and triggers have been identified:

• Minor tissue injury from dental work, hard brushing, sports mishaps or accidental biting
• Toothpastes and mouthwashes containing sodium lauryl sulfate
• Food sensitivities, especially to acidic foods like strawberries, tomatoes and citrus
• Nutritional deficiencies of B-12, zinc, folate, or iron
• Hormonal shifts during menstruation
• Emotional stress or lack of sleep
• Bacterial, viral or fungal infections
• Smoking and tobacco use
• Certain medications, including beta-blockers and chemotherapy medicines

Health Conditions Associated With Mouth Ulcers

Recurrent mouth ulcers can sometimes signal an underlying health issue, such as:

• Celiac disease, an immune reaction to gluten
• Inflammatory bowel diseases like Crohn's and ulcerative colitis
• Behçet's disease, a rare autoimmune disorder causing inflammation throughout the body
• Compromised immunity due to conditions like HIV/AIDS or diabetes
• Oral cancer, in rare cases

If you have frequent, severe mouth sores, it's important to see your doctor to rule out serious problems. Blood tests and biopsies can help determine mouth ulcer causes.

Are Mouth Ulcers Contagious?

No, most mouth ulcers are not contagious. The sores cannot be passed through saliva or close contact. Even herpetiform ulcers, despite their name, are not caused by the contagious herpes simplex virus responsible for cold sores. Aphthous ulcers develop due to internal imbalances and are not transmissible between people.

How Do Health Providers Diagnose Mouth Ulcers?

In most cases, your dentist or doctor can diagnose a mouth ulcer based on its appearance and your medical history. They'll ask about the frequency, duration and severity of your sores. Unless there are signs of infection or an underlying condition, no tests are usually required.

How Do You Treat a Mouth Ulcer?

Mouth ulcer treatment focuses on relieving pain, speeding up healing and preventing complications. Your doctor may recommend:

• Antimicrobial mouthwashes containing chlorhexidine gluconate
• Protective pastes or gels to cover the sore and reduce irritation
• Topical pain relievers with benzocaine
• Topical corticosteroids to reduce inflammation
• Oral medications for severe symptoms

In addition, avoid spicy, salty, and acidic foods that can irritate the sore. Brush your teeth gently with a soft toothbrush. See your dentist if a sharp tooth or dental appliance is causing the ulcer. Drinking cold fluids and taking OTC pain relievers can also help in mouth ulcer prevention.

How To Cure Mouth Ulcers Fast Naturally?

For natural mouth ulcer medicine, you can try:

• Rinsing with warm salt water a few times daily
• Applying a thin paste of baking soda and water
• Dabbing milk of magnesia on the sore
• Placing damp tea bags on the ulcer
• Using OTC numbing gels

Can We Prevent Mouth Ulcers?

While you can't always prevent mouth ulcers, these tips may reduce your risk:

• Practice good oral hygiene and visit the dentist regularly
• Avoid foods that irritate your mouth, including spicy, acidic and hard foods
• Chew slowly and carefully to prevent accidental bites
• Reduce stress through relaxation techniques
• Boost your immune system with a balanced diet and adequate sleep
• Treat any underlying conditions that contribute to ulcers
• Quit smoking and avoid alcohol

If you're prone to mouth ulcers, talk to your doctor about taking B-vitamin and zinc supplements to correct deficiencies. Using a daily antimicrobial mouthwash may also help prevent outbreaks.

How Long Do Mouth Ulcers Last?

The healing time depends on the type of mouth ulcer:

• Minor ulcers usually clear up in 1-2 weeks
• Major ulcers can take 2–6 weeks to heal completely
• Herpetiform ulcer clusters resolve in 1-2 weeks

Mouth ulcers that persist longer than 3 weeks should be evaluated by a doctor, as they may indicate infection, an underlying health problem, or in rare cases oral cancer.

When to See a Doctor?

Make an appointment with your doctor or dentist if your mouth ulcer:

• Is unusually large or painful
• Lasts more than 3 weeks
• Extends to the lips
• Is accompanied by fever, diarrhea, headaches or skin rash
• Interferes with drinking enough fluids
• Keeps coming back

Seek medical care if the sore makes it hard to eat, causes severe pain or shows signs of infection like pus, oozing and red streaks.

Mouth Ulcer vs. Canker Sore: What's the Difference?

Mouth ulcers and canker sores are actually the same thing. "Canker sore" is the common name for the medical condition known as "aphthous stomatitis" or simply "mouth ulcers." These painful sores are not contagious and differ from fever blisters or cold sores caused by the herpes virus. Unlike cold sores, canker sores only occur inside the mouth. So while all canker sores are mouth ulcers, not all mouth ulcers are canker sores. Mouth ulcers is a broader term that includes other types of sores in the mouth.

How Do You Know If Your Mouth Ulcer Is Bad?

See a doctor if your mouth ulcer:

• Gets worse or doesn't improve
• Lasts longer than 3 weeks
• Is painless (most mouth ulcers cause discomfort)

In rare cases, a mouth ulcer that doesn't heal may be a sign of oral cancer. Sores caused by infection may have redness, swelling, pain, fever and swollen lymph nodes. If your ulcer bleeds easily or has an irregular border, it's important to get it checked.

Are Mouth Ulcers a Sign of Cancer?

Most mouth ulcers are harmless and not a sign of oral cancer. However, if you have a sore in your mouth that doesn't go away after three weeks, it's important to see your doctor. Rarely, a long-lasting, painless mouth ulcer can be a symptom of oral cancer. Your doctor can determine if a biopsy or other tests are needed to rule out this possibility. When oral cancer is caught early, it's highly treatable.

Conclusion

While mouth ulcers are common and usually not serious, they can still be a literal and figurative pain. Fortunately, by identifying your triggers, taking preventive measures, and using proper treatments, you can keep uncomfortable canker sores at bay. Remember, your body often signals underlying imbalances through mouth ulcer symptoms. If troublesome mouth ulcers are impacting your quality of life, don't hesitate to consult your doctor or dentist.

Consider getting some diagnostic tests to pinpoint nutrient deficiencies, food sensitivities or signs of conditions like celiac disease that can trigger ulcers.

As India's leading diagnostic lab, Metropolis Healthcare offers comprehensive health check-ups and blood tests to get to the bottom of recurring health issues. With a nationwide presence, at-home sample collection, and online reports, taking control of your health has never been more convenient.