Mouth Ulcers

Many people suffer from recurrent ulcers in the mouth. These can be extremely painful, particularly if the tongue is involved and may make speaking and eating difficult. Usually one to five small ulcers appear (less than 1mm in diameter) on the inside of lips or cheeks, floor of the mouth or tongue. The ulcers tend to be concentrated towards the front of the mouth. Prior to the ulcers appearing, you may experience a burning or prickling sensation. They can last from a few days to a little over two weeks, but usually about 10 days. Aphthous ulcers are recurring ulcers with no known cause, and affect around 20-30% of the population.

Mouth ulcers can be triggered by a wide range of factors including:

  • Accidental biting of the inside of your cheek
  • Injury from a toothbrush (such as slipping while brushing) or vigorous brushing
  • Constant rubbing against misaligned/sharp teeth or an irregular filling
  • Constant rubbing against dentures or braces
  • Stress
  • Hormonal changes
  • Menstruation
  • Deficiencies in Vitamin B12, iron and folic acid
  • Burns from eating hot food
  • Irritation from strong antiseptics, such as a mouthwash
  • Oral thrush infection
  • Herpes infections for e.g. a cold sore
  • Reaction to certain medications 
  • Irritable Bowel Syndrome and immune disorders
  • Mouth Cancer

Treatment for ulcers

  • Avoid spicy and sour foods until the ulcers heal.
  • Drink plenty of fluids.
  • Regularly rinse your mouth out with warm, slightly salted water.
  • Keep your mouth clean.
  • Take pain-relieving medication, such as paracetamol.
  • Apply antiseptic gel to the ulcers.
  • Use an alcohol-free medicated mouthwash containing chlorhexidine gluconate.
  • Use a topical steroid mouthwash or ointment – generally prescribed by your dentist or oral medicine specialist.
  • If required, use immunosuppressant medication as prescribed by your oral health professional. (This is required, rarely, for severe oral ulceration.)

Maintenance of a high level of oral hygiene will reduce the likelihood of secondary infection when ulcers are present; this of course can prove difficult since you may find toothbrushing too painful. Use of antiseptics, for example chlorhexdine mouthwash, are reported to be helpful by some people. Topical steroids can also provide relief. Local anaesthetic lozenges have been used as a last resort to give some relief for example, when eating.

Visit your Dentist, GP or Pharmracist if your mouth ulcers don't clear up within a few days, or if you get them frequently to cause concern. It's important to seek the advice of a dentist who may refer more severe cases to a specialist in oral medicine for a thorough investigation.