Mouth ulcers, also known as canker sores or aphthous ulcers, are painful sores that form in the mouth, usually on the inside of the cheeks, lips, tongue, or gums. They are a common condition that affects people of all ages and can cause discomfort and inconvenience in daily life.

Mouth ulcers can vary in size, shape, and severity and are classified into different types based on their characteristics. Many things, such as minor wounds, hormonal changes, and mental stress, can cause them. Mouth ulcers are not contagious and usually go away in 10 to 14 days.

You should consult your healthcare practitioner if your mouth ulcers do not heal in two weeks or happen frequently. They might be able to identify the root cause of the problem. With proper care, mouth ulcers can be effectively treated regardless of their underlying cause.

What are the types of mouth ulcers?

The different types of mouth ulcers are classified based on their size, location, and characteristics. The main types of mouth ulcers are:

Minor ulcers: Minor mouth ulcers are the most common type. They often have a red or white center and are small, round, or oval in shape. Minor ulcers can occur anywhere in the mouth, including the inner cheeks, lips, tongue, and gums, and heal without leaving scars. The symptoms of minor ulcers include pain, discomfort while eating or drinking, tingling or burning sensations, and mild swelling. Minor ulcers usually disappear on their own in 1-2 weeks without any treatment.

Major ulcers: Major ulcers are deeper, larger, and less common than minor ulcers. They often take 2 to 6 weeks to heal and can be more uncomfortable. Major ulcers can develop anywhere in the mouth but are more commonly found on the soft tissues, such as the back of the throat, under the tongue, and along the sides of the tongue. They are characterized by well-defined edges, a grayish or yellowish center, and a raised, inflamed border. These ulcers may be accompanied by severe pain, difficulty eating, and even leave scars after healing.

Herpetiform ulcers: Herpetiform ulcers are a less common type of mouth ulcer. They are characterized by clusters of small, pinpoint-sized ulcers that merge to form a larger sore. Herpetiform ulcers typically have a yellowish or grayish center, irregularly formed edges, and are round or oval in shape. They can occur anywhere in the mouth and be very painful, making eating and speaking difficult. Herpetiform ulcers may also recur frequently, with new ulcers forming before the existing ones have healed.

What are the symptoms of mouth ulcers?

Depending on the underlying cause, symptoms of mouth ulcers can vary but usually include:

Pain that gets worse while eating, drinking, or speaking.
Red or white lesions with a yellowish or grayish center.
Swelling in the area of the ulcer.
Recurrence of mouth ulcers.
Difficulty chewing or cleaning teeth.
Tingling or burning sensation in the mouth before an ulcer appears.

What are the causes of mouth ulcers?

Although the precise cause of mouth ulcers is still not fully understood, doctors recognized various factors that can facilitate their growth. Some of the typical mouth ulcer causes include:

Injury or trauma: Mouth ulcers can develop as a result of trauma to the mouth, including accidental biting of the cheek, tongue, or lip or using a toothbrush with hard bristles.
Poor oral hygiene: Mouth ulcers can develop as a result of poor oral hygiene, such as insufficient brushing and flossing.
Spicy or acidic foods: Some people may develop mouth ulcers after consuming spicy or acidic foods, including citrus fruits, tomatoes, and chocolate.
Nutritional deficiencies: Deficiencies in some nutrients, such as vitamin B12, zinc, and iron, can weaken the immune system and increase the risk of oral ulcers.
Hormonal changes: Oral ulcers are more likely to occur after menstruation, pregnancy, or hormonal medication.
Stress: Anxiety and stress can weaken the immune system and lead to mouth ulcers.
Medical conditions: HIV/AIDS, inflammatory bowel disease, and celiac disease are among the medical conditions that can increase the likelihood of mouth ulcers.

How are mouth ulcers diagnosed?

During your appointment, the doctor will review your medical history and examine the appearance and location of the ulcers. If your doctor suspects you have an underlying deficiency or an inflammatory disease, you may need blood tests. If they can’t identify the cause of your mouth ulcers or if the ulcers do not improve after receiving the recommended treatments, you might need to have a biopsy of a portion of the ulcer and some of the surrounding tissue. During a biopsy, a tissue sample is obtained for analysis and evaluation.

How are mouth ulcers treated?

The treatment of mouth ulcers depends on the type, severity, and frequency of the ulcers. In most cases, minor ulcers heal on their own within 1-2 weeks and may not require special treatment; however, various cures and treatment alternatives can help alleviate the pain if the ulcers are causing substantial pain or discomfort, including:

Topical medications: Over-the-counter or prescription mouthwashes, gels, or creams containing corticosteroids, antimicrobial agents, or analgesics can be applied directly to the ulcers to help reduce pain and inflammation and promote healing.
Systemic medications: In severe cases of mouth ulcers, a doctor may prescribe systemic medications such as corticosteroids, which can be administered orally or intravenously. Systemic medications can control severe symptoms temporarily and should be used under medical supervision.
Nutritional supplements: Some mouth ulcers may be brought on by nutrient deficiencies, such as vitamin B12, iron, or folic acid deficiencies. In such cases, supplements may be prescribed by a doctor to correct the deficiencies and promote healing.
Lifestyle changes: Modifying your way of life can also help you efficiently treat mouth ulcers. Maintaining proper dental hygiene, managing stress, and avoiding foods that may irritate mouth ulcers, such as hot, acidic, or rough foods, can all aid in the healing process and stop mouth ulcers from recurring.

How are mouth ulcers prevented?

Maintain good oral hygiene: Flossing frequently, brushing twice daily, and using mouthwash can all help keep your mouth clean and lower your risk of bacterial infections, which can lead to mouth ulcers.
Steer clear of triggering foods: Foods that are spicy, acidic, or rough can irritate oral tissues and lead to the formation of mouth ulcers. Avoiding these foods will help prevent ulcers from developing.
Manage stress: Stress can weaken the immune system and trigger the formation of mouth ulcers in susceptible individuals. Exercise, meditation, or yoga are examples of stress-relieving practices that can aid in managing stress and preventing ulcers.
Address nutritional deficiencies: If you’ve ever experienced nutritional deficiencies, talk to your doctor about the right supplements to take to make up for them and lower your risk of getting mouth ulcers.
Prevent trauma to the oral tissues: To prevent trauma to the oral tissues, which can result in the development of ulcers, avoid biting your lips, cheeks, or tongue, and exercise caution when eating and brushing your teeth.

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