Due to their sensitive nature, daily activities such as eating, drinking and brushing can be uncomfortable. A mouth ulcer is also known as an oral ulcer or mucosal ulcer.(1^✔)

The two most common types of oral ulcers are:

• Mouth ulcers arising due to local trauma, such as injury from a sharp object
• Aphthous stomatitis (“canker sores”): these are the commonest ulcers whose underlying cause is unknown.

What are the Causes of Mouth Ulcers?

Some factors responsible for causing ulcers in the mouth are as follows:

• Poor oral hygiene
• Injury from a toothbrush
• Burns after eating hot food
• Irritation from mouthwash
• Cheek biting
• Nutrient deficiencies of vitamin B12, folic acid, zinc and iron
• Oral candidiasis
• Celiac disease
• Behcet’s disease
• Syphilis infection
• Malignancy
• Herpes simplex viral infection
• Drug reaction, such as chemotherapeutic agents
• Hand-foot-mouth syndrome
• Diseases like AIDS, tuberculosis, inflammatory bowel disease and diabetes mellitus
• Quitting smoking can lead to mouth ulcer in the first few days, which later subsides on its own
• Stress(2^✔)

What are the Symptoms and Signs of Mouth Ulcers?

The signs and symptoms of mouth ulcer depend on the underlying cause, but it may include:

• Round or oval shaped sores in the mouth which are yellow, white or gray in color
• Irritation and pain while eating spicy or hot food
• Swollen skin around the sore
• Inflammation around the edges
• Difficulty in maintaining oral hygiene
• Loss of appetite(3^✔)

How do you Diagnose Mouth Ulcers?

A diagnosis of mouth ulcer is often straight forward. A number of investigations may, however, be performed to search for causes when the ulcers are recurrent.

• Physical Examination - Your general practitioner will examine your mouth and will take your medical history to come to a conclusion.
• Blood Tests - The blood tests include:
• Complete Blood Count (CBC) - It is used to assess your overall general health and to search for underlying conditions such as infection, anemia or leukemia.
• Erythrocyte Sedimentation Rate (ESR) - This medical test can give clues to the presence of inflammation in the body.
• Serum Ferritin - It is a medical test used to evaluate the amount of iron present in the body. Deficiency of iron can lead to recurrent mouth sores.
• Serum Vitamin B12 - It is a medical test used to assess the amount of vitamin B12 present in the body. Deficiency of vitamin B12 can lead to recurrent sore mouth.
• Skin Biopsy - A small skin tissue is taken for analysis in a medical laboratory.(4^✔)

How do you Treat Mouth Ulcers?

Most mucosal ulcers are harmless and resolve by themselves. Recurrent ulcers, however, require to be investigated. It is difficult to fasten the recovery process of oral ulcer, but its symptoms and complications can be managed.(5)

Treatment depends on the type of oral ulcer.

• Painful ulcers may respond to the application of anesthetic gels; some require steroid gels, antiseptic gels or anti-inflammatory drugs
• Drink lots of liquids: dryness exacerbates the problems due to ulcers, hence keep the body adequately hydrated
• Licorice is a commonly used herb in the Ayurvedic medicine. Licorice has anti-ulcer and antibacterial properties which are effective to treat mouth ulcers.
• Take painkillers like paracetamol if the pain is not controllable otherwise
• Stay away from spicy and sour foods until the ulcer heals
• Frequently rinse your mouth with warm and slightly salted water
• Maintain a good oral hygiene
• Treat candidiasis with anti-fungal drugs
• Use anti-viral drugs to treat herpes simplex virus infection
• Rinse your mouth with a medicated mouthwash(6)

How do you Prevent Mouth Ulcers?

It is possible to prevent mouth ulcers by following some practices; such as:

• Brush your teeth carefully; take care not to hurt the delicate oral mucosa
• Floss on a regular basis
• Brush your teeth with a soft/medium toothbrush twice in a day

• Visit your dentist regularly
• Consume a well-balanced diet
• Keep your stress levels low
• Keep a check on any underlying diseases like diabetes mellitus or inflammatory bowel disease.(7^✔, 8^✔)

Health Tips

• Maintain good oral hygiene
• Try to avoid traumatic injury
• Take care of any underlying disease
• Brush your teeth properly