An ulcer is the result of a break in continuity of specialised lining tissues in the body. Externally, ulcers develop on the skin and internally, the stomach is known for them. It follows that breaks in the lining of the mouth, or oral mucosa, result in development of mouth ulcers.
Inside the mouth, saliva keeps the mucosa moist which means ulcers don’t form a protective scab as would occur on the skin. Consequently, the area is re-traumatised during normal eating and speaking and is also prone to secondary infection.
Causes of mouth ulcers
Identifying the cause of mouth ulcers will assist in preventing and, in some cases, treating them. Common causes include:
Trauma: Physical – either accidental biting of cheeks, lip or gum or from foreign objects such as dentures, chewing pens, hard foods
Thermal – a scald from hot food (eg. Pizza) or hot drink
Chemical – spicy foods containing caustic agents
Infection: mainly viral, such as herpes virus
Drugs: side-effect from medication for other medical conditions
Deficiencies: for example, in Vitamin B12 or iron
General conditions of the skin or lining of the gut, such as ulcerative colitis or Crohn’s disease
Unknown: when no other cause is identified, they are known as apthous ulcers.
Indirect or predisposing factors:
Hormonal changes including the normal menstrual cycle, stress, malnutrition and dry mouth syndrome can increase the likelihood of developing ulcers.
Treatment and management of mouth ulcers
In most cases, a dentist will identify causative or pre-disposing factors through a careful medical history and thorough oral examination. Occasionally further investigation will be recommended with referral to your GP or Specialist who may request blood tests or tissue biopsy.
Management is often directed at relieving pain – especially in the case of the apthous ulcer.
Avoiding citrus juice and other acidic foods can prevent discomfort,
Although tooth brushing can cause pain, it is essential to maintain good oral hygiene to prevent bacterial infection,
Mouth washes and anaesthetic gels available over the counter at many pharmacies may provide some relief.
It may be worth knowing that the common, recurring apthous ulcer resolves in 7 -10 days.