Mouth Ulcer – Types, Causes, and Remedies

A mouth ulcer is the erosion or loss of a portion of the sensitive tissue lining the interior of the mouth, known as the mucous membrane.

Mouth ulcers can result from various factors. Injury is the primary reason which includes accidentally biting the inside of the cheek. 

Various drugs, oral skin rashes, viral, bacterial and fungal infections, pollutants and other medical problems are additional reasons. 

Mouth ulcers usually go away on their own in 10 to 14 days without any medical intervention. A mouth ulcer that doesn’t heal with time develops into mouth cancer. 

Types 

Minor mouth ulcers 

The majority of mouth ulcers are of the minor mouth ulcer category and are the most usual kind. They can appear on the gums, inside the cheeks and on the lips and tongue. 

Few ulcers less frequently occur on the roof of the mouth. These ulcers often have a pencil-top size. One can develop four to six minor mouth ulcers at the same time.

They can develop as a single ulcer or as a cluster and are typically less than 5 mm in diameter. These ulcers don’t hurt much and are usually painless. 

Major mouth ulcers 

The severity and healing time of major mouth ulcers can vary. A dentist should be consulted to examine any ulcer that persists for more than three weeks. 

Tonsils may develop major mouth ulcers that can be extremely painful, especially while swallowing. Usually, one can only get one at a time.

It is possible to develop up to 100 tiny, agonising ulcers that last one to two weeks. 

Major mouth ulcers are less frequent, usually 5 mm or larger. They can develop as a single ulcer or in pairs. They can continue for two weeks to several months and be painful, especially while eating or drinking.

Herpetiform mouth ulcers 

Herpetiform mouth ulcers can develop when several small lesions fuse to form a big ulcer. Herpetiform ulcers are so named because they resemble herpes in appearance, although the herpes simplex virus is not the cause of herpetiform ulceration.

Symptoms 

Pain in the mouth 

A mouth ulcer is a tear in the mouth’s lining. An ulcer can be quite painful since mouths are so frequently in use in a human, and they are loaded with digestive enzymes and acids. It might be painful to unintentionally bite on a mouth ulcer.

Ulcers may bleed 

Most oral blood blisters appear after mouth ulcers, such as biting the inner cheek, consuming hot food that burns the mouth or being pierced by a sharp food item like chips.

Tenderness of the surrounding areas

Tenderness around the wound and the surrounding areas are a symptom of a mouth ulcer.

Cracks in the corners of the mouth 

The corners of the mouth become dry due to inadequate saliva. Angular cheilitis may result from extremely dry skin in this area. The dry skin can eventually start to break open. Cracks can occasionally become infected or inflamed by bacteria or fungi.

Dry mouth 

When the salivary glands in the mouth are unable to produce enough saliva to keep the mouth moist, dry mouth results.

Fever 

Fever occurs in case of severe mouth ulcers. 

Loss of appetite 

In some circumstances, a peptic or stomach ulcer can lead to the following severe symptoms— loss of appetite and weight loss. A mouth ulcer causes pain and trouble swallowing, which makes it difficult to maintain a healthy appetite and results in weight loss.

Malaise or lethargy 

At times, a secondary bacterial infection might develop in a mouth ulcer. A person might experience more discomfort or redness or feels sick with a high temperature (fever). 

Mouth ulcers are primarily characterised by discomfort at the region of the ulcer, but many patients also report fatigue, fever and enlarged lymph nodes.

Pus or white patches 

Dental abscesses are pus-filled swellings that develop due to a tooth infection, gum infection or a tooth injury. Abscesses can, but do not usually, cause pain. Dental abscesses may result in swelling of the face or swollen lymph nodes.

The inside surfaces of the mouth develop thick, white patches known as leukoplakia. Numerous things, such as recurrent injury or irritability, could be the cause. Additionally, it may indicate mouth cancer or precancerous alterations.

They are typically red in the middle with a white or yellow border and can be very painful.

Skin rash 

People with mouth ulcers may notice a rash made up of tiny, raised red patches on the skin not long after the mouth ulcers start to develop.

Sore throat 

A sore throat is an irritation or pain occurring in the throat. The most frequent cause of pain in the tongue and throat is mouth ulcers.

Swollen lymph nodes 

While certain individuals with ulcers have red spots on the lips and inside of the cheeks, others experience swollen lymph nodes.

Causes 

Allergic response to oral bacteria 

Viruses are the most prevalent infectious cause of mouth sores. However, bacteria can also result in mouth ulcers. The herpes simplex virus causes cold sores. However, certain bacteria, like streptococcus and actinomyces, can trigger mouth ulcers. 

Mouth sores and swelling may result from a bacterial infection. Overgrowth of bacteria or new organisms, especially ones not ordinarily found in the mouth, can result in infections.

Dental braces 

By constantly pressing on the mouth tissues over time, braces can lead to ulcers. The area gets inflamed and sore as the braces rub against the mouth tissues. The ulcer will only become worse and perhaps become infected if left untreated.

Hormonal changes during menstruation 

Some women experience oral changes, such as bright red, swollen gums, swollen salivary glands, and the development of mouth ulcers, as a result of hormonal changes (especially the rise in progesterone) that take place throughout the menstrual cycle.

Emotional stress or lack of sleep 

People are more prone to bite their lips or cheeks when feeling nervous or tense, increasing the risk of mouth ulcers. 

Recurrent mouth ulcers can be caused by excessive stress, an adrenaline-fueled lifestyle that involves inadequate nutrition, lack of sleep and mental stress. 

The body’s immune system responds to stress and anxiety by developing persistent mouth ulcers.

Citrus fruits and other foods high in acidity or spice 

Citrus fruits contain citric acid in addition to vitamin C, which helps to boost the immune system. Citric acid can irritate the soft tissues in the mouth and lead to or aggravate mouth ulcers. 

Spicy foods can damage the mouth’s lining, leading to an ulcer. Similar to acidic fruits, foods that are spicy have high acidity and are, therefore, more likely to irritate the skin.

Stress or anxiety 

Though the science behind this is unknown, mouth ulcers frequently result from stress and anxiety.

Genetic factors 

There is minimal proof that certain genes or genomic areas are responsible for mouth ulcers. The genes that a person inherits are also thought to play a part. Over 40% of persons with recurrent mouth sores claim that it runs in their family.

Poor-fitting dentures 

Mouth ulcers can be brought on by persons chewing their lips or tongue, rubbing against braces or sharp fillings, or having dentures that don’t fit properly. This kind of ulcer heals quickly and may perhaps vanish before a person realises it is there.

Remedies and treatment 

Ice 

Icing a mouth ulcer is one of the most effective treatments for pain relief. To ease the discomfort and lessen swelling in the mouth, use ice chips and let one slowly melt in the mouth. Never apply ice to the skin directly. Although this treatment only provides short-term relief, it feels pleasant since it reduces the agony.

Cucumber slices 

It is advised to chew papaya or cucumber well when mouth sores start to emerge. The oral cavity is opened up, allowing the protein-digesting enzymes to enter and travel to the sores’ inflamed and exposed surfaces. 

By gently digesting the surface of the sore, the enzymes create a sealed layer that makes the sore less sensitive to friction, acidity and the harsh texture of food. 

Cucumber and papaya go well together in a salad, and one may also juice them both or just one of them.

Witch hazel 

Witch hazel is an astringent herb that can be used as a mouthwash to relieve the discomfort of mouth ulcers. The herb contains tannins, which may help to reduce swelling.

Turmeric 

Mouth ulcers can be effectively treated with turmeric. It has inflammatory-reducing qualities. Apply a smooth paste to the ulcer by combining water and half a tablespoon of turmeric. After letting it sit for a few minutes, rinse it off with water.

Chamomile 

Chamomile has anti-inflammatory properties. Making a potent chamomile tea and using it as a mouthwash once it cools is one way to use chamomile as a mouth ulcer treatment. Additionally, they might put a chamomile tea bag directly to the ulcer after soaking it in warm water.

Mouthwashes 

When a mouth ulcer is painful enough, antimicrobial mouthwash can help eliminate bacteria, viruses or fungus that could infect the ulcer. They could hasten the healing process as well.

Oral medications 

Applying a topical anaesthetic that is available over the counter treats mouth ulcers. Even though the majority of mouth ulcers heal on their own, doctors may recommend topical medications to relieve pain and lower the likelihood of complications. 

Antiseptic gels, steroid ointments or prescription mouthwashes are usual mouth ulcer treatments. 

Immunosuppressants work best in extreme circumstances. A mouth ulcer can be effectively treated with antimicrobial mouthwash, a painkilling tablet, gel or spray, corticosteroid lozenges and saline mouthwash.

Nutritional supplements 

Mouth ulcers can be effectively treated with either vitamin B alone or vitamin B coupled with pantothenic acid. 

Vitamin B is not only efficient, but also greatly lowers the chance of recurrence, hastens ulcer healing, and shortens the duration of treatment. Regular vitamin B intake may help lessen or stop mouth sores.

Cauterisation 

During cautery, a tool or chemical substance is used to burn, scorch, or kill the tissue. Mouth ulcers and gum issues can be treated with Debacterol, a topical medication. This medicine may shorten the healing process to around a week by chemically cauterising the sores.

Avoid spicy and sour foods until the ulcers heal. 

An individual’s oral health may also be negatively impacted by a diet high in spicy or salty foods. So, avoiding spicy and sour foods helps ulcers heal quickly.

Drink plenty of fluids. 

By lubricating and moisturising the mouth with water, one can reduce the risk of developing painful bites and ulcers.

Keep your mouth clean. 

Poor oral hygiene also contributes to the emergence of mouth ulcers, which frequently result from plaque bacterial infections on the teeth.

Apply antiseptic gel to the ulcer 

Antiseptic mouth gel adheres firmly to the gums, inner cheeks and surface of the teeth. It functions by destroying the dangerous germs that result in gum inflammation, tartar buildup, foul breath and other oral illnesses.

Prevention of mouth ulcers

The possibility of developing mouth ulcers may be decreased by,

• Trying to keep the mouth as clean as possible.
• Utilising premium toothbrushes to reduce the risk of damage to the mouth.
• Consuming a healthy diet full of vitamins A, C and E 
• Eating foods like fresh fruit and vegetables lessens the risk of mouth cancer.
• Frequently visiting the dentist.

When to see a doctor?

Usually, ulcers heal on their own. However, one should see a dentist if they don’t recover in three weeks. 

A tongue ulcer, an ulcer between the cheek and gums, or an ulcer under the tongue that does not heal despite treatment could be an indication of oral cancer. 

To make sure that the issue is an ulcer and not something more severe like mouth cancer, dental experts will examine the mouth for a proper diagnosis. 

If an individual frequently experiences mouth ulcers, they should see a dentist rule out any underlying medical conditions.

Always visit a dentist or physician if

• There has been an ulcer for longer than three weeks.
•  There is a recurring fever.
• The ulcers recur frequently.

Conclusion

Mouth ulcers are erythematous, white-reddish patches that develop on the mucous membrane of the mouth. Mouth ulcers frequently appear in pairs or groups of four. 

Despite the pain, they usually don’t cause any issues and heal on their own. On the lips or the inside of the cheeks, mouth ulcers develop as round, yellowish patches. 

They may develop less frequently on the tongue, roof of the mouth or gums. Mouth ulcers are typically so easily diagnosed on their own without the use of additional diagnostic tests because of the way they emerge, develop and manifest. 

Gels, creams and mouthwashes with analgesic or anti-inflammatory ingredients can be used to treat the symptoms.

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