Mouth ulcers

DESCRIPTION

Definition
 
Mouth ulcers are small sores in the mouth that may be present on the insides of the cheeks, on the tongue, or the roof of the mouth.
 
Causes and Risk Factors
 
There are many causes of mouth ulcers:
1. Mechanical trauma such as rough brushing, use of braces, biting the insides of the mouth, or eating foods that may scratch the insides.
2. Eating very hot foods
3. Sensitivity to foods such as peanuts
4. Nutritional deficiencies such as that of iron, folic acid or vitamin B12
5. Infection such as candida or herpes
6. Gastrointestinal problems such as Crohn’s disease
7. Reactions to certain medicines such as aspirin, ibuprofen, beta-blockers, and blood pressure medicines
8. Oral cancer
9. Radiation therapy
10. Hormonal changes
 
Signs and Symptoms
 
The symptoms of mouth ulcers include:
1. A sore inside the mouth
2. Pain
3. Difficulty eating food
4. Fever
5. Swollen lymph nodes
 
Investigations
 
The doctor will physically examine the ulcers in the mouth. Treating the underlying condition or the cause of the sores will usually prevent them from coming back.
 
Treatment
 
Treatment of mouth ulcers involve:
1. Antibiotics -- it may be oral or in the form of a rinse
2. Corticosteroids to be applied on the sores
3. Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain

Some home remedies that may help treat mouth ulcers include:
1. Apply honey on the ulcers using a cotton swab. Do it a few times a day.
2. Apply glycerin on the ulcers.
3. Chew some tulsi leaves a couple of times a day.
4. Prepare a decoction of coriander seeds by boiling a teaspoon of seeds in a cup of water. When cold, use it to rinse your mouth.
5. Prepare a mouth rinse using sea salt. Add 2 teaspoons of sea salt in a glass of water and rinse your mouth with it.
6. Drink licorice tea a few times a day.
 
Complications and When Should You See a Doctor
 
The complications of mouth ulcers include:
1. Infection that spreads to the teeth
2. Infection of the skin and floor of the mouth
3. Oral cancer

See a doctor if:
1. Ulcers do not reduce with treatment and remain for 3 or more weeks
2. Pain persists
3. Ulcers keep recurring
4. Ulcers are accompanied by high fever
 
Prognosis and Prevention
 
Prognosis is excellent if the treatment is followed. The following tips can help prevent mouth ulcers:
1. Avoid spicy foods
2. Avoid hard brushing. Use a toothbrush with soft bristles.
3. Stay away from foods that may scratch the insides of the mouth.
4. Maintain a good dental hygiene by brushing teeth and rinsing your mouth after every meal.
 
References
 
Bope ET, Kellerman RD. Diseases of the skin. In: Bope ET, Kellerman RD, eds. Conn's Current Therapy 2017. Philadelphia, PA: Elsevier; 2017:chap 14.
Klokkevold PR, Mealey BL. Influence of Systemic Conditions. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds. Carranza’s Clinical Periodontology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.
 

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