Why am I getting ulcers? What do they mean and how do I treat them?
The most common cause of ulcers in the mouth are…..
1. Trauma from food or toothbrush. Resolves within a week and there is usually a memory of an incident
2. Recurrent Apthous ulcers MINOR small ulcers (less than 1cm) less than 10 at a time MAJOR. (bigger than 1cm) irregular shape, deep and painful. Unknown cause most likely auto-immune. Slow to resolve
3. Contact allergy. Change in toothpastes of food intake can cause a reaction in the mouth tissue which causes ulceration. Will occur in response to certain chemicals or foods. Often associated with more diffuse red areas and the ulcer. Eg aspirin burn. DON’T put undissolved aspirins in your mouth!
4. Fistula. This ulcer will occur on the attached gum adjacent to a tooth. It is caused by pus tracking to the surface and will be resolved by treating the infection in the tooth
5. Herpes simplex. The primary viral infection results in small ulcers all over the mouth and is accompanied by fever and malaise. The re-infection results in a larger ulcer in the mouth and commonly on the lips e.g. cold sores
6. Non-specific viral ulcers (Herpangina) 1-2mm white/grey ulcers typically around the tonsillar area. Some fever and malaise. Usually occurs in children less than 5 years old.
7. Hand, foot and mouth. Usually occurs in children less than 10 years old. Low fever, loss of appetite, cough. Ulcers are yellow/grey 2-8mm and there are skin lesions on hand and foot as well
8. Lichen Planus. Most commonly found on the inside of cheek and tongue. It is associated with white streaks around the ulcer and can be quite painful when eating. Unknown aetiology
There are many other causes of oral ulceration. They are associated with some diseases, oral cancer, vitamin deficiencies and other auto-immune conditions. Any ulcer that does not resolve within a week, recurs, or is in anyway worrying should be assessed by your dentist or GP
Dr Caroline Downing