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Mouth Ulcers
| Mouth ulcers are painful sores (lesions) found in the mouth on the cheeks or gums. They often start as a small bubble or blister which are not painful until they bursts leaving an ulcerated pit or crevice. They usually appear white in colour with a red or yellow border.
Mouth ulcers can appear singly or in clusters ranging in size from 1-5mm in diameter and sometimes larger. They are common and not thought to be infectious, unlike Cold Sores.
The main causes of mouth ulcers are:
Local causes
Recurrent aphthous stomatitis ( RAS; aphthae; canker sores)
Infections
Drugs
Malignant disease (cancer)
Systemic diseases
The most common causes of oral ulceration are the first two listed:
1. Local causes:
These can be as a result of trauma for example from the sharp edge of a tooth, a poorly fitting denture, or in children the brackets on their braces. The other local cause can be from burns. Burns can result in the mouth from:
- Chemicals - holding an aspirin (salicylic acid) by the side of a painful tooth causes a chemical burn and is not to be advised.
- Cold-such as ice
- Heat - i.e. the cheese on the top of pizzas is often very hot and may burn the top of the mouth behind the front teeth.
- Radiation - people undergoing radiotherapy around the head and neck can suffer from mouth ulcers.
2. Recurrent aphthous stomatitis (RAS)
The condition RAS is also called aphthae or canker sores. It is a very common condition and affects at least 20% of the population in the United Kingdom and is more commonly found in higher socio-economic classes.
Usually the first attack occurs in adolescence or young adulthood. These ulcers are usually small (less than 5 mm in diameter) and painful. They can occur as a single ulcer or a cluster of ulcers. People with RSA usually feel well apart from the pain in their mouths. The ulcers usually heal in 1-2 weeks, tending to recur at intervals over the course of many years. In some cases the recurrence may be constantly present for prolonged periods.
Certain factors may cause an outbreak of RSA. These include:
- Stress - ulcers may be worse at times of exams or work deadlines
- Trauma - from dentures rubbing
- Vitamin and mineral deficiencies-deficiencies of iron, folic acid (folate) or Vitamin B12
- Sodium lauryl sulphate - the foaming agent found in certain detergents and some toothpastes
- Smoking
- Gastrointestinal disorders - Crohn’s disease
- Hormone levels - changes during menstruation in women
- Immune deficiency - HIV
3. Infections
Infections that cause mouth ulcers are usually the result of a virus. The most common one is Herpes simplex virus which can cause an illness known as primary herpetic gingivostomatitis. This illness is most common in children. Numerous small painful ulcers occur on the lips, in the mouth and in the throat. The child usually feels miserable suffering from a fever and swollen glands in the neck. There may be difficulty eating and drinking because of the pain.
Another viral infection that results in mouth ulcers is hand, foot and mouth disease. This disease is most commonly seen in pre-school children. Small ulcers occur in the mouth and little blisters also on the hands and feet of the child.
4. Drugs
Certain drugs can cause ulcers as a result of local trauma - such as holding an aspirin on the gum next to a painful tooth or as a result of the chemicals in the drug affecting the cells making up the tissues inside the mouth.
5. Malignant disease (Cancer)
The majority of ulcers in the mouth result from relatively harmless conditions. However, an ulcer in the mouth may sometimes be the first sign of mouth cancer (oral cancer). People who smoke drink and drink alcohol are of greatest risk of mouth cancer.
6. Systemic disease
Mouth ulcers may be associated with disorders that affect other parts of body such as gastrointestinal disorders and disorders of the blood.
Treatment
Treatment of ulcers will often depend on their cause. If the cause of the ulcers is from trauma, then removal of that trauma will help. Salt water mouth rinses are often beneficial. Topical pastes such as Orabase, which can be found in chemists, may be beneficial acting as a barrier over the ulcer and helping it heal.
Most ulcers heal on their own, but if you are concerned or if one fails to heal after 2 weeks it is important to see the dentist or GP who may carry out a blood test or refer you for a specialist opinion. | | Send this story to a friend | Printer Friendly |
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