Mouth ulcers

A Mouth Ulcer is the erosion of part of the delicate tissue
that lines the inside of the mouth (mucous membrane).

DESCRIPTION

Certain medications, chemicals and infectious diseases such as
herpes or thrush can cause Mouth Ulcers. The most common cause is
injury, such as from ill-fitting dentures or accidentally biting
your cheek. In most cases, Mouth Ulcers are harmless and resolve
without treatment within a few days.

 

Aphthous ulcers are recurring ulcers with no known cause that
affect around 20 per cent of the population. Aphthous ulcers
usually first occur between the ages of 10 and 40, recurring from
time to time. There can be days, weeks, months, or years between
each bout of ulcers.

 

As a person becomes older, apthous Mouth Ulcers tend to recur
less often and in many cases, stop coming back altogether. Some
people feel a burning in part(s) of the mouth for a day or so
before an ulcer appears.

 

• Minor aphthous ulcers are the most common. These are small,
  round, or oval, and are less than 10 mm across. These ulcers are
  pale yellow with red and swollen surrounding tissue. Between 1 to 5
  ulcers may develop at the same time. Each ulcer lasts from 10 to 14
  days, is not very painful and resolves without leaving a
  scar. 
• Major aphthous ulcers occur in about 1 in 10 cases. These are
  10 mm or larger. Usually only one or two appear at a time. Each
  ulcer lasts from two weeks to several months, and then resolves,
  leaving a scar. These ulcers can be very painful and eating and
  talking may become difficult. 
• Pinpoint aphthous ulcers occur in about 1 in 10 cases. These
  are tiny, between 1 to 2 mm across. Many occur at the same time,
  but some may join together and form irregular shapes. Each ulcer
  lasts from 1 week to 2 months.

SYMPTOMS

The symptoms of a Mouth Ulcer depend on the cause but may
include:

• A round sore or sores inside the mouth
• Swollen tissue around the sores
• Tenderness
• Problems with chewing or toothbrushing because of the
  tenderness
• Irritation of the sores by salty, spicy or sour foods
• Loss of appetite.

 

As with all medical conditions your Doctor should be consulted
for diagnosis and treatment. Most Mouth Ulcers are harmless and
resolve without treatment within 2 weeks. Health management
involves relieving the symptoms and protecting the ulcers from
further irritation. Other types of Mouth Ulcers, such as the major
aphthous variety, or those caused by herpes simplex infection, need
medical treatment. Your Doctor may prescribe anti-inflammatory,
anti-viral or anti-fungal drugs depending on the cause of the Mouth
Ulcer. It is not possible to speed the recovery of Mouth Ulcers,
but the symptoms can be managed and the risk of complications
reduced.
The range of treatment options includes:

• Avoiding spicy and sour foods until the ulcers heal
• Drinking plenty of fluids
• Regularly rinsing your mouth out with warm, slightly salted
  water
• Keeping the mouth clean 
• Taking pain-killing medication, such as paracetamol 
• Applying antiseptic gel to the ulcers 
• Using a medicated mouthwash 
• Using steroid gels or tablets.

DIET HINTS

Mouth Ulcers are thought to occur from a low immunity and poor
nutrition. 

• A wholesome diet including plenty of fresh green vegetables is
  recommended. Foods should be only lightly cooked to keep the
  vitamin level high. Fresh fruits are also vital but some acid
  fruits, particularly citrus fruits, are not recommended as they may
  irritate the ulcers.
• Acidic and salty foods, for example vinegar, sugary foods,
  meats and coffee, should be eaten only in moderation.
• Garlic and onions can also be used in cooking. 
• Foods high in B vitamins (particularly B5 & B12) may help
  the nervous system. These include beans, eggs, sprouts, currants,
  brewers yeast and vegetables.
• Natural unsweetened yoghurt which contains acidophilus may help
  healing and infection.

VITAMINS/MINERALS/HERBS

• A deficiency in iron, folic acid or vitamin B12 may increase
  the risk of Mouth Ulcers 
• Vitamin C can be taken to stimulate the immune system.
• Zinc solution may be gargled to aid accelerate wound
  healing.
• Acidophilus bifidus may be taken to control microbial
  overgrowth in the gut. Microbial overgrowth may play a role in this
  condition. Acidophilus also aids in the absorption of the B
  vitamins. 
• Echinacea may be taken for its immune stimulating
  properties. 
• Vitamin A may be taken for its healing of mucous membranes
  properties along with calendula which has astringent and tissue
  healing properties.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Follow the Diet Hints.
2. Use an antiseptic ulcer gel or an anti-inflammatory paste
   available at your Pharmacy. Ask your Pharmacist to recommend a
   suitable product.
3. A local anaesthetic mouthwash will help take away the pain of a
   Mouth Ulcer before eating.
4. Check for food reactions e.g., chocolate, wheat foods, dairy
   foods, and citrus fruits. 5) Try to minimise stress. Stress is
   thought to promote the development of ulcers in the
   body. 
5. Try using a non-fluoride toothpaste with as little flavouring
   as possible. Some people may be sensitive to fluoride and/or
   artificial flavourings which are added to many toothpastes.
6. Pain relief tablets (e.g., aspirin), should not be held in the
   mouth or placed in the area of the Mouth Ulcers before swallowing
   as the chemical may burn and damage the gums. Paracetamol has a
   less irritating effect on the mucous membrane which lines the mouth
   and entire digestive tract. 
7. If the diet is inadequate consider the supplements suggested in
   this topic. A deficiency in iron, folic acid or vitamin B12 may
   increase the risk of Mouth Ulcers Ask your Pharmacist for
   advice.

 

Aspirin should not be given to children under 16 years of age
unless specified by a Doctor.