Mouth Ulcer

Mouth sores, also referred to as mouth ulcers, are a common occurrence that most people have experienced at one time or another.

To learn more about mouth sores, it is important to learn about the mucous membrane of the mouth.

Oral Mucosa Classification

The oral mucosa is the mucous membrane of the mouth. It lines the oral cavity and protects the underlying muscle, fat, nerves and blood supply. It can differentiate between hot/cold/touch and taste sensations.

There are three types of Oral Mucosa:

  • Lining mucosa: Lining mucosa is very thin. It is found in the following areas: inside the cheeks, floor of the mouth, lips, underneath the tongue and the soft palate.
  • Masticatory mucosa: Masticatory mucosa is very thick and tough and covers the hard palate and gums.
  • Specialized mucosa: Specialized mucosa is located on the top of the tongue and consists of taste buds.

Overview of Mouth Ulcers

mouth ulcer is a painful open sore inside the mouth caused by a break in the oral mucosa, the mucous membrane lining of the mouth. It usually occurs on the inside of the lips, cheeks, and gums.

An Aphthous ulcer, commonly referred to as a canker sore, is the most common type of mouth ulcer.

Causes of Mouth Ulcers

There are many different causes of mouth ulcers. Mouth ulcers can occur from any of the following conditions:

Minor injuries from:

  • Sharp edges of teeth
  • Accidental biting of lips, cheek or tongue
  • Chewing on hard food stuffs
  • Edges of ill-fitting dentures
  • Sharp points in dental braces
  • Harsh Tooth brushing

Infections:

  • Viral such as with Herpes simplex virus
  • Bacterial
  • Fungal

Immunodeficiency:

  • Chemotherapy
  • HIV
  • Mononucleosis

Hormonal changes:

  • Menstrual periods
  • Pregnancy
  • Menopause

Dietary deficiencies of:

  • Vitamin C
  • Vitamin B12
  • Folic acid
  • Zinc

Underlying Medical illness:

  • Celiac Disease
  • Crohn’s Disease
  • Reiter’s Syndrome
  • Ulcerative Colitis
  • Stress and anxiety
  • Food allergies

Symptoms

Ulcers can cause pain and a burning sensation in the mouth. You may also feel uncomfortable when eating certain foods.

  • Aphthous ulcers: These are canker sores and are small, white in color, and painful.
  • Traumatic ulcers: These ulcers appear as large red areas with a yellow center.
  • Cold sores (herpes virus): These are white blister-like spots which can be accompanied by fever.

Risk Factors of Mouth Ulcers

A risk factor is something that increases your chance of developing a condition or disease. Risk factors for developing mouth ulcers include:

  • Gender: Women experience more incidences of ulcers due to their hormone changes during their monthly cycle.
  • Heredity: The tendency to get mouth ulcers runs in families.
  • Stressful lifestyle: Stress is a known factor for developing mouth ulcers.
  • Diet: Excessive intake of coffee, chocolate, strawberries, almonds, cheese and peanuts can increase your risk of ulcers.

Complications of Mouth Ulcers

  • Secondary bacterial infection of ulcers can occur if it is not treated.
  • Spread of infection

Diagnosis:

Your Dentist will assess the oral mucosa of your mouth. Usually the appearance and location of the ulcers tells the dentist which type of ulcer is present.

A skin biopsy of the ulcer and blood tests may be ordered to confirm the diagnosis.

Treatment

The goal of treatment is relief of the patient’s symptoms and preventing the spread of infection. The cause, if known, should be addressed and treated accordingly.

Treatment Measures can include the following:

  • Corticosteroids: to reduce any inflammation
  • Pain Medication: to relieve discomfort
  • Topical anaesthetic gels: to numb the infected area before eating or drinking to prevent pain.
  • Vitamin supplements: such as Vitamin B12, folic acid or iron
  • Hormone treatment: aimed at women who are experiencing recurring mouth ulcers at certain times in their monthly cycle.
  • Immunosuppressant drugs: only prescribed in cases where there is severe pain and ulceration.

Prevention

The following measures may help to prevent the development of mouth ulcers:

  • Eat nutritious foods but avoid very spicy and acidic foods.
  • Reduce your stress.
  • Sleep at least 6-8 hours a night.
  • Avoid over or excessive brushing.
  • Use a soft bristled toothbrush