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Summary

A mouth ulcer is a commonly occurring condition in which there is an appearance of a tender sore accompanied by mild swelling and pain. It is primarily caused due to a damage to the membrane in the mouth since it is very delicate and sensitive. Mouth or oral ulcers are quite common in different age groups and can have several reasons that include an injury, nutritional deficiencies and poor oral hygiene. They are easy to diagnose on clinical examination and do not need blood tests. However, blood tests may be done to detect the cause of recurrent oral ulcers. Usually, a doctor will prescribe medication to expedite healing of the ulcer. There are several home remedies which are also helpful in healing mouth ulcers. The treatment of mouth ulcers is mostly primitive and involves the use of antimicrobial mouthwashes, vitamin B complex supplementation and topical pain-numbing gels. Prevention involves eating foods rich in vitamin B12 and folic acid. 

  1. What are Mouth ulcers
  2. Types of Mouth ulcers
  3. Symptoms of Mouth ulcers
  4. Mouth ulcer causes and risk factors
  5. Prevention of Mouth ulcers
  6. Diagnosis of Mouth ulcers
  7. Treatment for Mouth ulcers
  8. Prognosis and complications of Mouth ulcers
  9. Natural remedies for Mouth ulcers
  10. Medicines for Mouth ulcer
  11. Doctors for Mouth ulcer

What are Mouth ulcers

A mouth ulcer is a condition, which affects 20-30 per cent of the population. It is an erosion of the membrane that lines the mouth, known as the mucous membrane. They are not life-threatening, and there is a wide range of causes as well as treatment options available. Adults, as well as children, can suffer from oral ulcers and typically, these are painful. The sores may appear on the inside of the cheeks or lips and can last for two days to a week or more.

Types of Mouth ulcers

Based on the cause of the ulcer, mouth ulcers can be classified as follows:

  • Traumatic ulcers
    These occur due to an injury. Based on the cause of the injury, these can be further classified as: 
    • Mechanical ulcers
      Ulcers that develop due to injury, dentures, accident, lip bite, blow to the lips or face.
    • Chemical ulcer
      Ulcers caused due to chemicals like aspirin, silver nitrate, hydrogen peroxide, and others.
    • Thermal ulcer
      Sores that occur due to sudden exposure to excessive heat from hot foods or drinks, a hot object that touches the lips accidentally, like a hot dental instrument, and others.
    • Radiation ulcers
      These occur as a side effect of radiation that is used for the treatment of cancer.
    • Factitious ulcers
      These are ulcers that occur due to stress and emotional problems.
  • Ulcers due to infections 
    Such ulcers develop after or during a viral infection, measles, common cold, herpes, flu, and other such diseases.
  • Ulcers due to immune system conditions
    Chronic granulomatous disease, Reiter's syndrome (a condition characterised by mouth ulcers along with swelling or inflammation of the joints or arthritis, conjunctivitis, and swelling or inflammation of the urethra or urethritis), drug reactions, Behcet's syndrome (a condition in which the blood vessels of the body get inflamed or swollen) are some of the conditions that are associated with the development of oral ulcers. 
  • Ulcers of unknown cause or Idiopathic ulcers
    These ulcers do not have a clear underlying cause and hence are known as idiopathic ulcers. Since these are the ones that recur every once in a while, they are also known as recurrent aphthous ulcers. They are of the following types:
    • Minor ulcers 
      Minor ulcers range from about 2 mm up to 8 mm in size. They may take 1-2 weeks to clear up and could cause slight pain.
    • Major ulcers 
      Major ulcers are bigger and appear to be raised. They may seem irregular in shape and can cause pain while eating or even talking. They can take several weeks to heal and may leave behind a scar.
    • Herpetiform ulcers 
      These sores only resemble the herpes ulcers in shape but are not contagious and heal very quickly.

Symptoms of Mouth ulcers

Mouth ulcers can appear on the inside of the cheeks, lips or even on the tongue. It is possible that an individual may have more than one mouth ulcer at a time. They usually appear as a swelling with redness surrounding them. The centre of the ulcer may seem yellowish or grey.

Most common symptoms of mouth ulcers include:

  • Tender red erosions inside the mouth.
  • Pain while talking and eating.
  • Burning sensation.
  • Irritation.
  • Excessive saliva secretion or drooling.
  • Temporary relief on taking cold food or drinks.
  • Irritability (in case of children). 

Mouth ulcers usually heal within a few days. However, it is essential to see a doctor if one notices the following:

  • The appearance of a sore that is not causing any pain.
  • Spread of ulcers to new areas.
  • Sores lasting for more than 2-3 weeks.
  • Ulcers that are growing bigger.
  • Sores accompanied with fever.
  • Ulcers accompanied with bleeding, skin rash, or difficulty in swallowing.

When to see a doctor?

Mouth ulcers generally subside on its own within 3-4 days. However, If the mouth ulcer persists for more than 7 days you are advised to consult a dentist or a physician to ascertain the cause and type of mouth ulcer and also to get relief from pain caused due to the lesion. You are advised not to take any medication yourself, as some medicines do have certain harmful side effects which may aggravate your condition. 

Mouth ulcer causes and risk factors

Causes

Mouth ulcers can have several reasons, such as:

  • Injury
    Most common cause of a single mouth ulcer is an injury. The layer of the sensitive tissue could be damaged by:
    • Accidental biting of the cheek.
    • Poorly fitted dentures.
    • Eating food which is hard to chew.
  • Medical conditions
    Presence of certain medical conditions can also cause mouth ulcers, such as measles, diabetes, chicken pox, herpes, canker sores, and others.
  • Nutritional deficiency
    The deficiency of vitamin B12 and iron also gives rise to mouth ulcers. Coeliac disease is a condition of the small intestines producing an adverse reaction to gluten that causes nutritional deficiencies resulting in mouth ulcers.
  • Other causes
    Other common causes of mouth ulcers include:
    • Poor oral hygiene.
    • Burns from eating hot food.
    • Oral thrush (fungal infection).
    • Reaction to certain strong medications like methotrexate, beta-blockers, chemotherapy, and others.
    • Constant rubbing or friction against a sharp tooth.
    • Hormonal changes.
    • When a person is trying to quit smoking initially, mouth ulcers may occur.
    • Mouth ulcer could be the first symptom of oral cancer. The sores caused due to oral cancer stay for a long time and can persist without causing any pain. The risk of developing oral cancer increases significantly if one smokes, chews tobacco, uses certain tooth powders (“gul manjan”) and consumes alcohol in excessive quantities.

Risk factors

There are certain factors which predispose a person to develop mouth ulcers. These include:

  • Stress.
  • Hormonal changes in women (during menstruation or menopause).
  • Excessive consumption of spicy food.
  • Excessive smoking.
  • Presence of other oral and systemic diseases.
  • Dehydration.

Prevention of Mouth ulcers

The risk of developing mouth ulcers can be prevented by taking the following steps:

  • Avoid having food which is too hot or spicy. Eating spicy food can irritate the inner lining of the mouth.
  • Avoid chewing gum for a prolonged duration of time as it will also increase the risk of biting the cheek accidentally and causing an ulcer.
  • Find ways to manage stress and anxiety. Stress is a known cause of mouth ulcers. 
  • Maintaining proper oral hygiene is imperative. It involves brushing the teeth twice a day along with cleaning the tongue and flossing to get rid of the germs in the mouth. If you get mouth ulcers frequently, then avoid using harsh kinds of toothpaste and mouthwashes as they might irritate the inner lining of the mouth.
  • Getting regular dental checkups can lower the risk of developing ulcers.
  • Continued intake of alcohol, caffeine and constant smoking are important risk factors for developing mouth ulcers. One should limit or discontinue these things to prevent ulcers. 

Diagnosis of Mouth ulcers

The most common way of diagnosing mouth ulcers is a physical examination.

  • A thorough oral and general physical examination by the doctor will help to identify the cause of a mouth ulcer in a vast majority of the cases. The doctor will also inquire about your medical history and everyday food habits. 
  • Along with a complete physical or oral examination, specific blood tests can be done to rule out oral cancer as the underlying cause. The complete blood count test can be used to assess the overall health and to diagnose any infections or cancers like leukaemia.
  • Blood tests to detect deficiency of iron and vitamin B12 tests may be done.
  • A biopsy can also be done to rule out oral cancer, wherein a small part of the skin tissue will be used for medical analysis under a microscope. 

Treatment for Mouth ulcers

Mouth ulcers may or may not require medical intervention. They can usually be healed with the help of self-care and some minor home remedies. However, the doctor may also prescribe medication for faster relief. These include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) may be given to reduce the pain.
  • Antimicrobial mouthwashes and pain-numbing ointments help to reduce inflammation (swelling) and pain. 
  • Once the underlying cause of the ulcer is determined, a separate course of treatment may be followed specific to the disease. Oral antimicrobials for specific infections like antibiotics or antivirals.
  • Vitamin B12 or B complex supplements for a deficiency of the same.
  • Analgesic (pain-numbing) and/or anti-inflammatory local ointments for application on the ulcer to relieve pain and inflammation.
  • Appropriate therapy for oral cancer based on its stage, which includes chemotherapy, radiation therapy or radiotherapy, or surgery.

Lifestyle management

There are a few steps which can be taken to deal with mouth ulcers effectively.

What to do?

  • Use a soft-bristled, high-quality toothbrush while cleaning your teeth. Brush twice a day.
  • Eat foods that are rich in antioxidants like vitamins A, C and E. e.g, citrus fruits, papaya, mangoes, carrots, lemon, guava, bell peppers, almonds, amla, among others.
  • Eat soft foods that are easy to chew.
  • Get regular dental checkups.
  • Drink more water.

What not to do?

  • Eating spicy or acidic food.
  • Drinking soda.
  • Using strong mouthwashes or toothpaste.
  • Squeezing the ulcer to pop it.
  • Touching the ulcer constantly.
  • Drinking alcohol or smoking.
  • Drinking very hot beverages.
  • Eating a lot of chocolates and peanuts, and drinking coffee several times a day.

Prognosis and complications of Mouth ulcers

Prognosis

The prognosis of mouth ulcers is usually good. Mouth sores are rarely life-threatening or resulting in a complication. However, they can be uncomfortable and cause pain. Hence, preventing them from occurring in the first place is recommended and certainly possible.

Complications

Mouth ulcers are not life-threatening and complications are rare. However, constant touching and damage to the affected area can lead to bleeding and cause further inflammation. In case it has been caused due to a bacterial infection, the ulcer may spread and make one more uncomfortable. If the ulcer is caused due to a deficiency or underlying disease like cancer, then one may notice it recurring or even growing in size. 

Natural remedies for Mouth ulcers

Honey for Mouth ulcers

How to use it?

Just apply some organic honey to the sores using your finger (make sure your hands are clean) or using a cotton bud. 

Benefits

Honey has anti-inflammatory properties. Apart from this, honey can also help in reducing dryness around the ulcer and soothe the burning and pain. ​

Turmeric to get rid of Mouth ulcers

How to use it?

Take ½ a teaspoon of turmeric powder and mix it with a few drops of water to form a paste. Once a paste has been made, apply it on the ulcer and leave it for 5-6 minutes. Then rinse your mouth. Do this home remedy 3-4 times a day to expedite healing of the ulcer. 

Benefits

Turmeric is a potent antimicrobial and antiseptic spice found in every kitchen. It can help in reducing the inflammation or swelling very quickly. ​

Apple cider vinegar to treat Mouth ulcers at home

How to use it?

To use apple cider vinegar for healing the mouth ulcer, mix three tablespoons of apple cider vinegar with 1 cup of water. Use this solution to rinse your mouth at least 2-3 times a day. 

Benefits

Apple cider vinegar can help in getting rid of the bacteria or germs, which may be causing the mouth ulcers. ​

Ice to heal Mouth ulcers

How to use it?

Simply place the ice cube on the ulcer gently. Hold it in place for a few minutes. You can apply ice as many times as required. 

Benefits

Ice can work very well in healing an ulcer since it will not only reduce the swelling but will also provide relief from itching or any pain.  It will numb the area for some time.  Ice will also prevent the ulcer from growing. 

Coconut oil is beneficial in Mouth ulcers

How to use it?

Apply a drop of coconut oil on the sore and dab it gently. Do this remedy several times a day. You can also use a teaspoon of coconut oil and swish it in your mouth for a few minutes. This method is known as oil pulling and is very useful in eliminating the germs from the mouth. 

Benefits

Coconut oil is antibacterial and anti-inflammatory in action. It can help in healing the ulcer quickly by preventing bacterial growth and reducing the swelling. ​

Basil leaves for Mouth ulcers

How to use it?

Take a handful of basil leaves. Wash them thoroughly. Crush them using a mortar and pestle and make a paste using some drops of water. Then apply the paste to the affected area. You can also chew on the basil leaves several times a day. 

Benefits

Basil leaves have healing properties and are very useful in providing pain relief. ​

Garlic for Mouth ulcers

How to use it?

To use garlic as a remedy, cut a clove into thin slices and place it on the mouth ulcer. Let the slice stay for 15-20 minutes. Alternatively, you can also mash the garlic clove and apply the garlic paste. Repeat the remedy 3-4 times a day. You may continue this till the ulcer heals completely.  

Benefits

Garlic has strong antimicrobial properties. Thus, it hastens the healing process by killing the bacteria and preventing worsening of the ulcer.

Baking soda to get rid of Mouth ulcers

How to use it?

To use baking soda for healing a mouth ulcer, prepare a thick paste by mixing a little bit of baking soda with a few drops of water. Apply the baking soda on the sore 3-4 times a day. 

Benefits

Baking soda is anti-inflammatory. It helps to reduce the swelling by killing the germs in the mouth and neutralising the acid produced by them.

Dr. Mahesh Kumar Gupta

Dr. Mahesh Kumar Gupta

गैस्ट्रोएंटरोलॉजी

Dr. Raajeev Hingorani

Dr. Raajeev Hingorani

गैस्ट्रोएंटरोलॉजी

Dr. Vineet Mishra

Dr. Vineet Mishra

गैस्ट्रोएंटरोलॉजी

Medicines for Mouth ulcer

Medicines listed below are available for Mouth ulcer. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
EmergelEmergel 8.7%W/W Mouth Wash40.0
FitgelFitgel Mouth Gel51.0
OrawinOrawin Gel58.0
StroncipStroncip Oral Suspension51.0
Tess CsTess Cs Oral Gel48.0
UlciwokUlciwok Gel35.0
Viloral MouthViloral Mouth Paint31.0
ZyteeZytee 9% Oral Gel70.0
Zytee RbZytee Rb 0.02%/9% Gel77.0
AnabelAnabel Film68.0
DentocareDentocare Liquid28.0
Amlenox OralAmlenox Oral 5% Paste63.0
LexanoxLexanox Paste75.0
Lexanox PlusLexanox Plus Paste88.0
AcefateAcefate Syrup138.0
AcicotAcicot 1 Gm Suspension98.0
AcicrolAcicrol Oral Gel66.0
AlfateAlfate 1 Gm Suspension103.0
Carafil OCarafil O Syrup126.0
CarafilCarafil Suspension104.0
CoatzCoatz 500 Mg Suspension140.0
ElphateElphate 1 Gm Suspension67.0
GistressGistress 500 Mg Suspension55.0
Mac SMac S 1 Gm Suspension80.0
RafRaf 50 Mg Tablet47.0
SalfateSalfate 1000 Mg Syrup104.0
ScfScf Syrup99.0
ScorcidScorcid 1000 Mg Syrup86.0
SfSf 100 Ml Gel290.0
SftSft 1000 Mg Oral Gel136.0
Sft OSft O 100 Mg Syrup117.0
SigralSigral Kid 1 Gm Suspension74.0
SparacidSparacid Ds Suspension69.0
StalfateStalfate 1 G Suspension116.0
Sucracoat OtSucracoat Ot Suspension95.0
SucracoatSucracoat Suspension86.0
SucrafilSucrafil 500 Mg Suspension138.0
SucralSucral 1000 Mg Tablet48.4
SucramalSucramal 1000 Mg Tablet60.0
SucrasonSucrason Suspension94.0
SucrawallSucrawall Suspension140.0
Sufrate OSufrate O Suspension85.0
Sufrate PSufrate P Suspension85.0
SufrateSufrate Cream50.0
UlcoatUlcoat 100 Ml Suspension120.0
Alcid SAlcid S Syrup29.0
CralCral 1 Gm Oral Gel105.0
ElfateElfate Suspension67.0
ErocotErocot 1 Gm Syrup119.0
FilcerFilcer 100 Mg Suspension132.0
LozifateLozifate Suspension110.0
PepsigardPepsigard 1000 Mg Oral Gel142.0
Pepsigard JuniorPepsigard Junior 500 Mg Syrup84.0
Pepsigard TPepsigard T Cream77.0
RalfetRalfet Junior Syrup56.0
SanfateSanfate 1 G Suspension133.0
SkfSkf Suspension130.0
Sparcid Ds (Dr.Reddys)Sparcid Ds 1 G Syrup99.0
SucamSucam Suspension89.0
SucnolSucnol Suspension70.0
SucrabonSucrabon O Syrup115.0
SucrachemSucrachem Suspension50.0
SucracidSucracid 500 Mg Liquid129.0
SucradaySucraday Suspension70.0
SucraderSucrader Syrup46.0
SucragelSucragel Suspension70.0
SucralcoatSucralcoat Suspension155.0
SucralroseSucralrose Suspension193.0
SucramaxSucramax Syrup138.0
SucramoreSucramore Suspension50.0
SucrapilSucrapil Suspension33.0
SucrasureSucrasure 500 Mg Suspension97.0
SucratasSucratas Syrup31.0
SucroSucro Suspension101.0
SucroticSucrotic Syrup102.0
Sufet PSufet P Suspension47.0
SuphacidSuphacid Suspension27.0
TasulTasul Syrup110.0
UcralUcral Suspension71.0
Sufrate OroSufrate Oro Dental Cream60.0
SucrazenSucrazen Cream39.85
TantumTantum Gel53.0
GarbenzGarbenz Mouth Wash75.0
MucobenzMucobenz Mouth Wash430.0
Mamdew BabyMamdew Baby 7.50% Gel31.75
MucopainMucopain Gel50.0
T JelT Jel 7.50% Ointment38.45
OmnisootheOmnisoothe 10 Mg Lozenges16.0
Oragard BOragard B 20% Gel192.37
AppamideAppamide 10 Mg/5 Mg Eye Drops49.67
Audisol DropAudisol Drop34.0
WaxolveWaxolve Ear Drop65.89
WaxonilWaxonil Ear Drop74.0
DentacainDentacain 8.7%/2% Gel58.0
CurasilCurasil Gel32.0
Orogard SgOrogard Sg Ointment20.0
SelenoSeleno Gel45.0
DesolDesol Drop46.67
OtorexOtorex Drop75.6
Vovax Ear DropsVovax Ear Drops32.0
DomsafeDomsafe 500 Mg/5 Mg Suspension86.61
Sft DSft D Liquid89.92
Sucral DSucral D Suspension114.4
Healex PlusHealex Plus 0.36%/6.5% Spray176.73
Healol PlusHealol Plus Ointment79.95
Septigard AnSeptigard An Cream69.89
Sufrate TpSufrate Tp Lotion140.0
IricainIricain Eye Drop47.62
OproxyOproxy Eye Drop48.42
P Caine 0.5%W/V/0.5%W/V Eye DropsP Caine 0.5%W/V/0.5%W/V Eye Drops54.0
LidocamLidocam Mouth Wash84.75
Mugel Freshora 8.7%W/W/2.0%W/W GelMugel Freshora 8.7%W/W/2.0%W/W Gel40.0
Oraflora LaOraflora La 8.70% W/W/2% W/W Gel48.4
ViloralViloral 8.7%W/W/2%W/W Gel51.9
Anabel CtAnabel Ct 8.7% W/W/2% W/W Gel53.0
DentogelDentogel 8.7%/2% Gel57.7
Orex 8.7%W/W/10%W/W CreamOrex 8.7%W/W/10%W/W Cream59.0
PansoralPansoral Gel56.5
Quik KoolQuik Kool Gel65.0
Ora FastOra Fast Cream40.0
Orex LoOrex Lo Gel58.3
Softee(Leo)Softee Laxative Syrup94.9
Sufrate LaSufrate La Cream75.0
Sufrate MSufrate M Cream40.58
Sufrate PzSufrate Pz Powder144.13
Sufrate SsdSufrate Ssd Cream280.0
BurnosafBurnosaf Cream440.0
UlcehealUlceheal 0.02%/9% Gel15.0
ZypexZypex 0.02% W/W/9% W/W Mouth Ulcer Gel49.0
WounsolWounsol 15 Gm Ointment57.0
2 B122 B12 Capsule108.0
B Complex CapsuleB Complex Capsule16.75
BecosulesBecosules Capsule28.38
DequadinDequadin Lozenges4.8
Meganeuron Od PlusMeganeuron Od Plus Capsule98.0
Neurobion ForteNeurobion Forte Tablet8.71
Polybion LcPolybion Lc Syrup108.5
Polybion SfPolybion Sf Syrup62.4
Soliwax Ear DropSoliwax Ear Drop92.0

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