Mouth ulcers, also known as canker sores, are tiny, 2 to 4 mm ulcerations or open skin lesions occurring virtually anywhere in the oral cavity or on the surface of the lips. They are generally quite painful and, as a result, may encumber normal speech and eating habits. Mouth ulcers are generally harmless, though rare cases of malignancy may develop. Such cases, however, are accompanied by other telling signs and symptoms.
Mouth ulcers are believed to affect up to 20% of the world population. They are generally benign and will resolve themselves in a matter of days or two or three weeks at the most. A great majority of sufferers will notice them reappearing at irregular intervals throughout the year, which is a great opportunity to try to identify what may be causing them. Though there is no real cure for mouth ulcers, good oral hygiene is ideal for reducing severity and discomfort and may even reduce healing time and frequency of reappearance.
What are mouth ulcers and what do they look like? As mentioned above, mouth sores, mouth ulcers, mucosal ulcers or canker sores describe tiny, often circular or somewhat oval open skin lesions appearing anywhere in the oral cavity or, sometimes, on the lips. To sum things up, the two main causes for mouth ulcers are:
1) Trauma to the oral cavity such as accidentally biting yourself, injury from braces or broken fillings, teeth grinding and other similar actions.
2) Aphtous stomatitis or the well known canker sores.
How do I know if I have mouth ulcers (canker sores)? Aside from whitish, pinkish, relatively small, round or oval skin lesions with reddish borders that appear on the inside of the mouth, sometimes on the lip area and generate moderate pain and discomfort in the form of burning or stinging sensations when eating or talking, mouth sores do not have any other particular sign or symptom. They should heal in a matter of days or weeks with mostly just good oral hygiene.
The good news is that mouth ulcers in general are benign and resolve themselves (it helps to brush your teeth and use mouthwash after eating to help hurry the healing along). Nevertheless, if they do not heal in a matter of weeks or begin looking different (they start bleeding, growing, taking on different colors), then you might want to visit a medical professional to rule out other potentially serious conditions.
As a person with recurrent mouth ulcers, I asked myself: why do I keep getting mouth ulcers? It was not until I payed a little attention to what was happening that I noticed I got them either when I ate really salty pickled olives, fresh tomatoes from my garden (which I am slightly intolerant of) or when I had accidentally bitten the inside of my cheek (this happens when you want to eat and talk at the same time). Self-inflicted injuries, in other words biting myself, really salty foods or foods that trigger mild allergic reactions were what caused my mouth ulcers. But this was just my case.
What causes mouth ulcers?
Mouth ulcerations can have a variety of causes, such as those listed below:
1) Accidentally biting yourself while eating or talking.
2) Hurting yourself with braces, teeth fillings, toothbrush, etc.
3) Bad habits such as biting your cheek softly, using tooth picks aggressively, biting your lips, rubbing your tongue on your teeth, etc.
4) Dental treatments.
5) Eating or drinking hot foods.
6) Chewing certain medication that is meant for swallowing.
7) Consuming spicy foods.
8) Certain soft drinks.
9) Acidic foods (tomatoes, pickles, citrus fruit).
10) Foods that are too salty (salty aged cheeses or pickles).
11) Foods that may trigger a particular sensitivity (pineapple, strawberries, lemons etc.).
12) Viral or bacterial infections.
13) Poor hygiene (nail biting, putting fingers in the mouth, not brushing teeth etc.).
Where to they appear?
Where do mouth ulcers appear? Generally, they can appear anywhere on the inside of the mouth, but these areas are the most common:
1) On the inside of the cheeks.
2) On the inside of the lips.
3) Below the tongue.
4) At the base of our gums.
5) On the roof of the mouth.
Evolution of mouth ulcers
Anyone dealing with mouth ulcers often worries if whether or not they are a sign a deeper, underlying health problem. Because this is also a possibility, here are three questions you should be asking yourself about the evolution of your mouth sores:
1) What should mouth ulcers look like? Mouth sores are open lesions to the thin skin of the mouth. They should be round or somewhat oval in shape and have a few mm in diameter as well as a whitish, grayish or pinkish color. Major mouth sores may be bigger and take longer to heal, while mouth sores caused by the Herpes virus look like a larger ulceration made up of clusters of smaller, barely visible blisters, the size of needle points.
2) Has the appearance of my mouth ulcer(s) changed? If an existing ulceration becomes unusually large (bigger than your fingerprint, for example), if new ulcerations appear before the old ones heal, if existing ulcerations spread visibly to other parts of the mouth, if they change color (deep red, brown, black), if you do not experience pain or if your pain is excruciating, if you cannot eat or develop fever or other worrisome symptoms, then you need to seek medical help at once.
3) How long do mouth ulcers usually last? Depending on their cause, size or type, mouth ulcers should heal anywhere from 7 days to 2 weeks or, in rare cases, 6 weeks. Mouth ulcers that do not give any signs of healing, take more than 2-3 weeks to even begin to heal or progress should be examined by a medical professional as soon as possible.
Observing the evolution of your mouth ulcers is important. If they seem to progress as they should, then you just have to wait for them to heal by themselves. If you notice unusual changes or are unsure and simply want the advice of a medical professional, then seek it. There is no real treatment for mouth ulcers. Good hygiene and a bit of attention should help them heal faster and, sometimes, prevent them from reoccurring.
Prevention and treatment
So how do we make mouth ulcers go away faster or hurt less? Here is what you can do about them:
1) Avoid problematic foods (acidic, spicy, salty or hot foods and beverages). Opt for bananas and cottage cheese in the morning or as a healthy, nutritious midday snack to help keep you healthy and maybe hurry healing. Eating soft foods such as mashed vegetables or fruits can help with the pain.
2) Maintain a good hygiene. Change your toothbrush, brush teeth slowly, use an antiseptic mouthwash such as those containing chlorhexidine or made with herbal plants with natural antimicrobial properties. In general, using mouthwash at least two times a day after brushing your teeth is a great way to hurry along healing for mouth ulcers. This way you can prevent the existing skin lesions or ulcers from infecting. Avoid putting your hands or other unsanitary objects in the mouth.
3) Coconut water and honey. Some people massage their gums with coconut water and honey for pain relief and antiseptic benefits. However, it is unclear if this actually helps heal mouth ulcers faster.
4) Take your vitamins. It is believed that mouth ulcers may be caused by vitamin and mineral deficiencies, notably vitamin B9 (folate) or iron deficiencies. Improving your diet with foods rich in all dietary nutrients or taking supplements prescribed by your doctor may help hurry recovery and even prevent recurrence.