What are recurrent mouth
ulcers?
A Ulcers are sores that appear inside the mouth and can be itchy or painful. A
recurrent ulcer is one that comes and goes, sometimes every few weeks. They are
different from cold sores, which appear on the outer lips and are due to a virus
infection.
Are they
common?
Yes. Over 60% of the population have recurrent oral ulcers at some time in their
lives. Often they begin in childhood but most people grow out of them by their late
twenties. In many cases several members of the family may suffer from these ulcers,
which can be due to a family tendency and not to infection.
Where and how can they appear?
Minor ulcers can appear inside the cheeks, on the lips, tongue, gums and, more
rarely, the roof of the mouth. Most of these ulcers (minor type) are the size of the
top of a pencil and can sometimes come in clusters.
Large ulcers (major type) may appear near the tonsils and can be very painful,
especially when swallowing. It is also possible to have up to 100 very small ulcers
(herpetiform type). However these last two varieties are very rare.
You may get ulcers in other parts of the body e.g. eyes or genital area. It is
important to tell your dentist about this.
How long do they
last?
The ulcer is usually preceded by an itchy feeling at the spot where it is due to
appear. After 6-24 hours an ulcer forms and can last 7-10 days. The very large ones
usually take up to six weeks to heal.
What causes mouth
ulcers?
Recurrent mouth ulcers cannot be caught by kissing or sharing drinks and utensils, as
they are not caused by an infection. They may be an autoimmune disease caused by the
body attacking the cells lining the mouth.
It has been suggested that the following factors have a role in causing mouth
ulcers:
Too little iron or a lack of vitamins, especially B12 and C, in the diet.
Bowel disease such as Crohn's disease or ulcerative colitis.
Coeliac disease (gluten sensitivity).
Hormonal changes; many women get ulcers at the time of their period.
Stress
Certain foods.
Should I worry about my
ulcers?
A No. Most ulcers heal up on their own. In order to reduce the pain from these ulcers
it is important that you keep your mouth clean at all times. Use a diluted
chlorhexidine mouthwash once daily. You can buy this in any chemist. Sprays and
rinses are also available for pain relief. It is advisable to consult your dentist
in case you need additional medications or if the ulcers persist.
What will the dentist
do?
The dentist may refer you to have blood tests taken and will probably prescribe some
form of medication to help the ulcer to heal faster and so reduce the pain. However
these medications cannot stop the ulcers from appearing. Most are steroid based but are
safe to use provided they are not swallowed. It is usually recommended to use them as
soon as you feel an ulcer coming.
Laser treatment. At White House Dental we are fortunate to possess a laser machine which
can be used to coat the ulcer, eliminate the pain and reduce the healing time. Please
ask your dentist.
Adcortyl in Orabase. Dry the area first with a cotton wool bud and then use a wet finger
or a wet cotton wool bud to put the cream on the sore area. It is most effective to use
this cream last thing at night as it stays there for longer. You can use it up to four
times a day after meals. You may find it leaves a gritty feel in your mouth. You can buy
this yourself
Corlan Pellets are small, bitter tasting tablets that dissolve in your mouth releasing a
drug that acts on the ulcer. Place it near the ulcer. You can buy these yourself and can
use them four times a day
Becotide spray is occasionally used for those areas of the mouth which are difficult to
reach with other remedies. Use 2-3 puffs of the pump on the area that is sore. Do NOT
breathe in at the time of puffing, hold your breath as you do not want the spray to go
down into the lungs. You can use it up to four times a day.
Bioplex is a non steroidal powder that you make up as a mouthwash in a quarter of a cup
of warm water. Use up to four times a day.
Other medications can be prescribed by your dentist or specialist, if necessary.
If an ulcer fails to heal in three weeks, see a dentist who will refer you to a
specialist if necessary.