What Causes… Mouth Ulcers

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What Causes… Mouth Ulcers

October 26th 2013
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A mouth ulcer is a painful round or oval shallow lesion in the mouth, often on the inside of cheek but can occur on the gums, palate or lips. They are not infectious so cannot be passed on from sharing a drink or kissing someone. Whilst they are very common and generally self-limiting, it is often not known exactly how one has been caused. Some are caused by trauma for example from a stray bristle sticking out of your toothbrush or a scrape from a hard or rough piece of food. Other causes can include-

– Hormonal changes
– Stress, anxiety or a general sense of being ‘run down’
– family history- 40% of people with ulcers say is runs in the family
– stopping smoking- this is a temporary effect due to the body coping with the changes in chemicals
– underlying medical conditions including Vit B12 or iron deficiencies, Crohns Disease, Coeliac Disease or any condition that attacks or suppresses the immune system (such as HIV or lupus)
– Medications- drugs such as NSAIDS (eg. ibuprofen) or Beta- blockers can occasionally causes ulcers


The three main types of mouth ulcer are-
– Minor ulcers- these are the most common, are 2-8mm in size and usually last 10-14 days.
– Major ulcers- deeper and larger (up to the size of a finger nail) and can take 1 month to heal
– Herpetiform- small, pin-head size but up to 100 can occur and join together giving the appearance of being larger and irregularly shaped.

Most ulcers go away without treatment. Occasionally I recommend a mouthwash to prevent a bacterial infection on the ulcer surface. For big ulcers (over 1cm in size) there is a medicine which can be prescribed by your dentist. It is applied to the ulcer and can be tricky to make stay in place but works effectively.

Very occasionally an ulcer can be a sign of mouth/oral cancer. In this case the ulcer is usually very deep and has a rolled, punched out appearance. Of all the mouth ulcers I have seen in 25 years working as a dentist, only one was cancer. However, if you have any concerns you should ask your dentist to check.

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