While usually harmless, mouth ulcers can be incredibly painful and irritating. — dpa
There's a good chance you’ve had one, and the memory isn’t pleasant: a small, shallow lesion inside your mouth with a white or yellowish centre and red border.
Usually harmless, they can be painful and very irritating, making it difficult to eat, drink, talk and brush your teeth.
They’re mouth ulcers, also known as aphthous ulcers or canker sores.
They typically occur on the inner cheeks, inner lips, base of your gums or roof of your mouth, and can also appear on your tongue.
Thankfully, “mouth ulcers generally clear up by themselves within seven to 10 days”, says German Dental Association (BZÄK) president Dr Christoph Benz.
At least this is the case with minor ones – the most common type – which have a diameter of two to three millimetres, and are rarely as large as 10mm.
These ulcers heal without scarring.
Major mouth ulcers, on the other hand, can have a diameter of three centimetres and are extremely painful.
They take several weeks to heal and often leave scarring.
A third type, herpetiform mouth sores (which, despite the name, are not caused by herpes virus infection), are uncommon.
Pinpoint in size, they occur throughout the mouth in clusters of up to 100 and heal within seven to 10 days without scarring.
What causes them?
The exact causes of mouth ulcers haven’t yet been conclusively determined, according to Dr Benz.
“Under discussion as possible triggers are injuries to the oral mucosa from toothbrushes or a vitamin deficiency, for instance,” he says, adding that allergic reactions or stress could cause them too.
Mouth ulcers are made more likely by pressure marks from dentures or braces, and also fillings with sharp edges, notes Federal Union of German Associations of Pharmacists (ABDA) deputy spokeswoman Dr Ursula Sellerberg.
They’re more common in females than in males, and in younger people than older ones.
“The reasons for this are also unclear as yet,” Dr Benz says.
What can I do?
First of all, you can try to reduce inflammation with a mouthwash, e.g. one containing highly-dosed camomile extract.
Mouthwashes with alcoholic camomile extracts, as well as a camomile infusion (10 grammes of camomile flowers steeped in 100 millilitres of boiled water) are anti-inflammatory, says Dr Sellerberg.
They hardly alleviate the burning sensation or pain though, she says, and “normal camomile tea is dosed too low to have any real effect”.
What does help, however, are gels, pastes, ointments, sprays or tablets that are available in pharmacies.
Before you apply a gel, paste or ointment, dab the mouth ulcer dry with a cotton bud, as “this will prolong the time the medication remains on the mucosa,” Dr Sellerberg recommends.
Painkilling medicines are best taken before meals so that the pain while chewing is tolerable.
All other medications should be used after eating and brushing the teeth.
“You shouldn’t drink anything for 30 minutes afterwards,” she says, otherwise, the medication will be washed away and have little effect.
If symptoms are severe, a corticosteroid preparation can help.
Before using it for the first time though, you should consult a doctor.
When to see the doctor?
If your self-care measures bring no improvement within 14 days, it’s time to see a dentist.
Seeing a doctor is also advisable if you get mouth ulcers more than three times a year.
You should also see a general practitioner (GP), dermatologist or ear, nose and throat (ENT) physician if aphthous ulcers appear elsewhere on your body, or if you have other symptoms like a fever, swollen lymph glands or gastrointestinal problems, for example, as they could indicate certain illnesses.
“It could be a condition that affects the digestive system, such as Crohn’s disease or coeliac disease,” Dr Benz says.
Or perhaps your body has too few white blood cells.
It’s also conceivable that leukaemia or an infectious disease such as HIV/AIDS is behind the mouth ulcers.
Taking certain medications, such as corticosteroids, can cause them too, as can deficiencies of vitamin B12 or iron, for instance.
Can they be prevented?
“This is difficult since the causes aren’t quite clear,” says Dr Benz.
What nevertheless helps, says Dr Sellerberg, is to “reduce stress and maintain a healthy lifestyle with a balanced diet, plenty of exercise, no nicotine, little alcohol and sufficient sleep”.
If necessary, you should also get any ill-fitting dentures or braces fixed.
And proper oral hygiene is always important, of course. – By Sabine Meuter/dpa
