MOUTH ULCER

Mouth ulcers, also known as apthous ulcers, are small shallow ulcers that appear in the mouth and often make eating and talking uncomfortable. They are very common, with around one in five adults and 5%-10% of children  suffering from recurrent mouth ulcers.

Simple mouth ulcers. These may appear three or four times a year and last up to a week. They typically occur in people between 10 and 20 years of age.

Complex mouth ulcers. These are less common and occur more often in people who have previously had them.

CAUSES

The exact cause of most mouth ulcers is unknown. Stress or tissue injury is thought to be the cause of simple mouth ulcers. Certain foods, including citrus or acidic fruits and vegetables (such as lemons, oranges, pineapples, apples, figs, tomatoes and strawberries), can trigger a mouth ulcer or make the problem worse. Sometimes a sharp tooth surface or dental appliance, such as braces or ill-fitting dentures, might also trigger mouth ulcers.

Some cases of complex mouth ulcers are caused by an underlying health condition, such as an impaired immune system; nutritional problems, such as vitamin B-12, zinc, folic acid, or iron deficiency and gastrointestinal tract disease, such as Coeliac disease and Crohn's disease.

When you first quit smoking, you may develop more mouth ulcers than normal, but this is temporary.

Some medications, including common pain killers, beta-blockers and some chest pain medicines ?may cause a reaction that leads to mouth ulcers.

 Although cold sores and mouth ulcers are often confused for each other, they are not the same. Cold sores are caused by the herpes simplex virus, most often herpes simplex type 1. Unlike mouth ulcers, cold sores are extremely contagious. They cause uncomfortable, fluid-filled blisters that typically appear outside the mouth, usually under the nose, around the lips or under the chin, while mouth ulcers occur inside the mouth.

SYMPTOMS

You may have a mouth ulcer if you have:

A painful sore or sores inside your mouth, on the tongue, soft palate (the back portion of the roof of your mouth), or inside your cheeks.

Sores in your mouth that are round, white, or grey in colour, with a red edge or border.

In severe mouth ulcer attacks, you may also experience:

·         Fever

·         Physical sluggishness

·         Swollen lymph nodes

Pain from a mouth ulcer generally lessens in a few days and the sores usually heal without treatment in about a week or two.

If sores are large, painful or persistent, your dentist may prescribe an antimicrobial mouth rinse, a corticosteroid ointment, or a prescription or non-prescription solution to reduce the pain and irritation.

 MOUTH ULCER BE PREVENTED

Although there is no cure for mouth ulcers and they often reoccur, you may be able to reduce their frequency by:

1.     Avoiding foods that irritate your mouth, including acidic or spicy foods

2.     Avoiding irritation from gum chewing

3.     Brushing with a soft-bristled brush after meals and flossing daily, which will keep your mouth free of foods that might trigger a sore.

4.      

5.     Good dental hygiene

Seek medical advice about mouth ulcers if you have:

·         Unusually large sores

·         Sores that are spreading

·         Sores that last three weeks or longer

·         Intolerable pain despite avoiding trigger foods and taking over-the-counter pain medication

·         Difficulty drinking enough fluids

·         A high fever with the appearance of the mouth ulcer(s)

COMPLICATIONS

Mouth ulcers rarely cause any complications. Over time, most mouth ulcers will heal naturally. Those that do not can usually be treated with medication.

A mouth ulcer may indicate an underlying health condition, but the ulcer itself will not be the cause of any illness.

Bacterial infection

The only complication mouth ulcers can cause is a bacterial infection. However, this is very rare. In some cases, an infected ulcer can cause the bacteria to spread to other areas of your mouth, such as your teeth. If your ulcer becomes infected, you might need treatment with antibiotics.

TREATMENT

Mouth ulcers generally go away by themselves, and in most cases you can safely ignore them. Over-the-counter gels or lozenges that protect the ulcer or have a local anaesthetic effect to relieve the discomfort of a mouth ulcer are available.
Antimicrobial mouthwash can help to kill any micro-organisms causing mouth infections.

If your mouth ulcer does not respond to over-the-counter or at-home treatments, your doctor may prescribe a topical medication containing a steroid for the inflammation.