Mouth ulcer

Mouth ulcers are painful sores that appear in the mouth. They're uncomfortable, but they're usually harmless, and most clear up by themselves within 1 to 2 weeks.

Mouth ulcers are common. You can usually manage them at home, without seeing your dentist or doctor.

Mouth ulcers are usually round or oval sores. They commonly appear inside the mouth, on the:

• cheeks
• lips
• tongue

They can be white, red, yellow or grey in colour, and they can be swollen. You may have more than one mouth ulcer at a time, and they may spread or grow.

Don't confuse a mouth ulcer with a cold sore. Cold sores are small blisters that develop on the lips or around the mouth, and they often begin with a tingling, itching or burning feeling around your mouth.

• you have a mouth ulcer

They can give you advice and treatment.

If you have a dental problem, always phone your dentist first.

Your pharmacist may advise you to see your doctor or dentist if:

• your mouth ulcer has lasted 3 weeks
• you keep getting mouth ulcers
• the mouth ulcer grows bigger than usual or is near the back of your throat
• your mouth ulcer becomes more painful or red, which could be a sign of a bacterial infection that may need treatment with antibiotics

Mouth ulcers can also be a symptom of hand, foot and mouth disease. If you're unsure, speak to a doctor or phone the 16263 health line.

Most mouth ulcers clear up by themselves within 1 to 2 weeks, and you don't need any treatment for that to happen. Still, treatment can help bring down the swelling and ease the discomfort. It's worth considering if you keep getting mouth ulcers, or if an ulcer makes eating and drinking difficult.

There are some things you can do to help a mouth ulcer heal faster.

• use a soft toothbrush to brush your teeth
• drink cool drinks through a straw
• eat softer foods
• get regular dental check-ups
• eat a healthy, balanced diet
• try to reduce stress and anxiety

• don't eat very spicy, salty or acidic food
• don't eat rough, crunchy food, such as toast or crisps
• don't drink very hot or acidic drinks, such as fruit juice
• don't use chewing gum
• don't use toothpaste containing sodium lauryl sulphate

You can buy several types of mouth ulcer treatment at a pharmacy. Talk to your pharmacist about which one is best for you.

A doctor or dentist may prescribe stronger medicine if your mouth ulcers are severe, keep coming back or won't heal, or become infected. The treatments they may suggest include:

• steroid mouth spray or steroid tablets that dissolve in your mouth
• painkilling gels, ointments, sprays or tablets
• mouthwashes to kill or remove any germs in your mouth

In many cases, the reason for mouth ulcers is unclear. Most single mouth ulcers are caused by damage to the lining inside the mouth. For example:

• accidentally biting the inside of your cheek or a sharp tooth
• poorly fitting dentures
• hard food
• a faulty filling

It's not always clear what causes ulcers that keep returning, but these triggers are thought to play a part:

• stress and anxiety
• hormonal changes (some women develop mouth ulcers during their monthly period)
• eating certain foods, such as chocolate, spicy foods, coffee, peanuts, almonds, strawberries, cheese, tomatoes and wheat flour
• toothpaste containing sodium lauryl sulphate
• stopping smoking (when you first stop smoking, you may develop mouth ulcers)

Your genes are also thought to have a role. Around 40% of people who keep getting mouth ulcers say it runs in their family.

Mouth ulcers can sometimes be caused by certain medical conditions, such as:

• viral infections, including the cold sore virus, chickenpox, and hand, foot and mouth disease
• vitamin B12 or iron deficiency
• Crohn's disease, a long-term condition that causes inflammation of the lining of the digestive system
• coeliac disease, a common digestive condition where a person has an adverse reaction to gluten
• reactive arthritis, a condition that causes inflammation in various places in the body, usually as a reaction to an infection
• weakened immune system, for example due to HIV or lupus
• Behçet's disease, a rare and poorly understood condition that also causes swelling of the blood vessels

Some medicines and treatments can cause mouth ulcers. These include:

• non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• nicorandil, a medicine sometimes used to treat angina
• beta-blockers, which are used for conditions such as angina, high blood pressure and abnormal heart rhythms
• chemotherapy or radiotherapy, where the ulcers are a side effect known as mucositis

In a few cases, a mouth ulcer that lasts a long time can be a sign of mouth cancer. If it's found early, the chances of a complete recovery are good. Regular dental check-ups are the best way to spot the early signs.