Mouth Ulcers | Diagnosis and Causes

Mouth ulcers are small red oval sores with a white or yellow center that form on the inside of the mouth. They are found on the inside of the lips, cheek, tongue, or on the soft palette. Mouth ulcers generally appear as a single sore, but multiple lesions may be present. These lesions are not contagious. Men, women, teenagers, and children are susceptible to developing mouth ulcers.

There are three distinct types of mouth ulcers; Minor, Major, and Herpetiform. Minor ulcers account for roughly 80% of all mouth ulcers. They appear to have a round or oval shape, white or pale yellow in color, red and swollen, and generally not painful. One ulcer is usually present, but up to five may appear at the same time. Minor ulcers are present for seven to ten days and will disappear without any scarring.

Major ulcers are deeper and larger than minor ulcers and tend to occur in an average of one in ten cases. Generally, only one ulcer appears at a time, but two ulcers may be present. Major ulcers are painful, can last from ten days to several months, and will leave a scar when healed.

Herpetiform ulcers, also known as pinpoint ulcers, are tiny lesions that appear in clusters from as little as four ulcers up to one hundred ulcers. Each ulcer is no larger than 3mm in size. In some cases, the clusters combine together to form large, odd-shaped groups of ulcers. Herpetiform ulcers occur in 10% of cases, heal in about seven to ten days, and leave no scar.

The most common causes of mouth ulcers are;

Stress
High stress or anxiety causes strain on the immune system, which can lead to an outbreak of mouth ulcers.

Mouth injury
Dental treatment, biting or chewing the inside of the mouth, poorly fitted dentures, sports injury, or excessive toothbrush use can cause injury to the oral tissue, leading to formation of an ulcer.

Diet and food allergies
A diet lacking in iron, folic acid, and specific vitamins and minerals such as vitamin B6 and zinc, can contribute to the development of mouth ulcers. Highly acidic foods and beverages such as pineapple, strawberries, eggs, cheese, and coffee, may trigger a mouth ulcer to appear. Food allergies, although rare, can also cause mouth ulcers.

Hormones
Women are more prone to developing mouth ulcers due to hormone changes in the body at the onset of her period, pregnancy, or after menopause.

Hereditary
More than one member of the family may be prone to mouth ulcers if either one of the parents suffers from persistent mouth ulcers.

Medical condition
Mouth ulcers may appear due to an underlying medical condition that affects the immune system or causes inflammation in the body. Some common conditions that may cause mouth ulcers are; Reiter's Syndrome, HIV, Ulcerative Colitis, Coeliac Disease, and Crohn’s Disease.

Medicine
Mouth ulcers can develop as a reaction to specific medications such as beta-blockers, non-steroidal anti-inflammatory drugs , Nicorandil, and even over the counter drugs such as Ibuprofen. The ulcers may appear when the medication is first taken or if the dosage has increased.

Bacteria
Helicobacter pylori is one of the many kinds of bacteria found in the mouth that can lead to the development of mouth ulcers.

Toothpaste
Sodium lauryl sulphate is an ingredient found in many brands of toothpaste which can cause mouth ulcers.

Whatever the cause of the mouth ulcer might be, one thing is for certain, mouth ulcers are annoying, even painful at times. They can interfere with eating, drinking, and speech. Those who suffer from chronic or persistent mouth ulcers often find themselves feeling tired, possibly have a raised temperature, or have swollen glands. The good news is, there are treatments available to help ease the discomfort of a mouth ulcers which we will discuss in our next update.