Most people get mouth ulcers at some time in their life and, while they can be very painful, they usually heal quickly by themselves and cause no other problems. Mouth ulcer is also called an aphthous ulcer, canker sore, or an oral ulcer and is a relative common problem, so there are many causes for these ulcers. Rarely, though, there are more serious conditions underlying mouth ulcers.
They tend to be recurrent. They usually tend to disappear in about 7-10 days but cause a lot of discomfort. The pain can be unbearable. One cannot speak, eat, or drink properly.
Looking like a shallow crater, they usually have a grey or yellow to white appearance. Some have a raised border. Nerves are close to the surface in the mouth, so any break in the membrane exposes them and causes pain. This can make eating, drinking and oral care very uncomfortable.
Common Causes
and Certain medications like Aspirin, Diclofenac, Aceclofenac etc.
and After minor injury, such as accidentally biting the tongue or a knock with a toothbrush
and At times of stress
and After eating certain foods
and With hormonal changes (for example at a particular time in a woman\’s menstrual cycle)
and As a result of an injury, such as ill-fitting dentures or a rough edge on a tooth
and Virus, such as herpes simplex (cold sore) or varicella zoster (which causes chicken pox and shingles)
and Allergy to certain foods
and Intestinal conditions such as Crohn\’s disease or coeliac disease ,Liver failure
and Mouth cancer (rare)
and Nutrient deficiencies, such as vitamin B12, iron or folic acid.
Symptoms:
and Tiny shallow erosions in the lining of the mouth or on the tongue.
and The base may be white or grey in color.
and Increased salivation.
and Pain, burning sensation especially on contact with food or water.
and There may be bleeding from the ulcers.
and Mild fever if infection is the cause.
and Bad odor from the mouth.
Mouth Ulcer Treatment
Mouth ulcers usually heal within 7-14 days, however treatment can help to numb the pain, protect the ulcer from further damage and decrease the chances of a bacterial infection. Some medicines may also speed up the healing if used early.
and warm salt water mouth washes with little turmeric
and Paracetamol if severe pain
and antimicrobial mouthwashes (these fight the bacteria, viruses and fungi that can cause infection if you are not able to brush your teeth properly)
and local anesthetic treatments in the form of a mouthwash, spray, gel or ointment
and acyclovir, if the ulcer is caused by a herpes virus (cold sore, chicken pox or shingles)
and Corticosteroids.
Prevention
and Address any source of damage to the mucosal membrane: get damaged teeth, rough surfaces or ill-fitting dentures fixed.
and Use a soft toothbrush to minimize further damage and replace it regularly.
and Avoid any foods that you know cause the problem.
and Choose softer foods that are less likely to aggravate an ulcer.
and Visit your doctor to investigate underlying conditions such as herpes, shingles or an intestinal disorder.
Cauterizing the ulcer with Silver nitrate Stick
Silver nitrate sticks have been used for a long time to provide pain relief for the duration of an aphthous ulceration, with only one application. Silver nitrate causes chemical cauterization and increases the depth of injury.
Obviously, one need to be sure there is no other apparent etiology but, because the most common cause is not related to underlying disease, the silver nitrate stick works wonders, and patients walk out of the office pain free.
The procedure is simple, dry the area with a clean tissue paper and gently touch it to the ulcer base with the stick. When the ulcer turns white, remove the stick. Have patients swish out the silver nitrate and send them home. You should warn them that the procedure may sting for a moment but, considering that they are already in pain, they don’t really notice much difference.
The effect is rapid and lasts for the duration of the lesion. The treatment is simple and cost-effective in patients with infrequent recurrences.
*If the ulcers do not healing after two weeks, consider taking a biopsy
