What Are the Causes of Mouth Ulcers?

The causes of mouth ulcers can be a traumatic, environmental, systemic disease, or medication.

An ulcer usually forms as a break in the skin or mucous membrane with loss of surface tissue.

Mouth ulcers are also called canker sores, aphthous ulcers, and are a form of mouth sores. They are small, round ulcers that may be red, yellow, or gray. They occur inlining of the oral cavity (mucous membrane), usually on the inner surface of the lips and cheeks.

• Minor mouth ulcers: These are the most common type of mouth ulcer and typically occur three or four times a year. They occur more commonly in the age-group of 10 to 20 years. They are less than 1 centimeter in diameter and heal within a week with no scarring.
• Major mouth ulcers: These are less common. The ulcers are bigger and last more than weeks. They tend to heal with scarring.
• Herpetiform mouth ulcers: These are rare and appear as clusters of tiny ulcers. They usually heal in about a week.

The causes of mouth ulcers can be traumatic, environmental, systemic disease, or medication. Quite often, mouth ulcers are triggered by an underlying medical condition. Sometimes, mouth ulcers may be the only sign of a systemic disease.

Some common causes of mouth ulcers are:

• Traumatic:
  • Due to accidental bites of the tongue or cheeks
  • Sharp tooth
  • Dental procedures
  • Braces and dentures
  • Chemical burns
• Chewing tobacco and smoking
• Alcohol and drug abuse
• Hormonal imbalance
• Infections such as herpes simplex virus, hand, foot, and mouth disease, and infectious mononucleosis
• Psychological and physical stress
• Acidic fruits and vegetables such as lime, tomatoes, oranges, pineapple
• Medication such as painkillers and antibiotics
• Allergic reaction to certain medication
• Chemotherapy and radiation used in cancer therapy
• Allergic reactions to food, mouthwashes, toothpaste, or other products used in the mouth
• Acid reflux and peptic ulcer disease
• A weakened immune system due to underlying conditions such as HIV/AIDS and diabetes
• Autoimmune disorders such as systemic lupus erythematosus and Bechet’s disease
• Nutritional deficiencies such as vitamin B12, zinc, folic acid, or iron
• Gastrointestinal diseases such as celiac disease and Crohn’s disease

The diagnosis is mainly based on clinical examination by the doctor. With frequent or severe mouth ulcers, the patient may be advised to undergo laboratory and radiological tests to diagnose underlying conditions.

• Severe pain in the mouth, making eating and talking difficult
• Fever
• Fatigue
• Swollen lymph nodes

• Mouthwashes: Your doctor may prescribe medicated mouthwashes that have a steroid or painkiller.
• Topical medication: Medicated ointments containing antiviral medicine, steroids, or local anesthesia can be applied over the ulcer to numb the area.
• Oral medications: Oral tablets and syrups may be prescribed to promote healing and reduce pain.
• Nutritional supplements: These might be prescribed if a nutritional deficiency is suspected or to help the ulcers heal faster.
• Cautery: Dental lasers or cauterization (medically burning) of the ulcer with chemicals provide instant relief.
• Diseases: Treatment of underlying systemic disease.
• Home remedies: Most often, mouth ulcers may heal in just a few days with simple home remedies such as:
  • Saltwater gargling or gargling with baking soda.
  • Applying milk of magnesia over the ulcer.
  • Applying ice over the ulcers.
  • Placing a tea bag over the ulcers.
• Diet and lifestyle modification:
  • Avoid food that is spicy or hot.
  • Avoid acidic fruits and vegetables.
  • Avoid aerated drinks, coffee, smoking, alcohol, and drugs.
  • Stress management.