CONDITIONS A-Z

Mouth Ulcers

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mouth_ulcer_Canker-Sores-While mouth ulcers will usually heal by themselves within 7-14 days, they can cause significant pain and discomfort.

Below you will find a number of simple and effective remedies that can help to numb the pain, decrease the risk of a bacterial infection, as well as speed up the healing process.

There are also a number of suggestion for how to prevent recurring ulcers.

Mouth ulcers fall into three main categories; minor ulcers which are the most common and typically between 2-8mm in diameter, major ulcers which are larger, deeper and may take longer to heal, and herpetiform ulcers which are multiple pin head size sores.

What Causes Mouth Ulcers?

Most single mouth ulcers are caused by damage to the mouth, however the cause of recurring ulcers is often unkown. Some people simply tend to suffer from mouth ulcers more often than others, especially if there is a family history. Children and young adults are more commonly affected.

Students and people who are under a lot of stress may also suffer from ulcers more frequently. Some women tend to get ulcers just before their periods or during pregnancy. Occasionally they can be the sign of a more serious condition.

Common Causes

  • Damage to the inside lining of your mouth by very hot or acidic food and drink
  • Biting you inner cheeks
  • Brushing your teeth and gums very hard.
  • Poorly fitted dentures.
  • A very dry mouth due to a medical condition or from some medications
  • Eating food to which you are allergic
  • Scraping of the mouth lining by sucking hard sweets.
  • Being stressed, or lacking certain vitamins and minerals in your body such as folic acid and B-group vitamins or iron.
  • Certain medications.

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.

The Medicines and Healthcare products Regulatory Agency has warned parents not to use Bonjela to treat children's mouth ulcers. There is a chance that Bonjela could cause Reye's syndrome which is a serious condition that has the potential to cause brain damage and liver failure. Here are a few over the counter medications that can be used instead.

  • Aloclair Gel: Aloclair is an aloe vera extract and also contains hyaluronic acid.
  • Orlamedic: Oralmedia is a medicated lotion, applied with a single use cotton buds, that forms a seal over the ulcer.
  • Forever Bright Tooth: Forever Bright Tooth can be used when brushing or can be applied directly to the ulcer.
  • Iglu Gel: Iglu Gel forms a protective layer over the ulcer helping to fight infection and relieve pain.
  • Weleda Medicinal Gargle: Weleda is a mixture of a number of essential oils that will help to relieve pain. It also has antibacterial properties.

Coating the Ulcer

  • Over-The-Counter Products: The staple remedies for mouth ulcers are over-the-counter products that form a long lasting layer of protection over the ulcer.  These products come in the form of pastes, gels and liquid paints. As well as protecting the ulcer some of these treatments have anti-inflammatory ingredients and may prevent the ulcer from getting worse - if used early enough. Remember to dry to the ulcer with a cotton bud before applying the treatment.

  • Paste Treatments: Form a protective layer over the ulcer, helping the medicine stick to the ulcer. This allows the ulcer to heal faster and can help relieve the pain. Some pastes contain anti-inflammatory medicines that, if applied at the tingling stage, can prevent the mouth ulcer from developing further. You may need to dry your mouth first before applying the paste. Dab it on rather than rub it in.

  • Gel Treatments: Form a protective layer over the ulcer. Some also contain treatments that numb the pain. Avoid using large amounts of gels, especially in children under 12 years of age.

  • Mouth Washes: Are useful for hard to reach ulcers and when there are many at one time. Can help prevent bacteria causing an infection. Some can also numb the pain. Work best if you start to use them as soon as you feel the tingling sensation.

  • Liquid paint Treatments: Form a protective layer over the ulcer but need to be re-applied often. Ask your pharmacist to help you choose the most suitable treatment for your mouth ulcer. Apply pastes and gels during the day. Also apply at bedtime to allow longer contact with the mouth ulcer. Take a pain reliever like paracetomol if pain from the ulcer is severe. Check with your pharmacist if you are pregnant or breastfeeding or before giving children medication for mouth ulcers.

  • Liquorice: A form of liquorice known as degylcrrhizinated liquorice or DGL can also be used to coat mouth ulcers. You can get it in the form of small wafers from some health food shops. Chew one or two wafers two or three times a day.

  • Aloe Vera: The sap from an Aloe Vera plant can help to numb the pain. Squeeze some of the sap from the aloe leaf itself. Dry the ulcer with a cotton bud and then dab on the sap. You can repeat this as often as you need to.

  • Vitamin E: Applying vitamin E oil can also help. Cut open a vitamin E capsule and squeeze some of the oil onto the mouth ulcer.

Neutralizing Acid and Enzymes

  • Damp Tea Bags: Damp tea bags are alkaline and have astringent properties. Placing one against the mouth ulcer for around five minutes will help neutralize the acid and reduce pain.

Numbing The Pain

  • Topical Anaesthetics: Dab on a topical anaesthetic such as Anbesol liquid or Rinstead gel. These don’t stick so you will need to reapply them several times a day.

  • Babies Teething Gel: Try a babies ‘teething gel’. These have a mild numbing effect.

  • Pain Relieving Lozenges: Allow a pain relieving lozenge to dissolve in your mouth to take away some of the pain.

Battling Bacteria

  • Hydrogen Peroxide: Mix a tablespoon of hydrogen peroxide into half a glass of water. Add 1 teaspoon of bicarbonate soda and 1 teaspoon of salt and stir until they dissolve. Swish the solution around your mouth and spit out. Hydrgen perxode is a strong disinfectant – usefull because mouth ulcers are prone to infection which will make the pain worse. Bicarbonate soda is alkaline and will give further relief by neutralizing acids.

  • Goldenseal: To speed up healing apply a liquid form of the herb goldenseal to the sore three times a day, at least an hour before eating. Goldenseal has mild antibacterial properties.

  • Tea Tree Oil: Place a single drop of tea tree oil directly onto the mouth ulcer.

  • Calendula: Make a tea from calendula. Better known as garden marigold it has been used for centuries for treating minor cuts, cracked skin and insect bites. Pour a cup of boiling water over about 2 teaspoons of dried petals, strain and leave to cool until lukewarm. Gargle and swish around your mouth as often as you like.

Extra Measures

  • Lysine: Many experts believe that lysine, an amino acid, may be needed to remedy a deficiency associated with mouth ulcers. Take 1000mg of lysine three times a day on an empty stomach.

  • Echinacea: Echinacea is a herb believed to boost the immune system. Take 200 mg two to three times a day as soon as you first notice the ulcer. Do not take Echinacea if you have an autoimmune disease such as lupus or a progressive disease such as multiple sclerosis or tuberculosis.

  • Vitamin C: Vitamin C with flavanoids will help to heal the mouths mucous membranes. Citrus fruits supply dietary vitamin C but these can trigger mouth ulcers in some people. Instead try taking  20mg each of Vitamin C and flavanoids (which enhance the effects of vitamin C) three times a day.

The Power of Prevention

  • Avoid Ulcer Triggering Food: Potential trouble makers include whole wheat, rye, barley, pineapple or citrus fruits, figs, chocolate, tomatoes, green peppers, and strawberries. To find out if any of these are causing your ulcers cut them all from your diet and slowly reintroduce them, one at a time, and see if your ulcers return.

  • Live yoghurt: Live yoghurt contains lactobacillus acidophilus. This friendly bacteria might help fight the baddies in your mouth. Eat 3-4 tablespoons per day for prevention.

  • Toothpaste: check the label of your toothpaste for an ingredient called sodium lauryl sulphate or SLS. SLS is a foaming agent found in almost every brand of toothpaste and can trigger ulcers in some people.

  • Take care when eating sharp or hard edged food: Tiny cuts and grazes in the mouth can result in mouth ulcers. Take care when eating sharp edged food like crisps or baguettes. Use a soft bristled brush when brushing your teeth so as not to scratch your gums.

  • Ill fitting dentures: See your dentist if you have any kind of tooth problems that could irritate the inside of your mouth. Ill fitting dentures in particular can cause problems.

  • Vitamin B: people who suffer from frequent mouth ulcers may be deficient in vitamin B. Take a vitamin B complex and incorporate beans, wheatgerm and fortified breakfast cereals into your dite.

  • Stress: stress can trigger ulcers because it causes the body’s immune system to over react to bacteria normally in the mouth.

When To See Your Doctor

See your doctor if you have mouth ulcers that:

  • Are larger than 1 cm or you have lots of small ulcers join together to form a large ulcer.

  • Do not heal within 3-4 weeks even with treatment.

  • Bleed allot

  • Occur often in a very short space of time, e.g. every 1 -2 weeks.

  • Come with a sore throat, or rash on any part of your body

  • Are not painful at all

  • Occur with diarrhoea as well

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