What causes mouth ulcers?
Most minor, single mouth ulcers are often caused by mechanical injury—for example, biting your cheek, not brushing correctly, or by a sharp tooth or filling. Re-current mouth ulcers can be a sign of underlying medical problems such as iron or vitamin B12 deficiency, Crohn’s disease, hormonal fluctuations, and poor oral hygiene.
What are mouth ulcers?
Ulcers normally appear as small, painful lesions that may be pink or white in color. They often cause discomfort while eating, drinking, and talking. Although usually harmless and self-limiting—resolving within 1-2 weeks—if an ulcer takes longer to heal, you should seek medical attention.
Types of ulcers
There are 3 main types of ulcers:
1. Minor aphthous ulcer
These are the most common mouth ulcers. They are small, round or oval-shaped, less than 10mm in size, and typically heal within 1-2 weeks.
- Major aphthous ulcer
This type of ulcer is larger—generally 10mm or more—and usually appears one or two at a time. They are deeper, can be very painful, and may take up to 6 weeks to heal.
- Herpetiform ulcer
This type occurs when multiple ulcers appear simultaneously and merge into irregular shapes. Each individual ulcer may take from 1 week up to 2 months to heal.
Mouth ulcer symptoms
- Redness, soreness, tenderness, or a burning sensation in the mouth
- Swelling around the sores
- Pain while eating, drinking, or speaking
- Irritation from hot or spicy foods and drinks
Causes of mouth ulcers
1. General causes
Mouth ulcers can be triggered by various factors such as poor oral hygiene, stress, anxiety, lack of sleep, hormonal changes (e.g., during menstruation), food allergies or sensitivities, family history, deficiencies in vitamin B12, iron, or folic acid, and smoking.
- Mechanical causes
They can result from biting the inside of your cheek or tongue while chewing hard or hot foods, improper brushing techniques (such as injury from a toothbrush), sharp teeth, or poorly fitting dentures.
- Systemic causes
- Microbial diseases
Herpetic stomatitis, chicken pox, TB (tuberculosis), HIV, and hand, foot, and mouth disease.
- Gastrointestinal diseases
Celiac disease, Crohn’s disease, and ulcerative colitis.
- Blood disorders
Anemia, leukemia, and neutropenia.
- Rheumatoid diseases
Lupus erythematosus, Reiter’s disease, and Behçet’s disease.
- Cutaneous diseases
Pemphigus, chronic ulcerative stomatitis, lichen planus, and erythema.
Some drugs and medications can also cause mouth ulcers, such as ibuprofen, medications for angina, high blood pressure, and abnormal heart rhythm. Ulcers can also be a side effect of chemotherapy and radiotherapy.
Self care tips
The majority of ulcers tend to resolve on their own within a few weeks. You can help ease the pain by using a soft toothbrush to gently brush your teeth, avoiding hot, spicy, and acidic foods, drinking through a straw, and using lozenges or mouthwashes to ease discomfort and promote healing. If these self care tips do not aid healing, seek medical attention.