What are mouth ulcers?

Ulcers are painful sores that occur in the mouth. They are usually harmless and tend to clear up on their own.

What does a mouth ulcer look like?

Mouth ulcers are typically round or oval in shape and can appear on the cheeks, tongue, or lips. They vary in color—white, yellow, red, or grey—and you may have multiple ulcers at one time. (Learn more about oral health.)

What causes mouth ulcers?

Most single mouth ulcers are caused by damage to the lining of the mouth. Common causes include:

• Accidentally biting the inside of your cheek or a sharp tooth
• Poorly fitting dentures
• Eating hard food
• A defective filling

Triggers for recurrent mouth ulcers may include:

• Stress and anxiety
• Hormonal changes – for example, some women develop mouth ulcers during their menstrual cycle
• Eating certain foods – such as chocolate, spicy foods, coffee, peanuts, almonds, strawberries, cheese, tomatoes, and wheat flour
• Toothpaste containing sodium lauryl sulphate
• Stopping smoking – ulcers can develop when you first quit smoking

Genetics may also play a role; around 40% of people with recurrent mouth ulcers report a family history.

How to treat mouth ulcers

Mouth ulcers usually resolve on their own within one to two weeks. To ease discomfort and speed up healing, consider the following self-care tips:

• Apply a protective paste recommended by your pharmacist
• Use a soft toothbrush to gently brush your teeth
• Choose a toothpaste that doesn’t contain sodium lauryl sulphate to avoid irritation
• Avoid hard, spicy, salty, acidic, or hot foods and drinks until the ulcer heals
• Use a straw to drink cool beverages
• Avoid known triggers that may worsen your ulcers

If self-care isn’t effective, over-the-counter products are available at pharmacies. Options include:

• Antimicrobial mouthwash (note: contains chlorhexidine gluconate, which may stain teeth; not recommended for children under two)
• Pain-relieving formulations available as mouthwash, lozenges, gels, or sprays (children under 12 should avoid these)
• Corticosteroid lozenges to reduce pain and speed healing (best used as soon as the ulcer appears; not recommended for children under 12)

In rare cases, mouth ulcers that do not heal may signal mouth cancer, particularly if they appear on or under the tongue. Risk factors for mouth cancer include:

• Smoking or using tobacco products
• Heavy alcohol consumption (especially in smokers)
• Infection with human papilloma virus (HPV)

If mouth cancer is detected early, the chances of a full recovery are good. Please see your dentist if your mouth ulcer lasts for three weeks, if you get recurrent ulcers, or if an ulcer becomes more painful or red – this may indicate a bacterial infection that requires treatment with antibiotics.

• If you keep getting mouth ulcers
• If your mouth ulcer becomes more painful or red – this could indicate an infection needing antibiotics

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