Aphthous Ulcer

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What are aphthous mouth ulcers?

Aphthous mouth ulcers are painful sores that can occur anywhere inside the mouth. They are the most common type of mouth ulcer.

What causes aphthous mouth ulcers?

The cause is not known. They are not infectious, and you cannot ‘catch’ aphthous mouth ulcers. In most cases, the ulcers develop for no apparent reason in people who are healthy.

In some cases the ulcers are related to other factors or diseases. These include:

  • Injury – such as a graze from a harsh toothbrush, etc.
  • Changes in hormone levels.
  • Smoking.
  • A lack of iron, or a lack of certain vitamins such as vitamin B12 and folic acid.
  • Spicy food.
  • Mouth ulcers run in some families. So, a genetic factor may play a part in some cases.
  • Stress or anxiety .
  • Some medications can cause mouth ulcers. Examples of medicines that can cause mouth ulcers are: anti-inflammatory medicines (eg, ibuprofen) and oral nicotine replacement therapy.
  • Mouth ulcers are more common in people with Crohn’s disease, coeliac disease, HIV infection, and Behçet’s disease. However, these ulcers are not the aphthous type.

What are the treatments for aphthous ulcers?

Treatment aims to ease the pain when ulcers occur, and to help them to heal as quickly as possible. There is no treatment that prevents aphthous mouth ulcers from recurring.

No treatment may be needed

The pain is often mild, particularly with the common ‘minor’ type of aphthous ulcer. Each bout of ulcers will go without treatment.

General measures include

  • Avoiding spicy foods, acidic fruit drinks, and very salty foods (such as crisps) which can make the pain and stinging worse.
  • Using a straw to drink, to avoid the liquids touching ulcers in the front of the mouth. (Note: do not drink hot drinks with a straw, as you may burn your throat.)
  • Using a very soft toothbrush. See a dentist if you have badly fitting dentures.
  • If you suspect a medication is causing the ulcers, then a change may be possible. For example, if you are using oral nicotine replacement therapy (nicotine gum or lozenges), it may help to use a different type instead such as patches or nasal spray.

Some medicines may ease your symptoms from the mouth ulcers

  • Chlorhexidine mouthwash may reduce the pain. It may also help ulcers to heal more quickly. It also helps to prevent ulcers from becoming infected. Unfortunately, it does not reduce the number of new ulcers.
  • Steroid (Trialon) may also reduce the pain, and may help ulcers to heal more quickly.
  • A painkilling oral rinse, gel, or mouth spray may help to ease pain.