We've all felt that annoying sting of a mouth ulcer. Your tongue can't leave it alone, so you venture to the mirror and take a look, only to discover that it's so tiny that it's barely visible. For most of us it only happens once in a while, which is normal, but some people are more prone to mouth ulcers than others.
So what exactly is an ulcer? If your want to get technical, an ulcer is just a break in your skin, or mucosa, (which lines the inside of your mouth). Ulcers can turn up because of a cut , scratch, a burn, a burst blister, an infection, or as a bit of a mystery. Sometimes mouth ulcers can be a sign that your body isn't coping. It's not unusual to get a spate of them when you are stressed, when you have a cold, or if your diet is lacking in certain vitamins and/or minerals.
For an unlucky few, mouth ulcers are repeat offenders, and even the cleverest scientists are still trying to find out why. This condition is known as recurrent aphthous stomatitis, which is split into three main categories:
- Minor aphthous ulceration (MiAU), which is characterised by small (<10mm), shallow ulcers. There are usually only a few, or there may be even one lonely ulcer on its own.
- Major aphthous ulceration (MaAU), in which lots of large (>10mm) ulcers are found all over the inside of the mouth. The ulcers are deeper than in MiAU, so they take longer to heal.
- Herpetiform ulceration, which is NOT caused by a herpes virus and is NOT contagious. It gets its name because the ulcers have a similar appearance to those found in initial oral herpes infection, but that's where the similarity ends. Characteristic clumps of tiny ulcers form, up to 100 in a batch. They are generally very painful, especially when they all join together to make one big ulcer.
If you just get the occasional ulcer or two, there's likely nothing to worry about. Be careful about what you eat and drink so that you don't irritate the area, and generally they heal of their own accord in 1-3 weeks. Treatment is mostly to reduce discomfort, so if you're able to tolerate how annoying they are then you're best off leaving them alone. If you can't put up with it, an antiseptic mouth rinse with an anti-inflammatory in it can be relieving, Difflam-C is the most well known one. I tend not to recommend teething/ulcer gels, as they offer temporary relief but can delay healing due to their acid content. It's also a problem if you accidentally irritate the area while it's numb, as you don't find out about it until the effect of the gel has worn off!
Not all ulcers are innocent. If you have an ulcer that doesn't heal within three weeks, or keeps coming up in the same spot, please see your dentist. It may be something as simple as a sharp tooth which keeps biting your cheek, or as sinister as mouth cancer.
If you have ulcers which come up repeatedly, it's a good idea to see your GP. There's a chance you've got a dietary deficiency which can be easily fixed by taking supplements, or there may be an underlying problem which is showing itself in the form of those annoying little critters - mouth ulcers.