What are Oral Ulcers

Oral ulcers are sores inside the mouth or near the mouth. They may be called canker sores or cold sores, which are two types of oral ulcers.

Many oral ulcers are harmless and go away on their own. In some cases, oral ulcers may require medical care to determine the cause and proper treatment.

What are the causes?

Common causes of this condition include:

• Viral, bacterial, or fungal infection.
• Emotional stress.
• Foods or chemicals that irritate the mouth.
• Injury or physical irritation of the mouth.
• Medicines.
• Allergies.
• Tobacco use.

Less common causes include:

• Skin disease.
• A type of herpes virus infection (herpes simplex or herpes zoster).
• Oral cancer.

In some cases, the cause of this condition may not be known.

What increases the risk?

Oral ulcers are more likely to develop in:

• People who wear dental braces, dentures, or retainers.
• People who do not keep their mouth clean or brush their teeth regularly.
• People who have sensitive skin.
• People who have conditions that affect the entire body (systemic conditions), such as immune disorders.

What are the signs or symptoms?

The main symptom of this condition is one or more oval-shaped or round ulcers that have red borders. Details about symptoms may vary depending on the cause.

• Location of the ulcers. They may be inside the mouth, on the gums, or on the insides of the lips or cheeks. They may also be on the lips or on skin that is near the mouth, such as the cheeks and chin.
• Pain. Ulcers can be painful and uncomfortable, or they can be painless.
• Appearance of the ulcers. They may look like red blisters and be filled with fluid, or they may be white or yellow patches.
• Frequency of outbreaks. Ulcers may go away permanently after one outbreak, or they may come back (recur) often or rarely.

How is this diagnosed?

This condition is diagnosed with a physical exam. Your health care provider may ask you questions about your lifestyle and your medical history. You may have tests, including:

• Blood tests.
• Removal of a small number of cells from an ulcer to be examined under a microscope (biopsy).

How is this treated?

This condition is treated by managing any pain and discomfort, and by treating the underlying cause of the ulcers, if necessary. Usually, oral ulcers resolve by themselves in 1–2 weeks. You may be told to keep your mouth clean and avoid things that cause or irritate your ulcers. Your health care provider may prescribe medicines to reduce pain and discomfort or treat the underlying cause, if this applies.

Follow these instructions at home:

Lifestyle

• Follow instructions from your health care provider about eating or drinking restrictions.
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Avoid foods and drinks that irritate your ulcers.
• Avoid tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Avoid excessive alcohol use.

Oral Hygiene

• Avoid physical or chemical irritants that may have caused the ulcers or made them worse, such as mouthwashes that contain alcohol (ethanol). If you wear dental braces, dentures, or retainers, work with your health care provider to make sure these devices are fitted correctly.
• Brush and floss your teeth at least once every day, and get regular dental cleanings and checkups.
• Gargle with a salt–water mixture 3–4 times per day or as told by your health care provider. To make a salt–water mixture, completely dissolve ½–1 tsp of salt in 1 cup of warm water.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you have pain, wrap a cold compress in a towel and gently press it against your face to help reduce pain.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that gets worse or does not get better with medicine.
• You have 4 or more ulcers at one time.
• You have a fever.
• You have new ulcers that look or feel different from other ulcers you have.
• You have inflammation in one eye or both eyes.
• You have ulcers that do not go away after 10 days.
• You develop new symptoms in your mouth, such as:
  • Bleeding or crusting around your lips or gums.
  • Tooth pain.
  • Difficulty swallowing.
• You develop symptoms on your skin or genitals, such as:
  • A rash or blisters.
  • Burning or itching sensations.
• Your ulcers begin or get worse after you start a new medicine.

Get help right away if:

• You have difficulty breathing.
• You have swelling in your face or neck.
• You have excessive bleeding from your mouth.
• You have severe pain.