Mouth Ulcers: Causes, Symptoms, and Effective Treatment Options for Mouth Ulcer

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Superficial, soft tissue lesions inside your lips, gums, cheeks, and tongue are called mouth ulcers.

Mouth Ulcer

These are also known as ‘canker sores’ or ‘aphthous ulcers.’ 

Since the ulcers breach the inner lining of your mouth, exposing the nerve endings, these appear as painful oral lesions. 

Typically, canker sores appear round or oval and are crater-looking lesions of variable sizes that affect the pink mucosa and are easy to notice.  

Even though they last a few days, they can be so painful that it’s hard to eat anything except something as soft as a smoothie. 

These ulcers are not associated with any disease in the body but can appear repeatedly. Stress is one of the major causes of mouth sores out of so many causative factors.  

Whether you’re dealing with a pesky mouth ulcer or seeking preventative measures, this informative guide has got you covered.

What Are Mouth Ulcers?

1 out of every 10 people has canker sores; typically, 2 to 4 sores appear at a time.  Before a sore appears in your mouth, you’ll experience a burning sensation for a few hours. 

You’ll later notice the area swelling up a little, and you’ll be able to appreciate its red appearance. Soon, a whitish spot will appear on the pink gums, which will hurt. 

The pain disappears in a few days, and the soreness will take a week or two to disappear completely. 

A mouth ulcer is a white open wound with a well-defined margin that appears on the pinkish mucosa. It causes discomfort during speaking and eating and may also be uncomfortable at rest. 

You’ll notice a bright red or pinkish area around the sore margins circulating the white ulcer area. 

Sometimes, ulcers may also appear brown or yellow if caused by trauma from cheek bites or braces. 

  • Symptoms of mouth ulcers: 

One of the major symptoms of mouth ulcers is pain. 

Everyone perceives pain differently, but it can be considered somewhere between a mild and moderate threshold. 

Symptoms of mouth ulcers: 

When the superficial layer of your oral cavity peels off, it exposes the nerve endings, which causes pain. 

Initially, you’ll experience a tingling sensation only; however, a fully developed sore will express as burning pain. 

The pain may worsen with functions like speaking and eating. Foods like bread, citrus juices, and fruits can also exacerbate the symptoms. 

Rubbing the surface of the ulcer with a hard toothbrush will hurt more. 

  • Types of mouth ulcers:

Mouth ulcers can be classified as minor, major, or herpetiform. 

  1. Minor

Most common mouth ulcers are minor sores. These are small, usually 2-3mm in diameter, and occur inside cheeks, lips, and tongues. 

If you have these ulcers, you’ll recover within 2 weeks. People of all ages, from infants to adults, are prone to having them. 

Adults between the late 10s and early 20s are commonly affected. Healing is easy and prompt, as these ulcers heal without leaving a scar. 

Recurrent minor ulcers are alarming, and seek your attention to an underlying medical condition or hormonal imbalance.

In most cases, minor canker sores or mouth ulcers are just the body’s reaction to stress and are not something to worry about. 

  1. Major:

You have a major canker sore if you find an ulcer larger than a centimeter. These are less common than minor ulcers but are more painful. These take about four or more weeks to heal, and these cause more pain at the time of healing. 

These are larger and deeper and appear as shallow holes on the pink mucosal surface. They are also larger and round with rough, irregular borders. Upon healing, these ulcers leave a scar. 

  1. Herpetiform: 

If your ulcer looks like a pinhead and multiple appear together, you have an ulcer type called herpetiform. 

Less than 5% of ulcers are herpetiform, but these appear in clusters crowded next to each other. 10 to 100 of them will occur together anywhere in your mouth, causing pain. 

Unlike major and minor ulcers, herpetiform ulcers are associated with a viral infection. Usually, if you are suffering from herpes simplex 1 viral infection, you’ll see a typical presentation in your mouth. 

Don’t worry! It doesn’t mean you are suffering from herpes, but it’s just some of the viral strains managed to enter your blood through some physical contact or sharing of personal products.  

Common Causes of Mouth Ulcers

  • Stress and anxiety

“Stress doesn’t only make us feel awful emotionally. It can also exacerbate just about any health condition you can think of,” says Jay Winner, MD, author of Take the Stress Out of Your Life.

Stress and anxiety Ulcer

Stress causes several medical conditions, including mouth ulcers. Many times, flare-ups are seen in individuals living in a stressful environment. 

  • Hormonal changes

Some women experience mouth ulcers near and around their period dates. This is caused by changes in hormonal levels in the body. Changes in progesterone levels in the blood, particularly during menstrual cycles and irregular periods, lead to mouth ulcers.  

  • Food sensitivities

Acidic foods like lemonade and orange juices can significantly alter the pH levels in your mouth, giving rise to ulcers. Bacteria, commonly Helicobacter pylori, enter the blood through contaminated food. Avoiding oily, spicy, and fatty foods can help prevent ulcers. 

  • Nutritional deficiencies

A lack of vitamin B12, folic acid, and iron in your diet can lead to ulcers. A healthy, balanced diet can keep you safe from them. 

  • Braces 

Orthodontic braces and wires can cause repetitive irritation to your cheeks and gums. Continued trauma causes continued irritation, leading to ulcers in the mouth. 

  • Medications 

Certain medications, commonly called over-the-counter drugs, like aspirin, acetaminophen, and naproxen, contribute to ulcer formation. You may notice flare-ups if these medications are taken for pain relief during ulcers. 

Effective Treatment Options for Mouth Ulcers

  • Over-the-counter topical treatments

The topical treatments are very fascinating. These aren’t the typical analgesics, but the topical application of these medications numbs the oral mucous membranes where the ulcer is. It helps you eat and drink without letting the ulcer bother you. These topical gels are made with antiseptic, anti-inflammatory, and anesthetic properties, helping combat pain. 

  • Prescription medications

Several medications can be used to treat mouth ulcers. A major classification of drugs to treat the condition and to relieve the symptoms is as follows:

1) Antivirals: 

Mouth ulcers, like herpetiform, are caused by viruses. Antiviral medications like valacyclovir are taken orally. 

2) Antibiotics: 

When canker sores are recurrent and do not go away on their own, your general practitioner or dentist may prescribe antibiotics.


Antibiotics like doxycycline are mainly prescribed and are not available as over-the-counter medications. 

3) Anesthetic Agents:

Mouth ulcers may be really painful and can make eating and drinking difficult. Benzocaine is a common anesthetic agent used to numb the affected side to alleviate pain. 

4) Steroids: 

If the sores worsen and do not go away, your doctor may prescribe you steroids. Dexamethasone is a major one.

  • Home remedies and natural treatments

If you don’t feel like visiting your dentist or your appointment is scheduled too late, you may try a few remedies at home to alleviate pain and symptoms. Here are these: 

1) Saltwater rinses: 

Saltwater is long known to relieve inflammation. Dissolve 1 teaspoon of salt in a half cup of lukewarm water and rinse your mouth thrice daily. You’ll experience pain relief almost instantly. 

2) Baking soda rinse or paste: 

Baking soda or sodium bicarbonate is an antidote for an acidic oral environment. Mix 1 teaspoon of baking soda in half a cup of lukewarm water and rinse it to see a significant change in your oral condition. 

3) Essential oils:

Essential oils like tea tree oil and peppermint oil, when diluted with olive and coconut oil and applied to the sores, are noted to relieve symptoms. 

4) Honey:

Its antimicrobial and anti-inflammatory properties aid in healing both mouth ulcers and cold sores. 

5) Echinacea

It’s an herbal remedy that reduces inflammation and boosts the immune system. It is also known to reduce the recurrence of mouth ulcers and prevent flare-ups. 

6) Turmeric Powder: 

Turmeric has long been known as an anti-inflammatory product. Applying turmeric paste to ulcers can help combat pain.

When to Seek Professional Help for Mouth Ulcers

Mouth ulcers may be an indication of your underlying physical disease so you may take it seriously at times: 

  • Persistent or severe ulcers

If your mouth ulcers don’t go away within 2 weeks and persist longer, you may seek professional help. Your dentist or medical provider will conduct a thorough examination to find the root cause of ulcers.

  • Ulcers accompanied by fever

Mouth ulcers might accompany a raised body temperature. This indicates a sign of infection in your body. Your practitioner may carry out some medicines and will prescribe some medications to correct the cause.

  • Ulcers that interfere with daily activities

If ulcers are causing significant pain and discomfort and interfere with your daily speaking and eating, seek professional help. Persistent pain warrants immediate medical intervention.

Preventative Measures for Mouth Ulcers

  • Avoiding trigger foods

Certain foods trigger mouth ulcers. Mainly, food containing acids and spices irritates the soft lining of the tissues and starts a reaction in the body. It happens in certain susceptible individuals, which will also define the frequency and severity of the ulcers. If you’re such an individual, you must carefully choose your food.

  • Managing stress and anxiety

Stress is one of the main causes of mouth ulcers. It weakens the immune system, making it difficult to fight infections. 

Healing the existing ulcers becomes difficult in a stressful environment. Try adopting stress-reducing habits like deep breathing, meditation, yoga, and physical exercise. 

You may also seek help from a therapist who can advise you on a customized stress management plan. 

  • Maintaining a balanced diet

A balanced diet is crucial for oral health and overall well-being. Nutrient-rich foods that contain vitamin B12, folic acid, vitamin C, lean proteins, vegetables, and healthy fats can help prevent mouth ulcers. 

Diet Healthy

The essential vitamins and minerals, though needed in small quantities by the body, play a significant role in prevention. Also, drink at least 8 glasses of water daily as dehydration causes ulcers.

Are Cold Sores and Canker Sores The Same? 

Canker sores and cold sores are not the same things. A canker sore is a yellow or white ulcer on the inside of the lip or mouth, whereas a cold sore is an ulcer or pustule on the lip and around the mouth.

A cold sore is viral, while canker sores happen mainly due to nutritional deficiency or trauma.

A herpes simplex virus commonly causes a cold sore; it is inactive, so you can’t kill it with an antiviral. It stays in remission and, when activated, appears as a cold sore at the same location every time. Stress triggers the virus, and boom, the cold sire appears. 

Cold sores are contagious for about 10 days, while canker sores aren’t.

You may get canker sores when you consume refined foods like bread and grains.

You may also have canker sores when you have a leaky gut or diseases like celiac disease, where your body cannot absorb vitamins like B12 and folic acid to meet the nutritional demands of the body. 

Are Ulcers A Sign Of Mouth Cancer? 

In most cases, mouth ulcers are not a sign of cancer. Canker sores or aphthous ulcers are usually not cancerous and are caused by various causative factors. 

However, in a few cases, persistent, non-healing cancer may be of cancerous origin.

Seek medical attention if mouth ulcers persist for more than 2 weeks and are accompanied by other symptoms like fever. Your doctor will rule out other possible causes after a thorough examination or will ask you to get a biopsy done if suspecting cancer.

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