Do you get mouth ulcers? My guess is that everybody gets them from time to time. This condition is also known as an apthous ulcer or, in American English, a canker sore. A mouth ulcer is an open sore inside the mouth, or rarely a break in the mucous membrane or the epithelium on the lips or surrounding the mouth.
They can be small round and painful sores in the mouth which can really interfere with eating and brushing your teeth. These small annoying little sores can have a red appearance with a whitish center. Two common types are ulcers affecting the mouth (apthous ulcers or canker sores) and cold sores (fever blisters, oral herpes). Cold sores however around the lip are caused by viruses, and not by trauma or a nutritional deficiency.
When you have one of these ulcers, certain foods can really trigger pain, like chili or pepper. I have found that mouth ulcers can come in crops of up to four or five which last anywhere from a few days to a week in general. Some people experience them frequently such as weekly and others may just get the occasional ulcer only yearly.
There are many causes, and one of the biggest causes is stress and when you are feeling run down or stressed you are more likely to experience an oral ulcer. Some people may experience an increase after stopping smoking or changing their diet significantly, and making these lifestyle changes can be a significant stress for many.
Trauma to mouth
The second biggest reason is accidental damage to your tongue, gums or cheek lining. For example, biting the tongue or cheek lining by mistake, eating foods that are too hot, a sharp broken tooth, or wearing badly-fitting dentures can all be causative factors.
In terms of diet and nutrition, there are several reasons, particularly if recurring ulcers are a problem. Some people may be anemic (lack of sufficient iron, folate or vitamin B12). Zinc deficiency is possibly one of the biggest causes nutritionally, and zinc and Vitamin C lozenges are worth trying for any case, especially if there are no dental issues. I have found some patients with recurring ulcers to have food hypersensitivities or food allergies, and this is another area worth exploring.
Several studies have found a relationship between food allergies and mouth ulcers. Some of the top offending foods were found to be gluten (implicated in almost 25% of cases, twenty patients who had suffered from recurrent aphthous ulcers for a mean duration of 11.2 years followed a gluten-free diet. A complete remission of ulcers occurred in five patients (25%), and each of these five patients had a recurrence of ulcers after gluten challenge. I have found that other potential food triggers include citrus fruits, avocado, certain spices and food additives, flavoring agents and some artificial colours.
Some women I have seen in my clinic find that their ulcers are more likely to occur before their period, and hormones such as progesterone or estrogen might perhaps have a strong influence here. Additionally, a decrease in the stress hormone cortisol may well be implicated, as cortisol is one of the body’s most important anti-inflammatory hormones produced by the adrenal gland under stressful situations. After continued stress, cortisol becomes depleted which may leave the person more vulnerable to inflammatory conditions such as mouth ulcers.
Another reason you may develop a mouth ulcer is because you have an underlying medical condition like celiac disease (gluten intolerance) or inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. And if you do have an underlying medical condition for which you are taking a pharmaceutical drug, this may even be the cause. Some pharmaceutical drugs cause a burning in the mouth or digestive tract, especially if taken incorrectly, so see your doctor if you take a drug and suspect this to be a cause. These kinds of causes of mouth ulceration are more rare, but if your ulcer won’t go away you should see your health care professional.
Some older patients I have seen over time had mouth ulcers which turned out to be pre-cancerous or even cancerous, and I have found this more commonly in those who smoked tobacco and/or drank alcohol for many years. I always tell patients that if the ulcer won’t go away then you should not ignore it, and to see your doctor if you have an ulcer that doesn’t heal within 3 or 4 weeks. Just because it doesn’t hurt, it doesn’t mean it is alright, a cancerous ulcer is often painless but nevertheless quite destructive and can even be life threatening if left unattended.
PREVENTION and TREATMENT
It is important to practice good dental hygiene, brushing your teeth after meals and taking care particular not to damage your teeth and gums. Do visit your dentist at least annually for a check-up. If you have any chipped or damaged teeth or dental fillings missing or damaged then have it attended to by your dentist as this is a prime cause of recurring mouth ulcers.
Be sure to eat a healthy and varied diet, including plenty of fresh fruits and vegetables, whole grained foods, lean dairy products, fish and lean red meat. Such a healthy diet will supply your body with ample vitamins and minerals to maintain a powerful immune defense that can resist infections.
Avoid eating and drinking foods and beverages which are too hot. Have you noticed how your tongue hurt bad once after you drank a hot drink or had some food straight from the stove top without letting it cool sufficiently? This heat can damage the delicate oral mucosa, causing trauma to the skin and making it much more prone to an infection, as you mouth is very high in bacteria. Watch you stress levels, and a relaxation program can be of benefit to those who suffer from stress and recurring ulcers. Remember, low cortisol levels which are caused by a general depletion of the adrenal (stress) glands can be a cause as well.
- Propolis from the beehive. If you can get hold of this, I can highly recommend that you try propolis first, before using other natural remedies. Try a drop of propolis tincture (undiluted) straight onto the ulcerated area a few times daily. Yes, it will cause a smarting sensation for a second or two but then feel a lot better. If you can’t get propolis, try a mixture of the herbal medicines Calendula and St. John’s wort. You can sometimes get herbal tinctures in a lower alcohol percentage (25%) which will mean less stinging when applied to the oral mucosal areas.
- Get some chamomile tea. I have found that a strong cup of chamomile tea can work wonders. Allow it to cool until room temperature, then swill it around the mouth before swallowing it. Do this a few times daily before meals.
- There are other popular natural medicines I recommend in liquid form include the herbal medicines echinacea, myrrh, and licorice.
- Grapefruit seed extract. According to L. Tenney from Utah the use of grapefruit seed extract (diluted in water and used as a mouth rinse) is excellent for the treatment of mouth ulcers.
- Vitamin B 12 is worth taking for a few weeks if your ulcers keep coming back and yet your dental health is fine. A study found that those who suffer recurring ulcers gained benefit from taking B12, even in those whose blood levels of vitamin B 12 was normal. Patients with recurrent oral ulcerations have more frequently iron, folic acid and vitamin B12 deficiencies than those with other diseases of the mouth.
- Take a B-complex vitamin, especially one containing folic acid and the vitamins B1, B2, B6, and B12.
- Look for a sodium lauryl sulphate (SLS) free toothpaste. A study in 1999 showed that those who used a SLS free toothpaste had less than half the recurring mouth ulcers than those who didn’t.
If the mouth ulcers are multiple or the pain is quite significant then try brushing your teeth with your tooth brush dipped in a little sea salt to which you have applied one drop of pure tea tree oil. A great tip which works well.
While you are waiting for the mouth ulcer to heal, it is nice to be able to reduce the painful sensations felt which can ruin your ability to enjoy your meal. Patients have asked me on various occasions in the clinic what I would recommend for the smarting, stinging or burning sensation felt from having mouth ulcers, so here are a few suggestions:
– It is best if you try to avoid hot, spicy, very salty or sour foods in particular until the ulcer has healed. These foods will only aggravate the ulcer and delay the healing response.
– Before eating, rinse your mouth with very cold water which is very effective in reducing the pain making eating a more comfortable experience.
– After you eat, rinse your mouth with water and spit it out. The dissolve a quarter of a teaspoon of Himalayan salt in water and swirl it round your mouth before spitting it out.
– If you case of mouth ulceration is particularly severe or ongoing for medical reasons, you can buy a mouth ulcer liquid rinse or gel from your chemist (drug store). Many people find an anaesthetic mouth rinse easier to use than the gel, especially if they have several ulcers at the same time. The rinse offers immediate pain relief and in addition forms a protective barrier over the ulcer as well to relieve the pain.
See your dentist
I have a good friend who is a dentist who has mentioned on more than one occasion how amazing it is that so many people have not only teeth problems when they see him for a regular checkup, but also present unknowingly with mouth ulcers. Your dentist is an expert with regard to all types of mouth problems, so seeing your dentist if you have recurring ulcers is sound advice. One of the prime causes of mouths ulcers that recur is a broken or chipped tooth, or mouth braces or dentures which fit poorly.
You can conquer those annoying mouth ulcers, and it does make sense to establish the cause as a matter of priority, and then cure this rather annoying condition with natural medicine instead of pharmaceutical drugs.