Mouth Ulcers
EDP column by Dr Ketan Dhatariya

“My little girl has recently developed a few small, painful mouth ulcers. What causes these? ”

Mouth ulcers are a breach or break in the ‘mucous membrane’ or lining of the inside of the mouth. They often look like small depressions in the mucous membrane and are usually yellow or white colour. They may vary in size from a millimetre or less in diameter to several centimetres. They are often painful.

There are two common causes of ulcers, those caused by trauma – such as biting your cheek when eating, or those which seem to appear out of nowhere. These are known as aphthous ulcers.

Most people probably get aphthous mouth ulcers at some time in their life. Usually the first attack occurs in adolescence or young adulthood. These ulcers are usually small (less than 5 mm in diameter) and can be very painful. There may be just one or two at a time, or there may be very numerous ulcers in the mouth. People with this condition usually feel fairly well apart from the pain in their mouth. The ulcers usually heal in 1 to 2 weeks but they tend to recur at intervals over the course of many years. In some cases recurrences can be so frequent that mouth ulcers may be constantly present for prolonged periods.

Other causes of mouth ulcers include viral infections, abnormalities of the blood, and adverse reactions to medications. Certain skin conditions in which rashes or ulcers may occur on other parts of the body can also affect the mouth. People who suffer from intestinal conditions such as ulcerative colitis or Crohn's disease may also get mouth ulcers. Mouth cancer may also first come to light with ulceration.

Treatment of aphthous mouth ulcers is usually symptomatic using warm mouth washes or antiseptic ointments. Avoidance of salty or spicy food and acidic soft drinks help. Sometimes topical local anaesthetics may help but these are often only temporary. In young children it may be easier to give paracetamol. The other causes of mouth ulcers are best treated by treating the underlying condition.

If the mouth ulcers last for more than 2 or 3 weeks, then it may be best to see your doctor to make sure that there is nothing else responsible for the mouth ulcers.

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