You feel it coming on: A spot in your mouth starts to burn or tingle, and you know what’s about to happen. By tomorrow you’ll have a nagging sore cratered into the lining of your cheek. Aphthous ulcers afflict 20% of the population, recurring intermittently and often without a distinct pattern. After a week or two, the pain disappears and your mouth feels whole again.
Aphthous ulcers are sometimes confused with cold sores, but they’re only related by their discomfort and proximity to each other. Cold sores occur on the lips and surrounding skin as a result of the Herpes Simplex Virus. Aphthous ulcers don’t have such a clear cause. These lesions show up on movable tissue surfaces inside the mouth and may be difficult to pin to a single instigator. We understand that the body’s immune system sends inflammatory cells into an area and destroys its own tissue, but what triggers the assault?
Where Do They Come From?
Mouth sores may show up one at a time or in groups spread across multiple areas. Many patients feel frustrated by their inability to control these painful ulcers, but understanding possible causes may help you take steps to eliminate or reduce outbreaks. Here are a few triggers to consider:
- Stress. If we started a list of all the maladies stress creates in our bodies, we’d need to buy a ream of paper to finish it. Aphthous ulcers often erupt when we’re experiencing a high level of stress.
- Hormone Changes. Some women experience outbreaks before their period, while others are ulcer-free until after menopause.
- Vitamin and Mineral Deficiencies. Low levels of iron, vitamin B12, calcium, selenium, or folic acid are just a few nutrients linked to aphthous ulcers.
- Genetics. A lot of health conditions run in the genes, and mouth ulcers seem to be one to add to the list.
- Toothpaste. Most toothpastes contain a foaming agent called sodium lauryl sulfate (SLS). This ingredient is linked to mouth ulcers in some patients. Sensitivity to mint flavoring may also lead to a similar problem.
- Systemic Diseases. Crohn’s Disease, Coeliac Disease, Reactive Arthritis, and Behcet’s Disease are a few conditions that might also include mouth sores.
- Medications. Some people find that non-steroidal anti-inflammatory drugs, like ibuprofen, lead to mouth sores. Beta-blockers, used to treat high blood pressure and certain heart conditions, along with chemotherapy agents, are also culprits.
- Foods. When a sore shows up, consider certain foods in your diet in the previous 24 hours. Chocolate, coffee, spicy foods, peanuts, almonds, strawberries, cheese, and wheat flour are known initiators.
Most episodes of aphthous ulcers clear up and move on within a couple of weeks. If you have a sore that doesn’t resolve within a month, it’s time to see the team at Timothy Hess DDS. In these cases, a closer analysis of the area should be done.
While identifying a cause may lead to a lifestyle adjustment that eliminates sores, many patients end up enduring the discomfort until they heal. Here are a few tips to minimize the disruption:
- Be Gentle. Stay away from spicy or acidic foods during an outbreak. Use a soft toothbrush and consider an SLS-free toothpaste for awhile.
- Numb It. Grab a tube of a numbing or coating agent like Oragel, Kanka, or zilactin-B. Carry it in your pocket and apply as needed to cut the pain.
- Rinse. You might try mixing ¼ cup hydrogen peroxide, ¼ cup water, 1 tsp baking soda, and 1 tsp salt to create a rinse that disinfects and neutralizes sore spots. This mix is particularly useful if you’re suffering from multiple ulcers. Rincinol PRN is a commercial rinse available at many retailers that draws strong reviews from users.
- Try Tea. Some patients get relief by applying a damp tea bag to a mouth sore for a few minutes at a time. You may also find that sipping licorice tea helps.
- Bump B-12. A well-designed research project showed that patients taking 1000 mg of sublingual B-12 experienced a significant reduction in mouth ulcers and pain levels. Regardless of initial B12 blood levels, 74% of patients were ulcer-free after six months compared to 32% in the control group. Definitely worth considering!
- Chat With Us. If you’re dealing with mouth ulcers, talk to us the next time you’re in our office. We may be able to personalize our recommendations and offer other management suggestions.
At Timothy Hess DDS, we want to help you find answers to every question you have about your dental health. Aphthous ulcers frustrate many people, but sometimes just one tip contributes to reducing your pain. We look forward to discussing all your concerns at your next visit!