Mouth Ulcers (Recurrent Aphthous Ulcers)

The cause of recurrent mouth ulcers cannot always be established. They appear in people who are healthy in every other way.

What brings them on

• Inflammation of the upper airway and the upper digestive tract
• Problems with the immune system
• Tobacco products and alcohol
• Allergies
• Eating very sour and spicy food, often or in quantity
• A lack of vitamins and minerals such as folic acid, B12, iron and zinc

What they look like

Mouth ulcers are small sores in the lining of the mouth. They are oval or round, hollow in the middle with a raised edge. The centre is dirty white, yellowish or white, and the area around it is redder.

They appear almost anywhere in the mouth: on the tongue, the gums, the cheek, the palate, the pharynx and around the tonsils.

They are usually harmless and short-lived, though they affect how comfortably the person lives while they last.

When they point to another disease

Some recurrent ulcers are linked to diseases in the body: Behçet’s disease, Reiter’s syndrome, recurrent erythema multiforme, coeliac disease, Crohn’s disease, ulcerative colitis, AIDS, and periodic fever with pharyngitis and adenitis, which is called PFAPA syndrome.

Treatment

If a specific cause or deficiency in the body is present, treating it plays an important part in clearing the ulcers. Removing the causes that weaken the immune system, such as broken sleep or psychological strain, helps.

Treatment otherwise rests on

• removing local causes: cutting down tobacco, alcohol, sour and spicy irritants, drinking enough fluid and keeping the mouth clean
• controlling the pain
• shortening how long the ulcer lasts
• speeding up healing
• keeping the area antiseptic, so that a second infection does not start

Painkillers applied to the ulcer as a cream or a solution usually bring relief.