Mouth ulcer

A mouth ulcer or canker sore is a painful open sore inside the mouth caused by a break in the mucous membrane. The condition is also called aphthous stomatitis or aphthous ulcer, especially if there are multiple or recurring sores.

Image:Canker sore.jpg

Symptoms

Mouth ulcers often begin with a tingling or burning sensation at the site of the future sore. In a few days they often progress to form a red spot or bump, followed by an open ulcer.

The mouth ulcer appears as a white or yellow oval with an inflamed red border and is on average about 3 mm across, but can be up to 1 cm across and occasionally larger. Sometimes a white circle or halo around the lesion can be observed. The grey, white, or yellow coloured area within the red boundary is due to the formation of layers of fibrin, a protein involved in the clotting of blood. The ulcer, which itself is often extremely painful when agitated, may be accompanied by a painful swelling of the lymph nodesbelow the jaw, which can be mistaken for toothache.

Mouth ulcers may last anywhere from 1 to 4 weeks, and can cause intense local pain throughout the healing process.

Causes

The exact cause of mouth ulcers is unknown, but factors that appear to provoke them include stress, fatigue, illness, injury from accidental biting, hormonalchanges, menstruation, food allergiesand deficiencies in vitamin B12, ironand folic acid.

In 1982 a previously unknown bacterium, Helicobacter pylori, was discovered to be the cause of stomach ulcers. It is hypothesized that bacteria are at work in mouth ulcers, though the specific organism has not been isolated.

Dental bracescan be a cause of mouth ulcers because the wires and hooks could break the mucous membrane inside the mouth. Dental wax can prevent and help heal the ulcers.

Consumption of particular foods, such as chocolatemay also trigger mouth ulcers in some. A common cause of ulcers is gluten intolerance, in which case consumption of wheat, rye or barley can result in chronic mouth ulcers. If gluten intolerance is the cause, prevention means taking most breads, pastas, cakes, pies, cookies, scones, biscuits, beers etc. out of the diet and substituting gluten-free varieties where available. Artificial sugars, such as those found in diet cola and sugarless gum have been reported as causes of mouth ulcers as well.

Other disorders can cause mouth ulcers, including oral thrush, leukoplakia, gingivostomatitisand oral lichen planus. Mouth ulcers are also associated with ulcerative colitis, Crohn's disease, coeliac disease(gluten sensitivity), bullous pemphigoid, and Behçet's disease. Chemotherapyis a common cause of mouth ulcers. The treatment depends on the cause.

A common urban mythis that mouth ulcers are directly connected to the onset of the herpes simplex virus, but in reality ulcers associated with herpes (or cold sores) are of an entirely different nature from mouth ulcers.

Unlike cold sores, mouth ulcers are not contagious.

Home Treatment

Mouth ulcers normally heal without treatment within seven to ten days. The best start is to make sure you have good oral hygiene and avoid spicy/acidic/salty foods and drinks as they may irritate existing ulcers. In addition, one can treat the pain with several pain-relieving gels like Anbesol, Bonjela, Campho-Phenique, Orabase B, or Kanka, available in drugstores. Some people claim that such gels also accelerate the healing of their sores.

Use of a hydrogen peroxideantiseptic mouthwash can help to clean debris and bacteria that can accumulate in an ulcer, thus reducing complications associated with its presence. This treatment is widely available at pharmacies from companies such as Colgate, whose product is called Peroxyl.

Other home remediesvary in efficacy. Certain techniques heal sores for some people, but there are no treatments with widespread medical support. Most seem to be based on an antiseptic (mild antibiotic), an antacid, or both. Antiseptic techniques suggested include the following:

• Gently clean the sores by roughening with a toothbrush and when clean, apply antiseptic
• Swab the sores with sea-buckthornfruit oil or hydrogen peroxide
• Rinse the mouth with an antiseptic mouthwash(e.g. Listerine). This can relieve pain for a few hours.
• Pouring saltdirectly on the ulcer can prove effective, however this can be extremely painful and can scar. Avoiding pressure on the ulcer after applying the salt minimizes the pain.
• Apply glyoxide directly to the sores and swish around mouth
• Rinse the mouth with salt water—1 teaspoon of salt dissolved in 1 cup (250 ml) of warm water (aka. a salinesolution)
• Take Lysine-Lsupplements
• Rinse mouth and especially the affected area with sage tea 3 times a day. The improvement can be seen as early as within 24 hours.
• Paint half-strength gentian violetsolution on sore.^[1]
• Gargle a mouthful of warm vinegar with half tablespoon of salt for about 30 secs, 3 times a day. Extremely painful but healing can be seen in about 2 days.

Antacid techniques suggested include the following:

• Swab the sores with milk of magnesia
• Apply powdered alumdirectly to the sores—available in the spice aisle at your grocery store
• Make a paste of baking sodaand water—apply directly to the sores
• Make a paste of crushed Tums (antacid) and water—apply directly to the sores
• Rinse the mouth with a baking soda-Water mix—1 teaspoon of baking soda dissolved in 1 cup (250 ml) of warm water
• Avoid acidic foods such as tomato, citrus, and soft drinks

Combination therapies tell you to use the antiseptic first, and then the antacid, i.e., swab sores with hydrogen peroxide and then swab them with milk of magnesia.

A good temporary remedy for the pain of the canker sore is to numb the affected area with ice. Although this may cause intense pain in the beginning, it is highly effective and lasts for about half an hour, depending on the number of ice cubes used and the time spent using said ice cubes.

Treatment for severe cases

Treatments based on antibioticsand steroidslike Dexamethasone Elixir are reserved for severe cases, and should be used only under medical supervision. Tetracyclinesuspension is a common antibiotic prescribed for mouth ulcers. Some doctors may also prescribe a local anesthetic, such as lidocaine, for cases of multiple or severe sores. If the ulcer does not heal within a week, a doctor or dentist may cauterizeit using a silver nitrateapplicator or laser. This procedure immediately burns off the sore, causing it to completely disappear within a few hours or two to three days.

Some dentistsrecommend a sulphuric acidsolution for treating mouth ulcers, such as debacterol.

The miracle cures that are advertised should be viewed with scepticism. However, aqueous sulphuric acid products as listed above can provide significant pain relief, if not treating the underlying causes.

Prevention

In some cases, switching toothpastes can prevent mouth ulcers from occurring, with some being able to reduce the occurrence of ulcers by approximately 80%. Sodium dodecyl sulfate(sometimes called sodium lauryl sulfate or simply SLS), a detergent found in most toothpastes, is thought to increase the incidence of mouth ulcers. Using toothpaste free of this compound has been found to help many people by reducing the amount and size of ulcers and in some cases, completely stopping them. A few individuals have noticed that switching to a toothpaste with Baking Soda prevented reoccurance of mouth ulcers.

Many people have found that taking Lysine-Lsupplements can help to reduce the frequency of mouth ulcer appearances. Additionally, zincdeficiency has been observed in people with recurrent mouth ulcers, and zinc supplementation decreased recurrence of the mouth ulcers [2].

Some people have reported that the frequency of mouth ulcer occurrences decreased greatly after a particularly large amalgam tooth filling was replaced by some other kind of dental restoration. However, the connection between amalgam fillings and mouth ulcers is not universally accepted, and such replacement can be costly.

External links

• MayoClinic.com: Canker sore
• MedlinePlus Encyclopedia: Canker sores
• Management of Aphthous Ulcers, American Family Physiciande:Aphthe

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This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Mouth+ulcer Wikipedia article Mouth ulcer.