Oral mucosal ulcer
Unlike a scratch or erosion, an oral mucosal ulcer affects both the superficial layer and deeper structures. The healing process for such a wound takes longer, requires a particularly careful approach, and often requires medical attention.
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When treatment is needed
In some cases, a mouth ulcer will resolve on its own within a few days, but sometimes medical intervention is necessary. The main rule is to closely monitor your symptoms.
What symptoms are considered typical?
Oral ulcers are characterized by:
- Pain – the pain can be constant, sharp, and intensifies with pressure and eating.
- Burning sensation when in contact with food.
- Tissue redness.
- Swelling.
- White or yellowish coating on the surface of the ulcer.
What signs require urgent medical attention?
You should schedule an examination if you experience the following signs:
- The ulcer does not heal within 10-14 days
- The pain is getting worse
- The ulcer interferes with speaking or eating
- There is significant swelling of the oral tissues
- The body temperature rises above 37.5 degrees Celsius
- The ulcer is bleeding and hardening
- Bad breath develops
- Multiple ulcers form in the oral cavity
Causes
Defects in the mucous membranes can develop due to a number of internal and external factors.
Traumatic causes
This is the most likely cause of the wounds. Injuries to the mucous membranes can be of various types:
- Acute – accidental biting of the cheek, injury from cutlery or hard food
- Chronic – when there is constant friction of the mucous membrane, for example, against the sharp surface of a damaged tooth, due to a malocclusion, wearing braces, or getting used to dentures
A characteristic feature of a traumatic defect is its location. An oral ulcer will be located near the source of the injury.
Aphthous and inflammatory processes
The main cause of recurrent ulcers is inflammation. Aphthous stomatitis is characterized by the sudden appearance of affected areas with plaque and a hyperemic border – aphthae. They can be a consequence of hormonal imbalances or chronic stress.
Infectious causes
Infections can manifest as erosions and ulcers on the oral mucosa. Such lesions are caused by the herpes virus and candidiasis; less commonly, they are caused by a bacterial infection, such as Vincent's ulcerative necrotizing gingivostomatitis, which causes ulcers to form on the gums.
Common diseases and deficiency conditions
Among other things, mouth ulcers can be caused by:
- Gastrointestinal pathologies
- Autoimmune conditions
- Immunodeficiencies
- Micronutrient deficiencies, in particular, B vitamins and iron
In deficiency conditions or somatic pathologies, ulcers on the oral mucosa will not be the only symptoms.
When examining a patient, doctors consider the location of the damaged area, its size, shape, color, the presence of plaque, swelling, redness of surrounding tissue, and the nature of the pain to determine the appropriate course of action.
Table 1. Differences between different types of mucosal lesions
| Nature of the lesion | Visual features | Medical care measures |
|---|---|---|
| Traumatic ulcer | Painful, solitary | Eliminate the source of injury, administer local treatment for the mouth ulcer |
| Aphtha | Small, round, with a light coating | Conduct symptomatic treatment to eliminate local inflammation of the oral mucosa. |
| Infectious lesion | Characterized by swelling of surrounding tissues and redness of the mucous membranes. | Conduct therapy depending on the identified cause of the mouth ulcer. |
| Non-healing mouth ulcer | Increasing in size, causing discomfort and pain, and not healing for a long time. | Consult a doctor for a more detailed diagnosis. |
Location: cheek, gums, palate, under Tongue
The location of the ulcer directly affects the patient's condition:
- Ulcers on the cheeks are often painful, but heal faster than others
- Ulcers on the palate can cause difficulty swallowing
- Ulcers on the gums bleed when brushing teeth, which slows the healing process
- Ulcers under the tongue are accompanied by pain when talking
How is an ulcer different from an erosion or wound
Different lesions of the oral mucosa require different approaches.
Table 2. Comparative characteristics of ulcers, erosions, and wounds
| Type of oral mucosal lesion | Depth of tissue damage | External features | Duration of healing period |
|---|---|---|---|
| Mouth wound (abrasions) | Does not extend beyond the superficial layer | Reddish surface without specific plaque and clear boundaries | 2-4 days |
| Erosion | Penetrates the epithelium | Weeping surface with redness | 5-7 days |
| Ulcer | Affects underlying layers | Rounded, dense, with a red border and white or yellow coating | Depending on the volume of affected tissue |
General information
Diagnosis
Mouth ulcer symptoms are often nonspecific, so self-diagnosis can lead to the wrong treatment, wasted time, and complications.
Examination and collection of complaints
During the examination, the doctor will clarify:
- When did the ulcer appear?
- Does it hurt?
- Have there been similar episodes before?
- Was there a traumatic factor?
- Have any associated diseases been diagnosed?
Additional tests
In most cases, an examination is sufficient for diagnosis and treatment of a mouth ulcer. Additionally, the following may be performed:
- A smear or scraping from the ulcer surface to rule out infection.
- A complete blood count to detect inflammatory changes.
- A biopsy for histological examination.
When a consultation with related specialists may be needed.
The dentist may refer the patient to a related specialist for a comprehensive treatment approach. A consultation with a gastroenterologist, hematologist, allergist, or infectious disease specialist may be necessary.
You can prevent canker sores by following these preventative measures:
- Brush your teeth regularly and properly
- Treat cavities promptly and replace poor-quality fillings
- Correct your bite
- Use orthodontic wax when wearing braces
- Eat a balanced diet, ensuring adequate vitamins and minerals
- Give up the habit of chewing pens and pencils
- Manage your stress levels
- Treat chronic diseases promptly
- Get regular preventative dental checkups
FAQ
What should you do if a mouth ulcer recurrs?
How can you help yourself before your doctor's appointment?
Which specialist can make an accurate diagnosis? If you notice painful sores in your mouth, you should make an appointment with a dentist.
Are antibiotics necessary?
Any medications—antibiotics, painkillers, antiviral, antifungal, hormonal, or immunomodulatory agents—should only be prescribed by a specialist after the exact cause of the mouth ulcer has been determined. Self-medication may temporarily alleviate symptoms but not eliminate the underlying cause. This is dangerous because the underlying condition may continue to progress cryptically, and the opportunity for timely diagnosis will be lost.
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What is an oral ulcer?
A canker sore is a painful growth that can appear anywhere in the mouth. These lesions are typically small, but can grow larger and become uncomfortable.