Note: This article is for general information purposes and does not replace individual dental advice.
Mouth ulcers (aphthous ulcers) are small, painful changes in the lining of the mouth that almost everyone knows. They appear as whitish-yellow, flat defects in the mucous membrane with a red border and can be very unpleasant when eating, drinking and speaking. Although mouth ulcers are harmless in most cases and heal on their own, they can considerably affect quality of life.
What are mouth ulcers?
Mouth ulcers (also called aphthous ulcers or aphthae) are superficial ulcers of the oral mucosa. They can occur on the inside of the lips, on the tongue, on the gums, on the palate or on the inside of the cheeks. The small sores are not contagious and should not be confused with cold sores (herpes), which typically appear on the outside of the lips.
A distinction is made between three forms:
- Minor aphthous ulcers: The most common form (around 85% of cases). They are smaller than 1 cm and heal within 1 to 2 weeks without scarring
- Major aphthous ulcers: Larger than 1 cm, deeper and more painful. Healing can take several weeks and may leave scars
- Herpetiform aphthous ulcers: Very small but numerous ulcers that can merge into larger areas
Causes of mouth ulcers
The exact cause of mouth ulcers has not been conclusively established. Various factors can make them more likely to occur:
- Minor injuries: Biting the inside of the cheek, scratches from hard foods or a toothbrush that is too hard
- Stress and psychological strain: A weakened immune system makes mouth ulcers more likely
- Nutrient deficiency: In particular a lack of iron, zinc, folic acid or vitamin B12
- Food intolerances: Certain foods such as nuts, citrus fruits, tomatoes or hot spices can trigger mouth ulcers
- Hormonal changes: Some women notice that ulcers occur more frequently during menstruation
- Sodium lauryl sulfate (SLS): This ingredient in many toothpastes can promote mouth ulcers in sensitive people
- Illnesses: In rare cases, chronically recurring mouth ulcers can be an accompanying symptom of underlying conditions such as Crohn's disease, coeliac disease or immune disorders
Treating mouth ulcers – what helps?
Home remedies for mouth ulcers
- Salt water rinse: Dissolve half a teaspoon of salt in a glass of lukewarm water and rinse your mouth with it several times a day. This can ease the discomfort
- Camomile tea: Use cooled camomile tea as a mouth rinse – camomile has an anti-inflammatory and soothing effect
- Sage tea: Sage has antibacterial properties and can bring relief as a rinse or dabbed directly onto the ulcer
- Honey: Apply honey to the ulcer – it can have a soothing effect
- Ice cubes: Hold briefly against the affected area to numb the pain temporarily
Medical treatment
- Pain-relieving gels: Numbing gels containing lidocaine can be applied directly to the ulcer and ease the pain when eating
- Antiseptic mouthwashes: Rinses containing chlorhexidine can speed up healing and prevent a bacterial superinfection
- Corticosteroid pastes: For larger or very painful ulcers, a prescribed adhesive paste containing a corticosteroid can reduce the inflammation
- Dabbing with myrrh tincture: Myrrh has disinfecting and astringent properties
What should you avoid with mouth ulcers?
- Hot, sour or very salty foods and drinks
- Hard foods (crisps, bread crusts) that further irritate the mucous membrane
- Toothpastes containing sodium lauryl sulfate (SLS) – try an SLS-free alternative
- Alcohol and tobacco, which delay healing
- Pressing or scratching at the ulcer
When should you see a dentist?
In most cases, mouth ulcers heal on their own within one to two weeks. However, you should see a dentist if:
- The ulcer has not healed after two weeks
- The ulcers are very large (over 1 cm) or particularly painful
- Mouth ulcers keep coming back (more than 3 to 4 times a year)
- Fever or a general feeling of being unwell develops as well
- The ulcers spread to other areas of the mouth or the throat
- You have difficulty eating or drinking
At our dental practice in Düsseldorf, we examine recurring or unusual mouth ulcers thoroughly and rule out possible underlying conditions. If necessary, we can treat larger ulcers with medication or arrange further diagnostic tests.
Preventing mouth ulcers
- Eat a balanced diet with sufficient vitamins and minerals
- Reduce stress – relaxation techniques can help
- Use a soft toothbrush and be gentle with the mucous membrane when brushing your teeth
- Try an SLS-free toothpaste if mouth ulcers occur frequently
- Keep a food diary to identify possible triggers
This article is for general information purposes and does not replace professional dental advice. If you have symptoms, please contact your dentist.
