Do you also get frequent sores inside your mouth? Let's talk about mouth sores (Aphthous Ulcers)!

Do you sometimes get small sores inside your mouth, on your cheeks, or under your tongue that are so painful that you can't even eat? Many people have experienced this. We call these "mouth sores." There's nothing to worry about, this is a very common condition. So today, let's talk about this in a little more detail.

What exactly are Aphthous Ulcers?

Simply put, these are small, painful sores that develop inside our mouths – on the inside of our cheeks, inside our lips, at the base of our gums, on our tongue, or under our tongue. These can sometimes make it difficult to eat, drink, or even brush our teeth. Imagine how frustrating it would be to try your favorite food and not be able to enjoy it properly because of a sore in your mouth.

These lesions are usually circular in shape. The center is covered with a whitish-yellow color, and there is a clearly visible red ring around it. It looks like a small crater.

Mouth sores and fever blisters are two different things, right?

Yes, this is something that many people get confused about. Aphthous Ulcers and Cold Sores are two different things.

• Aphthous Ulcers: These form inside the mouth. Most importantly, they are not contagious . This means that you cannot spread these sores to anyone else.
• Cold Sores: These usually occur outside the mouth, around the lips, on the cheeks, on the chin, and sometimes inside the nostrils. They are caused by a virus . Also, cold sores are contagious .

So it's better not to confuse the two, right?

How do you recognize this mouth ulcer? (Symptoms)

Before a mouth ulcer develops, you may sometimes feel a slight tingling or burning sensation in the area. Then the ulcer appears. The main symptoms are:

• Appearance: Round, flat lesions. White or yellow in the center, red around the edges.
• Size: Most often these are small, about 6 millimeters (about an inch). However, sometimes larger, deeper lesions can develop.
• Number: Usually a single lesion occurs, but sometimes several lesions may appear in the same area in small clusters.
• Pain: There is pain associated with the wound. This pain can sometimes make it difficult to eat or even talk.

How long will it take for these wounds to heal?

Most of the time, these mouth ulcers heal on their own within about two weeks . However, the pain is most intense for the first 3-4 days. After that, the pain gradually subsides and the ulcer heals.

Important: Usually, these small wounds do not leave scars after they heal. However, if the wound is very large and deep, a small scar may sometimes remain.

Why do we get these mouth sores? (Causes)

It's hard to pinpoint a single reason for this. There could be many factors at play. Some of the main reasons are:

• Minor injuries inside the mouth:
• Injuries caused by mistake while brushing teeth.
• Inadvertently biting your cheek or tongue while eating.
• Injuries to the gums of people with braces.
• After some dental treatment.
• Some types of food:
• Acidic fruits like lemons, oranges, and pineapples.
• Spicy, salty foods like sausages and chips.
• Some people dislike things like chocolate, coffee, peanuts, and strawberries.
• Nutritional deficiencies:
• When nutrients like vitamin B12, zinc, folate (vitamin B9), and iron are lacking in the body.
• Stress: Don't be surprised, excessive stress can also be a cause of this.
• Hormonal changes: These lesions can develop especially in women during their menstrual cycle.
• Toothpaste and mouthwash: Some people are sensitive to the chemical Sodium Lauryl Sulfate (SLS), which is found in some toothpastes and mouthwashes, and can cause sores.
• Allergies to bacteria in the mouth.
• Some medical conditions:
• Celiac disease (gluten allergy).
• Inflammatory Bowel Diseases (IBDs) such as Crohn's disease or Ulcerative colitis.
• Behcet's disease.
• Weakened immune system (e.g. HIV/AIDS).
• Genetics: Some people may also see other family members develop mouth ulcers frequently.

Are there types of mouth sores?

Yes, there are three main types:

1. Minor aphthous ulcers: This is the most common type . They are usually small (less than 1 cm) and heal without scarring within a week or two.

2. Major aphthous ulcers: These are larger and deeper . They can take weeks or months to heal, and sometimes leave scars. They are very painful.

3. Herpetiform aphthous ulcers: These are very rare . Although the name sounds like herpes, they are not related to the herpes virus. What happens in this is that very small (1-2 mm) ulcers (about 10 to 100) form in clusters. These also heal in a week or two.

What can be done for this at home? (Home Treatment)

When you get a mouth ulcer, there are a few simple things you can do at home to help reduce pain and help it heal faster:

• Gargle with salt water: Dissolve about a teaspoon of salt in a glass of lukewarm water and rinse your mouth with that water several times a day. This will help clean the wound and reduce pain.
• Baking soda paste: Mix some baking soda with a little water to make a paste and apply it to the wound.
• Honey: It's also good to rub a little honey on the wound. Honey has natural healing properties.
• Avoid foods and drinks that aggravate the wound: Limit spicy, sour, and coarse foods (e.g., toast, chips) on days when the wound is sore.
• Medications available at the pharmacy: Pain-relieving topical anesthetic gels or medicated mouthwashes can be purchased at the pharmacy without a prescription. However, talk to your pharmacist to choose the right one.
• Ice cube: Placing a small ice cube on the wound can help reduce pain and swelling.
• Use a soft toothbrush: When brushing your teeth during the sore period, brush slowly and carefully.

When should we see a doctor?

Although these mouth sores usually heal on their own, there are some cases where it is important to see a doctor. These include:

• If the wound is unusually large.
• If you have frequent sores: This means that new sores appear before old ones heal, or if they occur several times a month.
• If the wound has not healed for more than two to three weeks.
• If you have severe pain that cannot be controlled with home treatments.
• If food and drink are too hard to swallow.
• If you have a fever along with mouth sores.
• If the sores appear to have spread to the outside of the lips (as this could also be a fever blister).

If you have these symptoms, it's best to see a doctor for advice rather than self-medicate, as sometimes these can be symptoms of another medical condition.

What kind of treatment can a doctor provide?

When you see a doctor, they will examine your wound, ask more questions if necessary, and try to find the cause. Treatment may include:

• Medicated mouthwashes: Mouthwashes that have antiseptic properties or contain corticosteroids to reduce pain and inflammation.
• Topical medications: Pastes, creams, or gels containing corticosteroids can be applied directly to the wound.
• Oral medications: If the condition is severe or occurs frequently, medications such as oral corticosteroids may be given for a short period of time. In some rare cases, immunosuppressant medications may also be given.
• Nutritional supplements: If you suspect a nutritional deficiency, you may be advised to take appropriate vitamin or mineral supplements.
• Cauterization: This involves “burning” the surface of the wound using a chemical or device. This can provide quick relief from pain, but it is not used as often anymore.

Can these mouth ulcers be prevented from recurring? (Prevention)

Although it is not possible to completely stop mouth ulcers, you can reduce the frequency of mouth ulcers by following some things:

• Maintain good oral hygiene: Brush your teeth gently twice a day with a soft toothbrush. Floss.
• Identify and avoid foods that irritate you: If you find that certain foods cause you to get sores, reduce them as much as possible.
• Eat a balanced diet: Include fruits, vegetables, and herbs that are rich in vitamins and minerals (especially B vitamins, iron, and zinc).
• Manage stress: Relax your mind through things like yoga, meditation, and exercise.
• Use SLS-free toothpaste: If you feel uncomfortable with SLS, choose SLS-free toothpaste.
• Be careful when eating: Eating slowly and talking while eating can reduce the chance of your cheeks getting chapped.
• Do not put anything with sharp edges in your mouth.

Final Take-Home Message

So, mouth ulcers (Aphthous Ulcers) are very common and very annoying. But remember:

• These do not breed .
• Most of the time it heals on its own .
• Simple treatments that can be done at home can reduce the pain .
• However, if the sores are very large, occur frequently, do not heal for a long time, or are accompanied by other symptoms such as fever, you should definitely see a doctor.

I hope this information is helpful to you. If you have a similar problem, don't be afraid to talk to a doctor!