Q. I have a tendency to develop mouth ulcers and they can get as big as 1cm. Sometimes it goes away in a few days; other times it stays around for a longer time. When I eat, I will bite on to the ulcers, or on the inside of my cheeks, which is very painful and frustrating. I have been taking cooling teas, using mouth rinses and a cream I got from the pharmacy but relief is always short-lived. Is there a way to stop them from coming back? Are there any underlying illnesses associated with mouth ulcers?
A. All of us would have experienced an ulcer in the mouth or gums at some stage of our lives and may even remember how uncomfortable or unbearable that could have felt.
Oral cavity is one of the more sensitive parts of the body; it is also the receptacle for food and water intake and is responsible for our ability for speech, taste and chewing. Our daily function involves so much of our oral cavity that it is no wonder we feel almost desperate when even a tiny ulcer forms in our mouth.
Traumatic Oral Ulcers
Trauma from hard foods, rough dentures or accidental biting of the inner lining of the cheek could lead to a painful ulcer. However, this should heal within 1-2 weeks and no active treatment is needed.
Recurrent Aphthous Ulcers
This is one of the commonest types of mouth ulcers although the cause is unknown. They present more commonly in the younger population and may occur as a solitary ulcer or in groups of multiple ulcers all over the mouth. They are typically very painful and have an interesting correlation to stress, menstrual cycles, hormonal or nutritional deficiency. Most ulcers heal within 1-2 weeks; the larger ones taking several weeks.
Oral manifestation of systemic disease
Sometimes, oral ulcers form as a manifestation of underlying poor health. For example in vitamin deficiency (particularly C & B12), autoimmune disease, as well as some types of blood disorders (leukaemia or even AIDS).
There are less common but also dangerous causes of ulcers such as oral or tongue cancer where treatment may involve surgical intervention. Viral infections like Hand-Foot-Mouth Disease and may give rise to blisters in mouth, hands and feet.
As a general guide, healing for all ulcers should take place within 2 weeks. If there is pain, adequate pain killer should be administered together with symptomatic relief such as throat gargles or lozenges. Sometimes, topical applications of anti-viral ointment or steroidal creams may be used.
However, if the ulcer fails to heal or starts to worsen and even progresses in size after a period of watchful waiting, see a doctor. The diagnosis can be readily established with a simple biopsy or a sample may also be taken to search for possible infections.
ENT Consultant Surgeon & Director
Mount Elizabeth Medical Centre
Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission