Mouth ulcers

Dentists at the University of Florida Health Oral Medicine clinic treat oral ulcers. 

Definition

Mouth ulcers are sores or open lesions in the mouth.

Oral ulcers are painful breaks in the mucosa and can be caused by 100s of different things including trauma, heredity(aphthous ulcers or canker sores), drugs, autoimmune diseases(lupus, pemphigus or pemphigoid), allergic reactions(erythema multiform),  etc.

Treatment revolves around finding the cause and treating the underlying diseases.  Topical steroids are often used for these ulcers for symptomatic relief.

Alternative Names

Oral ulcer; Stomatitis - ulcerative; Ulcer - mouth

Causes

Mouth ulcers are caused by many disorders. These include:

A skin sore caused by histoplasmosis may also appear as a mouth ulcer.

Symptoms

Symptoms will vary, based on the cause of the mouth ulcer. Symptoms may include:

  • Open sores in the mouth
  • Pain or discomfort in the mouth

Exams and Tests

Most of the time, a health care provider or dentist will look at the ulcer and where it is in the mouth to make the diagnosis. You may need blood tests or a biopsy of the ulcer may be needed to confirm the cause.

Treatment

The goal of treatment is to relieve symptoms.

  • The underlying cause of the ulcer should be treated if it is known.
  • Gently cleaning your mouth and teeth may help relieve your symptoms.
  • Medicines that you rub directly on the ulcer. These include antihistamines, antacids, and corticosteroids that may help soothe discomfort.
  • Avoid hot or spicy foods until the ulcer is healed.

Outlook (Prognosis)

The outcome varies depending on the cause of the ulcer. Many mouth ulcers are harmless and heal without treatment.

Some types of cancer may first appear as a mouth ulcer that does not heal.

Possible Complications

Complications may include:

  • Cellulitis of the mouth, from secondary bacterial infection of ulcers
  • Dental infections (tooth abscesses)
  • Oral cancer
  • Spread of contagious disorders to other people

When to Contact a Medical Professional

Call your provider if:

  • A mouth ulcer does not go away after 3 weeks.
  • You have mouth ulcers return often, or if new symptoms develop.

Prevention

To help prevent mouth ulcers and complications from them:

  • Brush your teeth at least twice a day and floss once a day.
  • Get regular dental cleanings and checkups.

Images

References

Daniels TE, Jordan RC. Diseases of the mouth and salivary glands. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 425.

Hupp WS. Diseases of the mouth. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2019. Philadelphia, PA: Elsevier; 2019:969-975.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Disorders of the mucous membranes. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 34.

Mirowski GW, Leblanc J, Mark LA. Oral disease and oral-cutaneous manifestations of gastrointestinal and liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 24.

Review Date: 
2/7/2019
Reviewed By: 
Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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