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Dr. Andrew Rynne

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Have recurring mouth ulcer. How to get rid of this?

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Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2015 Questions

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Posted on Fri, 8 Feb 2013 in Dental Health
Question: I have had a recurring mouth ulcer in the exact same location of the roof of my mouth on and off for the last 3 or so months.

The ulcer is not sore or irritable, and seems solely irritated by fizzy drinks or concentrated acidic fruit drinks. The strange thing is that the ulcer may disappear for 3-5 a days, but then it will suddenly re-appear one day over the course of a few hours. I used to smoke regularly for the course of approximately one year (around 2 years ago) and have since quit. I did not have any ulcers back then.

I do not get ulcers regularly, and I am very unlikely to be deficient in vits and minerals (take regular supplements). The only other time I have had ulcers in the past was around 6-7 months ago when I had a very brief outbreak of ulcers during what may have been a virus (raised temp, glands and random mouth and lip ulcers). I can not remember having any other ulcers other than this one on and off since that point. All the ulcers other than this one appear to have cleared up.

I am only writing this because I am concerned as to why this ulcer has persisted for more than 3 weeks and my current doctor believes it may be stress, however I'm not continuously stressed, yet it still persists. Any thoughts or opinions on this problem would be most welcome. For now, the ulcer has not grown in size and I have not seen any new ulcers appear in or around my mouth. If it was something malignant or suspicious should I have expected changes by now in terms of shape, size or new ulcers to have appeared?

I will upload a picture of my ulcer after I have submitted this.

Kind Regards

doctor
Answered by Dr. Kalpana Pathak 2 hours later
Hi XXXXXXX

Thanks for writing to us.

From the image and clinical history that you have provided, it seems you are most probably having recurrent aphthous stomatitis( RAS). RAS is commonly seen in second decade of life.
Some of the causes for RAS are- hereditary( if one of the parent has similar history, chances are high in offspring), stress, trauma, nutritional deficiency( vitamin B12, iron, folic acid) and it can be autoimmune also( that is body's own immunity works against our body cells). Surprisingly cessation of smoking too can increase RAS risk. But that does not mean you should resume smoking!
Your previous episode where you had enlarged glands and mouth ulcers were probably RAS only.
Be completely reassured that it is not at all cancerous.

To treat the same, try these general recommendations-
1) Take supplements specifically for iron, folic acid and vit b12
2) Do warm saline gargles or betadine gargles after every meal
3) Apply a steroid oral cream like kenacort over the ulcer to speed healing.
4) If its too painful, you may also apply oral benzocaine or lignocaine half an hour prior to eating food.

Hope that answers your query. Should there be more questions, I would be happy to assist you.

Take care

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Kalpana Pathak 33 minutes later
Thank you very much for the kind and reassuring reply. If I follow your recommendations do you believe that it will eventually disappear? I am guessing that considering it has been ongoing on and off for the last few months it many well take a number of further months to completely resolve?

Kind Regards
doctor
Answered by Dr. Kalpana Pathak 5 minutes later
Hi XXXXXXX

It would resolve on treatment. However, further recurrences can be there as basis of such ulcers could be hereditary or autoimmune factors. One needs to worry about mouth ulcers, only when being on treatment for more than three weeks, and they do not show any response.

Wish you a speedy recovery.

Take care.
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Kalpana Pathak 2 days later
Thanks again. I have a mouth wash solution for after meals which contains Hexetidine and a mouth ulcer stick. When it came up again a couple of days ago it then eventually burst and went down again and has come up very slightly again as of yesterday afternoon. The issue I am having is finding out exactly what foods and drinks irritate it - I know to stay away from fizzy drinks, acidic fruits and fruit drinks, ketchup and extremely hot foods? As long as it does not get larger than it has done, change shape or new ulcers appear, then I should have nothing to worry about though you think?
Apologies, and also SLS in toothpastes I gather may cause re-occuring mouth ulcers. Would this be worth eliminating from my tooth paste for the next week or two?

Thanks again for your time!
doctor
Answered by Dr. Kalpana Pathak 21 minutes later
Hi XXXXXXX
Thanks for writing back.

To prevent aphthous ulcers:

Avoid trauma- use soft bristled toothbrush, chew food properly to avoid teeth biting of oral mucosa
Avoid hard coarse foods (toasts, potato chips etc)
Avoid hot foods as well as spicy food
Avoid aerated drinks and acidic food (tomato, lemons, pine apples, orange etc)
SLS in toothpaste is also implicated for the same, so avoiding it would be a good choice.
Maintain good oral hygiene, rinse mouth after every meal.

A single ulcer not increasing in size and responding to treatment ensures that you need not worry.
Wish you a speedy recovery. Take care.

Above answer was peer-reviewed by : Dr. Shanthi.E
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