Learn about symptoms and causes of mouth ulcers, self help treatment options, medication and when to seek medical help.

What is a mouth ulcer?

Mouth ulcers are sores that develop in the mouth. The sores are usually round or oval with a greyish yellow centre and a red border. They may occur on the lips, inside the cheeks, on the gums or on the tongue. 

What are the possible causes of this condition?

Mouth ulcers can be caused by the following:

• Minor trauma 
  • Injury caused by biting the inside of cheeks and lips, injury caused by tooth brushing, and dentures or braces may result in mouth ulcers.
• Stress or hormonal changes
  • Stress and anxiety, or hormonal changes during menstrual periods and pregnancy may cause mouth ulcers.
• Nutritional deficiencies
  • Lacking of certain vitamins (e.g. vitamin B12, folic acid) and minerals (e.g. iron) in your diet can cause ulcers to occur repeatedly.
• Medications
  • Ulcers can be a side effect of certain medications, such as Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Bisphosphonates, Beta-Blockers and certain cytotoxic drugs.
• Viral infection
  • Cold sores, caused by the Herpes Simplex Virus (HSV), is an infection of the mouth and lip which causes blisters, crusting on the lips, lining of the cheeks and the back of the lips. Other viruses such as the Coxsackie (Hand, Foot, and Mouth Disease), Varicella (Chickenpox) and HIV viruses can also cause mouth ulcers.
• Medical Conditions
  • Mouth ulcers may be a result of certain medical conditions, such as Inflammatory Bowel Disease (IBD), Behçet’s Disease and Systemic Lupus Erythematosus (SLE).

What are the symptoms of mouth ulcers?

Mouth ulcers may cause pain, swelling or discomfort, especially when talking, eating or brushing of teeth. The ulcers are usually harmless and clear up within 1 to 2 weeks.

What can I do to treat mouth ulcers?

Mouth ulcers can be treated with the following medications:

• Antiseptic mouthwash (e.g. Chlorhexidine gluconate, Cetalkonium Chloride) helps to kill the germs that can cause minor mouth and gum infections
• Anaesthetic gel or spray  (e.g. Benzocaine, Lignocaine) helps to numb the pain and provide pain relief
• Steroid gel or paste, (e.g. Triamcinolone), pain relief gel or paste (e.g. Benzydamine, Choline Salicylate) and oral painkillers help to reduce inflammation and pain

When do I need to see a doctor?

Although mouth ulcers can be treated without a doctor’s consultation, there are times where the condition might be more serious. 

You should see a doctor if you experience any of the following:

• If symptoms do not improve after 7 days of treatment with topical medicines 
• If the ulcer does not heal within 14 days without treatment
• If the symptoms worsen during self-treatment 
• If you have a fever or rash
• If you have mouth ulcers very often 

What else can I do to manage this condition?

Other than using medications to treat the condition, mouth ulcers can also be managed by the following methods:

• Avoid spicy, hot or acidic and hard foods until the ulcers heal
• Rinse your mouth with a saline solution to soothe discomfort. To prepare the saline solution, add 1 to 3 teaspoons of salt to 120 ml to 240 ml of warm water.

The following are some suggestions to prevent mouth ulcers from happening again:

• Go for regular dental check-ups and maintain good oral hygiene
• Use a soft bristle toothbrush to brush your teeth gently
• Reducing triggers such as stress through relaxation exercises 
• Increasing your intake of nutrients like Vitamin B, folic acid or iron in the diet or with supplements 

Disclaimers

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

 The content above is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Always speak with your physician, pharmacist or other healthcare professional before taking any medication or supplement, or adopting any treatment for a health problem.