Mouth ulcers are sores that develop in the mouth and are painful. They can happen to anyone in any age group and usually take some time to heal. There is not just one cause for these mouth ulcers, so getting a proper diagnosis is essential to understanding why they occur; the cause differs from person to person. The article lists the symptoms of ulcers, their causes, and their management.

Causes
As mentioned, multiple causes, risk factors, and triggers can be identified for the development of ulcers.

• Dental braces
• Nutrient deficiencies of vitamin B9 or folate, vitamin B12, iron and zinc
• Emotional stress
• Toothpaste that contains SLS or sodium lauryl sulfate
• Allergic response to oral bacteria
• Bacterial, viral, or fungal infections affecting the mouth, such as the hand, foot, and mouth disease.
• Hormonal changes that occur during the menstrual cycle or even during pregnancy
• Lack of sleep
• Sensitivities to some acidic foods like citrus fruits, coffee, strawberries, pineapple, and chocolate
• Minor injuries from dental work, sports injuries, accidental bites, or brushing the teeth too hard

Sometimes, mouth ulcers are an indicator or symptom of some other underlying illnesses, so make sure to always get a diagnosis if the problem recurs frequently. A few other causes are mentioned below:

• Celiac disease
• Diabetes
• HIV
• Inflammatory bowel disease, which also includes ulcerative colitis
• Some autoimmune diseases like oral lichen planus, lupus, and Behcet’s disease, a rare condition that causes inflammation in the blood vessels

Signs and symptoms
The symptoms of mouth ulcers may depend on the cause. Some of the typical signs to notice are as follows:

• Painful sores that could be yellow, red, or white
• Sores on inside of the mouth, like on the tongue or insides of the cheeks and lips
• Worsening pain when eating, drinking, or talking

Mouth ulcers are usually not contagious; however, if they are caused by hand, foot, or mouth disease, they can be contagious, so you have to be extra careful of the cause.

Even in mouth ulcers, there are canker sores, the most common type of mouth ulcer, and they are categorized into three types called minor, major, and herpetiform.

The minor ones heal within one to two weeks and do not cause any scars; the major ones take weeks or even months to heal and may even cause long-term scarring. Herpetiform canker sores usually appear in clusters on the tongue and merge to form one big sore. They heal within one month and do not leave any scarring.

Doctor’s visit
You must visit your doctor when these ulcers appear, especially when the symptoms worsen. This can include unusually large mouth ulcers, sores that last for more than three weeks, sores that extend to the lips, severe problems in drinking and eating, high fever, and diarrhea whenever the sores appear, unmanageable pain, and also new mouth ulcers that appear before the old ones heal and even painless sores.

Treatment and remedies
No severe treatment is needed for mouth ulcers unless an underlying condition needs attention and treatment. However, there are many remedies available that can help treat ulcers and bring relief from the pain.

• Saltwater rinse: This is one of the most common and effective remedies for mouth ulcers. All you have to do is dissolve one teaspoon of salt in a glass of warm water. Take a sip and swirl this around in your mouth so it touches all the sores. Spit this out after a couple of seconds. Repeat this every few hours.

  The saltwater can dry out the sores, which can help in the recovery process.

• Honey:  This is known to have antibacterial and anti-inflammatory properties, and studies suggest that using honey can reduce the pain and redness of the sores. The remedy is simple: all you have to do is apply honey directly to the sores four to five times every day. It can have a soothing effect, and the taste of honey will not spoil your mouth.
• Baking soda:  This is known to restore the pH balance in the mouth, which can help reduce inflammation and heal canker sores. Dissolve one teaspoon of baking soda in half a cup of water. Just like a saltwater gargle, swirl this solution in your mouth for a couple of seconds and then spit it out. You can repeat this process every few hours.

Foods to eat to manage the condition

One of the best ways to help treat mouth ulcers is to eat bland and soft foods that are easy to swallow. Foods that are too hot or spicy can irritate and even worsen the inflammation in the mouth.

Stick to foods like yogurt or cream soup, and also eat foods in smaller bites. Cold foods like popsicles, iced tea, and cold water are recommended. Anything that does not irritate the skin inside the mouth and helps reduce the inflammation. You can even puree some soups and have mashed potatoes. Some foods to avoid are coffee, chocolate, citrus fruits and juices, tomatoes, nuts and seeds, and salty and spicy foods.