Painful mouth ulcers? What could be the cause?

A mouth ulcer can be very uncomfortable, as even the slightest touch can cause severe pain, making it difficult to eat - and sometimes even to speak. Most of us have, at various points in our lives, encountered these clearly defined sores, which are covered with a whitish coating (pseudomembrane).

Good oral hygiene and regular tartar removal with ultrasonic cleaning are important, but the truth is that there can be many different causes for mouth ulcers. Ulcers are not contagious, but they are very painful and heal slowly.

What types of mouth ulcers are there?

The most common are small sores called Mikulicz’s ulcers, which are less than 5 mm. You can get a single ulcer or several at once, making it even more difficult to chew and speak. These usually heal within 4-14 days and are less painful than Sutton’s ulcers, which are larger and deeper. These can be up to 2-3 cm in diameter and may appear two at a time - making them even more disruptive in the mouth. The worst part is that healing can take several weeks, even months, and during this period, even eating or drinking can be extremely painful.

The third type is herpetiform ulcers, where small pinpoint sores merge together. They resemble herpes (hence the name), but they are not caused by the herpes simplex virus.

What do mouth ulcers look like?

They typically have a round shape, but can also be more irregular. Around the sore, there is often a reddish border, while the sore itself has a whitish-yellow surface (pseudomembrane). They can appear in many places in the mouth, but most commonly on the inside of the lips, along the sides and underside of the tongue, and on the gums.

The most unpleasant thing is that they are very painful to the touch, making it difficult to eat, drink, brush your teeth - and even speak.

The only good news is that they are not contagious, so you don’t need to worry about spreading them to others.

What causes them?

There can be many causes for the occurrence of mouth ulcers: vitamin and mineral deficiencies, hereditary predisposition, a weakened immune system, or they may be caused by physical trauma - for example, using a hard toothbrush, eating sharp foods, or accidentally biting the inside of the mouth. Problems with braces, sharp edges on dentures, or nighttime teeth grinding (bruxism) can also be triggering factors.

Stress is also a very common cause, as are hormonal changes, and certain types of foods - especially acidic and spicy ones - can increase the risk.

When should you contact a doctor?

If mouth ulcers occur frequently and the problem keeps recurring, you should find out the cause. It could be related to other diseases or even serious health conditions, such as milk allergy, inflammatory bowel diseases like ulcerative colitis, autoimmune diseases such as rheumatoid arthritis, metabolic disorders, or certain medications that can cause sores in the mouth.

You should be careful and attentive with mouth ulcers - it’s not always safe to assume they are just caused by a vitamin deficiency!

The first step should be a visit to the dentist, as this can reveal issues such as a cracked tooth or a defective filling. If everything is fine at the dentist, but the ulcers keep recurring, you should contact your doctor for further evaluation