Recurrent Mouth Ulcers/ Apthous Ulcers

Have you ever suffered from that annoying painful ulcer/ ulcers in your mouth? These painful, round or oval ulcers which appear on the inner surface of the cheeks, on lips, base of gums, roof of the mouth and lips are called apthous ulcers . They are yellow, red or grey in colour. Dentists in delhi as well as dentists in India have found them to be present in 3 varieties.

1- Minor Ulcers- They are less than half inch in diameter. They heal within 2 weeks and donot leave any scars.
2- Major ulcers- They are almost half inch in diameter. They take more than 2 weeks to heal and leave scars.
3- Herpetiform ulcers- This is characterized by a cluster of dozens of small ulcers. This is rare though.

CAUSES

The dental clinics in Delhi and dental clinics in India have seen a steady rise in the number of patients with apthous ulcers. This is attributed to the following

Factors

1- Stress and anxiety
2- Hormonal changes eg women usually get these ulcers just before their monthly period or around menopause.
3- Ex smokers get these ulcers just after they have stopped smoking
4- Nutritional deficiencies viz Vitamin B12, folic acid, iron also cause these ulcers
5- A food allergy may cause these or a medicine allergy.
6- Damage to the lining of the mouth due to an ill fitting denture/ sharp filling may cause these.
7- It may be genetic. In 40 percent of the cases the cases there is a hereditary factor causing these ulcers.
8- Dentists in India have seen in a lot of cases, ulcers happen in certain medical conditions

a- Reactive arthritis
b- Immune deficiency diseases like lupus/ HIV.
c- Viral infections such as chicken pox, hand foot and mouth disease

9- Some medications like anti inflammatory drugs ie ibuprofen, oral nicotine replacement therapy may cause these ulcers. These could be a side effect of chemotherapy or radiotherapy
10- Dentists in Delhi, have observed some patients using toothpastes containing sodium lauryl sulfate also land up having these ulcers.

TREATMENT

Dentists in Delhi usually try to do treatment for their patients by giving them symptomatic relief.

Infact patients visit Dental clinics in India for the treatment of Apthous ulcers, if these ulcers

– do not heal until 3 weeks
– are too recurrent
– become red and infected, then it may be having a superimposed bacterial infection which may need antibiotics
– The dentist may need to do a biopsy of the non healing ulcer to eliminate cancer.

The dentists advise the patients the following as part of the treatment

a- A chlorhexidine mouthwash
b- A steroid lozenge
c- A painkiller spray or gel
d- A multivitamin regime including a B complex
e- The dentist will advise the patient to avoid spicy foods Avoid using toothpaste with sodium lauryl sulfate

Use a soft tooth brush
Use a straw to drink cold drinks

If there is an ill fitting denture or sharp filling it will be sorted by the dentist

In some reputed dental clinics in Delhi as well as dental clinics in India, the dentists are providing counseling sessions either themselves or through counselors, to understand if there is too much stress and anxiety in a person’s life which may be causing these recurrent ulcers.

Dentists in Delhi do carry out blood tests and biopsy to rule out any underlying disease for which these mouth ulcers are just symptoms.  If an ulcer is non healing then the dentist needs to eliminate mouth cancer. The factors which increase the risk of cancer are smoking and drinking. The ulcers related to cancer usually occur below the tongue. If cancer is diagnosed then the prognosis is good as mouth cancer can be treated. It is heartening that dentists in India and not just the dentists in Delhi, are adopting a systematic approach to treat the apthous ulcers. If any investigations are needed then both the dental clinics in Delhi and Dental clinics in India are carrying out the required blood tests or biopsy.

Posted By – Dr. Suprriya B. Bhatia