Mouth ulcers

Mouth Ulcers

Mouth ulcers are a wound in the lining of the mouth and on close inspection they look like a crater. We have all had simple ulcers which heal in 3-4 days, some people get aphthous ulcers which take 10-14 days and lichen planus can last for ages. Any ulcer that lasts longer than 2 weeks needs to be checked by a dentist or oral surgeon.

The most common ulcers are from a lack of coordination. We hit ourselves with toothbrushes, bite our own lips and cheeks, spear ourselves with sharp food, and take the food that is burning our fingers and toss it in our mouth to burn the soft flesh there.

Recurrent ulceration (keeps coming back , maybe in different places but the pain feels much the same) can be from food allergies, stress, smoking, alcohol, viruses, autoimmune, cancer…

Ulcers are either:

straight to crater appearance or

fluid filled blisters at very start, and then turns into crater


Traumatic-e.g. hit self with toothbrush, sharp food.  Usually heals in 2-3 days. Salt water mouth rinses are the best treatment. Don’t bother with any “over the counter” mouth rinses.  Use “Orabase” ointment from the chemist if it is too sore to work around. Apply with a clean fingertip in a single dabbing motion.

Aphthous - don’t remember any injury, can be recurring, vary in size and can occur on other areas of the body. Takes longer to heal, usually 10-14 days and can be quite painful, and can require prescription steroid ointment for relief of symptoms. It is hereditary and non-infectious

Drink lots of fluids, take painkillers and you may need to apply steroid ointments

         “Kenalog in Orabase” available from the chemist without prescription

          Prescription only betamethasone valerate 0.05% ointment

You can apply the ointment if you feel an ulcer coming and it may prevent the worst of it

Oral Lichen planus- a long (term) white spider web/lichen pattern on the inner surfaces of the cheeks, however, it can appear as areas of ulceration. It is thought to be an autoimmune condition, it is non-hereditary and non-infectious. Symptoms may include a burning or stinging discomfort in the mouth when eating or drinking. Mild cases may be symptom-free.

It cannot be cured, but it may come and go spontaneously.  In most patients oral lichen planus is not serious. However it can (rarely), transition to cancer so should be checked yearly

         “Kenalog in Orabase” available from the chemist without prescription

          Prescription only “betamethasone valerate 0.05% ointment”

Apply steroid ointment when needed (2x day for the first 10 days, then 1x day for the next 10 days then 2x week until manageable)


Cluster pattern-over a specific area of the mouth e.g., Left half only of the palate, right side only of the inner lip = viral. Wait it out, it will take 10 days to heal. Take painkillers and drink lots of water. Do not apply any steroid ointment, it won’t help and may hinder healing

Non cluster pattern- just spread randomly over the mouth, needs a specialist to diagnose and treat.

NB. The use of a steroid ointment can lead to an overgrowth of other bacteria in the mouth causing candidiasis (thrush) seen as white and red spots across the palate. This is easily treated with Nilstat drops (chemist) once a day.

In short, if you have a painful mouth ulcer, rinse with salty water a few times a day.

If this is not enough, visit the chemist for some “Orabase” or “Kenalog in Orabase” It is a very thick grainy paste that you apply with one dab of the fingertip.

If the ulcer lasts longer than two weeks, particularly if it doesn’t hurt when it looks like it should, get it checked


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