What is an oral ulcer?

An oral ulcer is the loss of full thickness epithelium in the mouth. In other words, the lining skin of the mouth, also known as the mucosa, has a breach in the surface layer, a little like having a cut in the skin. Ulcers may appear singly or as multiples. They may last days, months or even longer. They may also be recurrent, or “come and go”.

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What causes oral ulcers?

There are many reasons why an oral ulcer may develop. Some of the reasons they may form include trauma, allergy, an infective cause such as a virus, because of a dry mouth, as the result of medication, as a result of many conditions affecting the body, or may even be something concerning like oral cancer. Some of the medical conditions which may cause oral ulcers include anaemia, vitamin deficiencies, gastrointestinal problems, and some syndromes.

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Sometimes, we do not know why oral ulcers develop. An example of this is a condition known as recurrent aphthous stomatitis. These are recurrent, painful mouth ulcers which typically start in childhood. They occur in approximately 25-60% of the population.

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Common medications which may cause oral ulcers as an adverse side effect include those for high blood pressure, those for diabetes, and anti-inflammatory medications. The list of possibly implicated drugs is long.

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Signs and Symptoms

Some ulcers may have a preceding stage before they actually appear, also called a prodromal phase. This may include tingling or burning.

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Ulcers may be painful, or painless, depending on their type. It’s important to report both painful and painless ulcers.

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How are oral ulcers diagnosed?

The Clinicians at Perth Oral Medicine & Dental Sleep Centre have expertise and experience in diagnosing oral ulcers. Reaching a diagnosis requires thorough history taking and a clinical examination, and investigations such as blood tests and biopsies may also be undertaken.

 

How are they treated?

The management options for oral ulcers are varied and depend on the cause of the ulcer/s and the diagnosis. Some ulcers will heal by themselves once the underlying reason is addressed, and some ulcers require medication, corticosteroid injections, or surgical intervention. If the ulcer is due to oral cancer, more extensive management is necessary.

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Recovery

Most patients will experience a resolution or reduction of their symptoms. Sometimes, different medications or management options will be trialled to find the best fit for you.