Why do I keep getting mouth ulcers?

Mouth ulcers, also known as aphthous ulcers or canker sores, are small sores that develop on the inside of the mouth. These ulcers are typically painful and can make eating and talking difficult. While many ulcers resolve without treatment within one to two weeks, recurring ulcers affect up to 25% of individuals. Understanding the causes of mouth ulcers can help manage and prevent them, as well as identify potential underlying health concerns.

Three main types of recurring mouth ulcers exist: minor, major, and herpetiform. Around 80% of ulcers are minor, characterized by their small size (about the size of a green pea), shallow depth, and round or oval shape with a yellow or gray center. They usually heal within two weeks without treatment. Major ulcers are larger, deeper, and irregularly shaped, often causing scarring and taking weeks or months to heal.

Herpetiform ulcers appear in clusters of up to 100 tiny sores, which may merge to resemble a large ulcer and take two to three weeks to heal. Herpetiform ulcers are not contagious, unlike those caused by the herpes simplex virus.

Recurring mouth ulcers can be triggered by various factors, including injury, stress, hormonal changes, genetic predisposition, nutrient deficiencies, medications, or underlying systemic diseases. These ulcers may appear during periods of illness or stress and can be linked to shifting hormone levels, with some women experiencing more frequent ulcers before menstruation.

Family history plays a role, with up to one in two people reporting a family history of recurring ulcers, which may be due to a mix of genetic predisposition and an overactive immune response.

In some cases, recurring mouth ulcers may indicate a deficiency in iron, vitamin B12, vitamin C, or folate. Consulting a doctor for a blood test can help identify the underlying causes and suggest appropriate dietary or supplement changes. Certain diseases, such as celiac disease, inflammatory bowel disease, and autoimmune conditions like lupus or Sjögren's syndrome, can also cause mouth ulcers.

Additionally, some medications can trigger or worsen mouth ulcers, including chemotherapy, painkillers like naproxen and ibuprofen, certain antidepressants, and medications prescribed for heart conditions. If a medication is suspected to cause ulcers, it is essential to consult a doctor or pharmacist before making any changes.

Most mouth ulcers heal without treatment within a week or two. However, for temporary relief, individuals can use medicated mouth gels to reduce pain and swelling and numb the area, making eating more comfortable. It is crucial to consult a pharmacist or dentist for available options. While recurrent ulcers that heal on their own are generally not a cause for concern, any ulcer that persists after two weeks should be evaluated by a dentist or doctor to rule out cancer.

Early detection of mouth cancer is crucial for effective treatment. Any unusual signs, such as a lump, swelling, bleeding, difficulty swallowing, voice changes, or unexplained weight loss, should prompt an immediate medical or dental assessment.