Mouth ulcers: how to shorten the sore and the sting

A common mouth ulcer is not an infection and not only a heat problem. It closes on its own in seven to fourteen days; what you can do is shorten the sting, avoid what triggers it, and find the deficiency if they keep coming.

What it usually is

A round or oval sore with a white or yellow centre and a red rim, on the soft inside of the cheek, the inner lip, under the tongue or at the base of the gum. It stings on anything salty, spicy or acidic, and it is not catching.

• It is not a blister from a fever sore, which sits on the lip edge or the hard palate and starts with a tingle.
• One or two at a time is ordinary. Six at once, or ulcers with fever, is something else.
• It heals without a scar in a little over a week. If it is still open at three weeks, that is not a canker sore.

Why they appear

Most often several small things arrive together rather than one cause.

• The inside of the cheek bitten, a hard brushing stroke, a sharp tooth edge, or a bracket rubbing the same spot.
• A toothpaste that foams aggressively; the detergent in it is a genuine trigger in a noticeable number of people.
• Pineapple, tomato, lemon, vinegar and very salty food on a lining that was already raw.
• Poor sleep, exams, a hard stretch of stress, and the irregular periods some women notice ulcers arrive with.
• Iron, vitamin B12 or folate running low. This is the common finding in people with repeat ulcers.
• An illness, a course of antibiotics, or a diet that skipped meals for a fortnight.

What shortens the sore

• Rinse with plain warm salt water, half a teaspoon in a glass, three or four times a day. It is not a cure; it keeps the sore clean and less angry.
• Cool water held in the mouth before eating takes the edge off the sting.
• Apply a little honey on the sore and let it sit. Traditional, mild, and most people find it settles the burning.
• A cold ice chip held against the spot for a minute numbs it enough to eat.
• An ordinary protective gel or film from the chemist, put on before meals, is the single most useful thing for a sore that stops you eating.
• Coconut oil swished for a minute and spat out. Harmless, and the coating feels good on a raw lining.
• Warm milk with turmeric is a folk measure that does no harm. Putting dry turmeric paste into an open ulcer only stings and adds nothing.
• Soft food, cut small, chewed on the other side, for the two or three worst days.

What to avoid while it is open

• Spicy, sour, salty and crunchy food, and hot drinks.
• Straight lemon, vinegar, or a salt pinch rubbed into the sore. Pain, no benefit.
• Alcohol-containing mouthwash on an open ulcer, and the strong mint sprays.
• Tough brushing over the spot with a hard brush.
• Tobacco of any kind, and gutkha, which both start ulcers and make a sore that will not heal far more serious.
• Biting the cheek again on purpose because the edge feels rough.

Change these if they keep coming

• Switch to a toothpaste without the foaming detergent and use it for a month. Some people get a clear reduction; others do not, and then it was never the toothpaste.
• A soft brush, and slower strokes.
• Fix the sleep. Ulcer runs in the same weeks as the bad sleep, every time.
• Get iron, vitamin B12 and folate looked at rather than taking supplements on faith. A normal level on a normal diet tells you to look elsewhere; a low one is worth treating properly for three months.
• Eat regular meals with protein. Skipping breakfast for a fortnight shows in the mouth before it shows anywhere else.
• Notice which food arrives before each bout, and cut that one, not the whole kitchen.

When it is not an ordinary ulcer

These need to be examined, not soothed.

• A sore still open after three weeks, or one that is hard, painless and growing.
• Ulcers with fever, swollen glands, bleeding gums, or sores at another place on the body.
• Ulcers with red eyes or sores on the genitals, which is a single condition seen together.
• A white patch that does not rub off, or a red patch, next to an ulcer.
• Sores in a small child who will not drink, or in anyone whose immunity is being lowered by treatment.
• Ulcers that start with a new medicine, or that arrive every time a period comes.
• A very large ulcer that leaves a scar when it heals.
• Any sore in someone who chews tobacco and is not healing, which is examined without waiting.

In a free video consultation an Aksa physician looks at where the ulcers sit, how long each one stays, what you eat and sleep like, and what has already been tried, and says whether this is a lining that needs its routine changed or a deficiency and a report to chase.

Every individual is different. This page is general education, not a prescription for you, and it cannot replace an examination.