Symptoms, examination and treatment choices.
A small sore in the mouth can be very painful: it can sting while eating, interfere with tooth brushing, or speaking. A common cause of such sores is aphthous ulcers. They usually appear on the inner side of the lips, cheeks, or on the tongue and often heal within one to two weeks.
However, not every mouth sore is an aphthous ulcer. The mucous membrane can be damaged by a sharp tooth edge, biting, an ill-fitting denture, or another disease. When evaluating, it is important not only to look at the appearance of the sore but also to consider how long it has been present, whether it recurs, and if there are other symptoms.
An aphthous ulcer is often round or oval, with a whitish or yellowish center and a red border. Before it appears, the area may tingle or burn. Even a small lesion can be very painful, especially when touched by food, a toothbrush, or the tongue.
Sometimes there is a single sore, sometimes several. Larger or deeper lesions may take longer to heal, but prolonged sores should not simply be attributed to a “stronger aphthous ulcer.” If it is unusual, enlarges, bleeds, or does not heal, a dental examination is needed. A photo on the internet is not a sufficient basis for a self-diagnosis.
Typical aphthous ulcers are not contagious. Lip herpes is caused by the herpes simplex virus; it is characterized by clustered blisters, often on the lip edge or surrounding skin. However, viral lesions can also occur inside the mouth, so location alone is not an absolute difference.
A traumatic sore can result from biting the cheek, burning the mucosa with hot food, or constant rubbing from a sharp tooth edge. In such cases, it is important to remove the irritant. If the sore repeatedly opens in the same spot near a filling, bracket, or denture, show it to a dentist. You should not try to file your tooth or adjust the appliance yourself.
There is no single universal cause. For some people, they appear after minor mucosal injury, fatigue, or stress. Genetics and individual provoking factors may also play a role. However, the fact that a sore appeared during a stressful week does not prove that all recurring sores arise solely due to stress.
With frequent recurring lesions, the doctor may assess for iron, vitamin B12, or folate deficiencies and other health conditions. Tests are selected based on complaints and examination. Taking supplements in large doses without a confirmed need is not a universal prevention for aphthous ulcers.
Inform your doctor if you have digestive disorders, weight changes, skin rashes, other mucosal lesions, or joint pains. Such information may change the examination plan. Newly started medications are also important.
While the ulcer is healing, choose softer, non-hot foods. Acidic fruits, spicy seasonings, salty snacks, and hard crumbs may irritate it. It is not necessary to completely change your diet—temporarily avoid what specifically causes pain and try to drink enough fluids.
Brush your teeth gently with a soft toothbrush. Avoid directly rubbing the ulcer but do not stop overall oral hygiene. If you notice that a certain toothpaste consistently irritates, discuss alternatives with your dentist. Some people tolerate toothpaste without sodium lauryl sulfate, but this is not necessary or guaranteed for everyone.
Do not pick at the ulcer or try to ‘burn’ it with alcohol, concentrated peroxide, or other strong substances. These can further damage the mucosa. Gentle mouth rinsing may ease discomfort, but strong burning sensations are not a sign of effectiveness.
A pharmacist or dentist can help choose a topical agent to reduce pain or protect the affected area. Use it according to instructions, considering age and health status. Not every oral gel is suitable for young children or all mucosal diseases.
For severe or frequently recurring aphthous ulcers, the doctor may prescribe local anti-inflammatory treatment. Sometimes additional tests or consultation with another specialist are needed. Antibiotics are generally unnecessary for common aphthous ulcers, and antiviral drugs for herpes are not automatically appropriate for all oral ulcers.
If a sore is caused by mechanical irritation, the cause must be addressed: a sharp edge, a restoration or appliance causing trauma. An anesthetic gel alone will not protect against repeated injury.
If the ulcer clearly does not decrease within two weeks or repeatedly recurs in the same place, arrange for an examination. Any oral lesion persisting longer than three weeks must be checked. This does not mean a serious disease is diagnosed – the examination helps to determine why the sore is not healing.
Seek help sooner if the ulcer is very large, hard, bleeds spontaneously, if a neck lump appears or swallowing is difficult. Also do not wait if pain prevents adequate drinking, you have a fever, or your overall condition is poor. Suspicious lesions are evaluated by the doctor immediately, without waiting for a set number of weeks to pass.
The dentist examines not only the ulcer but also the entire oral mucosa, teeth, and possible irritants. They will ask when the lesion appeared, how long previous ulcers took to heal, if they recur, and what measures you have already tried. If you have previous photos, they can help assess changes.
Usually, examination is enough for aphthae. However, unusual or long-lasting lesions may require additional tests, referral to a specialist, or a tissue biopsy. The choice of test depends on specific findings. It is important to agree on when the sore will be rechecked if it does not heal by then.
Record the date of appearance, location, and healing duration. Note possible biting, a new oral hygiene product, medication, or other changes. Such brief notes help to notice recurrence and provide more precise information to the doctor.
Aphthae alone do not require avoiding many foods or following a strict diet. Changes should be based on clear connections or a diagnosed disease. If ulcers increase in number, are larger than before, or the mouth does not heal between episodes, broader evaluation is needed.
Common canker sores are not contagious. However, similar-looking oral lesions may have other causes, so in case of uncertainty, they should be evaluated by a specialist.
Small canker sores often heal within one to two weeks. If the lesion does not decrease, changes, or persists longer, waiting is not enough – an examination is needed.
Sometimes a deficiency of certain substances is found, but this is not the cause of all canker sores. Tests and supplements are chosen according to the individual situation.
It is not advisable. Alcohol and other strongly irritating substances can damage the mucosa. It is better to use a product designed for the oral mucosa according to a specialist’s advice and instructions.
A traumatic sore may form in that area, which is not the same as a recurrent canker sore. The dentist should assess the tooth edge and remove the cause of irritation.
Not always. Products have age and usage restrictions. Consult a pharmacist or doctor, and if the child drinks very little due to pain, seek care without delay.
No. There can be various causes. However, prolonged or unusual lesions cannot be reliably evaluated at home, so doctor’s examination and, if necessary, additional tests are important.
Book a consultation: online · +370 696 66247.
This information is for patient education and does not replace an individual examination, diagnosis or treatment plan.
