What are the main causes of recurrent mouth ulcers?

Mouth ulcers are common and uncomfortable conditions that affect the soft tissues inside the mouth [1]. To understand more about how to maintain your oral health and avoid these disorders, you can read our article on Common Oral Disorders: Diagnosis, Treatment, and Daily Care (Arabic). To understand why some individuals suffer from recurring ulcers, it is necessary to look at the underlying causes and triggers rather than just treating the symptom.

Factors Causing Recurrent Mouth Ulcers

There are many causes for mouth ulcers; simple ulcers are usually the result of minor injuries or avoidable factors. Direct causes of individual ulcers may include: biting the inside of the cheek, incorrect use of a toothbrush, or ill-fitting dentures that cause constant friction [4]. For ulcers that recur regularly, internal and genetic factors are often involved.

Contributing factors to the recurrence of this condition include:

• Genetic factors: There is a familial tendency that makes some individuals more prone to developing recurrent mouth ulcers compared to others [4].
• Nutritional deficiencies: The frequent appearance of ulcers may be linked to low levels of essential vitamins and minerals in the body, such as iron, zinc, folic acid, and vitamin B or D [4].
• Psychological and physical state: Feeling tired, stressed, or having chronic anxiety is a common trigger for ulcers in many people [4].
• Hormonal changes: Some women may notice a correlation between their menstrual cycle or periods of hormonal change and the appearance of these ulcers [4].
• Underlying diseases: In some cases, multiple and persistent ulcers may be a symptom of other health conditions, such as gastrointestinal diseases (e.g., Crohn's disease or celiac disease) or a weakened immune system [4].

Home Care and Symptom Relief

Although most ulcers are not serious and heal on their own within a week or two, good care can speed up the healing process and reduce pain. It is recommended to use a soft-bristled toothbrush to avoid irritating the tissues and to ensure a balanced diet is maintained. It is also essential to avoid foods and drinks that further irritate the area, such as spicy, salty, or acidic foods, and very hot drinks [4].

You may also consult a pharmacist regarding over-the-counter treatment options, such as saltwater mouth rinses (dissolving half a teaspoon of salt in a cup of warm water and rinsing with it), or using topical analgesic gels to reduce local pain [4].

When Should You See a Doctor?

You should visit a dentist or general practitioner in specific cases that require careful medical examination. Consult a doctor immediately if you notice that the ulcer has lasted for more than three weeks without healing, if the ulcer is growing in size or looks different than what you are used to, or if it is accompanied by bleeding [4]. Likewise, medical intervention is required if ulcers appear in other areas of the body, such as the skin or genital area, or if they are accompanied by joint pain and swelling, as these signs may indicate health conditions that require specialized treatment [4].

Medical references

• Mouth ulcers - NHS
• Mouth Disorders