Mouth ulcers are painful breaks in the lining of the mouth, usually inside the lips, cheeks or on the tongue. They are not contagious and are different from cold sores around the lips. Most heal within one or two weeks without scarring.
Single ulcers often follow biting, a sharp tooth, poorly fitting denture, braces, hot food or vigorous brushing. Stress, hormonal change, some toothpastes and medicines can contribute. Recurrent ulcers may occasionally be associated with iron, vitamin B12, folate or zinc deficiency, coeliac disease, Crohn’s disease or immune conditions.
Soothing the area
Use a soft toothbrush and choose softer, cooler foods while the ulcer is tender. Avoid very spicy, salty, acidic, rough or extremely hot foods and drinks. Toothpaste without sodium lauryl sulphate may reduce irritation for some people. A saline rinse can be made with half a teaspoon of salt in warm water; rinse and spit it out.
Recognising serious symptoms
A pharmacist can recommend antimicrobial mouthwash, pain-relieving gel or spray, or corticosteroid lozenges. See a GP or dentist if an ulcer lasts longer than three weeks, is unusually large or near the back of the throat, bleeds, becomes increasingly red and painful, or occurs with ulcers elsewhere or painful swollen joints. Persistent ulceration can occasionally be a sign of mouth cancer.
Food and deficiency testing
A healthy varied diet is appropriate; routine avoidance of gluten or a long list of suspected foods is not. Testing for coeliac disease must be performed while gluten is still being eaten. Blood tests can identify anaemia or relevant deficiency when recurrent ulcers and other symptoms make this plausible.
Correcting a demonstrated deficiency may reduce recurrence, but taking iron automatically can cause harm and may hide the need to investigate blood loss or malabsorption.
Useful supplements
Supplements should be selected for the individual rather than used automatically. Product directions and advice from an appropriately qualified professional should take precedence over general information.
| Supplement | Effects |
|---|---|
| Zinc | Supports normal tissue repair and inflammatory regulation. |
| Vitamin C | Supports collagen formation and normal wound healing. |
| Multivitamin and mineral formula containing iron and B vitamins | Provides nutrients involved in red-blood-cell formation, tissue renewal and energy metabolism. |
High-dose vitamin C can cause diarrhoea and may increase kidney-stone risk in susceptible people. Excess zinc can cause copper deficiency. Iron should be taken only when need is established or clinically advised, and it must be kept away from children because overdose can be fatal.
The useful distinction is between an isolated traumatic ulcer and a persistent or recurrent pattern. Comfort measures are suitable for the former; the latter may warrant dental examination, medicine review and targeted blood or gastrointestinal investigation.
Looking for personalised nutrition and lifestyle support? An FNTP member may be able to help you explore an approach suited to your individual needs. Find an FNTP practitioner.
This article is for general education and does not replace individual medical advice, diagnosis or treatment.
