Oral Ulcers: Concerns and Treatments Explained

Consultation with a doctor?

Hello Dr.
Hong, I visited the ENT department at a large hospital because I had taken cold medicine from a general clinic three times, but I still felt pain on the right side of my throat.
Yesterday, I noticed a white spot on the inner membrane of my mouth on the lower right side, which made me worry it could be something serious.
I also felt that the pain and foreign body sensation might be coming from that area, so I went for a consultation early this morning.
After the examination, the doctor confirmed that there were indeed two ulcers in that area, but there was no need to worry as they were not anything bad.
He applied some medication for me, but since I couldn’t reach the area well, he prescribed a mouthwash.
He also mentioned that my nasal allergies were quite severe, so he prescribed some allergy medication and cough expectorants.
I have two questions for you, doctor.
During the examination, I had to keep my mouth open for about a minute.
Although the doctor reassured me not to be afraid, he used a tissue to pull my tongue, and I felt that the distant mirror had been sterilized with alcohol or something similar.
However, I am still worried about the possibility of contracting COVID-19.
While waiting, I noticed some people coughing, and although everyone was wearing masks, is it possible for the virus to linger in the air? I also noticed that the doctor did not wear goggles during my examination.
My second question is regarding what the doctor referred to as a canker sore.
He said that the white area where it has ulcerated is not a concern, but I feel that besides the canker sore, there is another white spot that is quite noticeable.
When I looked in the mirror, I also saw one or two grayish-white lines on the oral mucosa nearby, which looked like a thin membrane.
Could this be due to straining? I noticed it slightly even when I wasn’t straining, but it wasn’t very obvious.
I also saw a little bit on the left side; does this mean that the original color of my oral mucosa was not completely pink and uniform? I am really worried that this white area could indicate a mucosal lesion, but I don’t know what that type of white appearance looks like.
Although the doctor has examined me and mentioned it might take 2-3 weeks to heal, I forgot to ask if this color of the oral mucosa is considered normal.
I apologize for disturbing your lunch break.
Thank you for taking the time to respond.
Thank you!

w, 20~29 year old female. Ask Date: 2020/05/27

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
Currently, ENT clinics in Taiwan should be following standard disinfection procedures, so there should be no risk of contracting COVID-19 from this.

2.
The color changes you described in the mucous membranes are basic variations associated with mucosal inflammation, which are typically seen in normal inflammatory conditions.
It is recommended to follow the advice of an ENT specialist and observe for 2-3 weeks to see if there are any further changes.
Thank you for your inquiry.

Reply Date: 2020/05/27

More Info

Oral ulcers, commonly referred to as canker sores or aphthous ulcers, can be a source of significant discomfort and concern for many individuals. These painful lesions can appear on the inside of the cheeks, gums, tongue, and even the roof of the mouth. Understanding the nature of these ulcers, their causes, and potential treatments is crucial for managing symptoms and alleviating anxiety related to oral health.

Understanding Oral Ulcers
Oral ulcers are typically characterized by their round or oval shape, with a white or grayish center surrounded by a red halo. They can vary in size and may be singular or multiple. The exact cause of oral ulcers is not always clear, but several factors may contribute to their development:
1. Trauma: Accidental biting of the cheek or tongue, aggressive brushing, or dental work can lead to ulcer formation.

2. Nutritional Deficiencies: Deficiencies in vitamins and minerals, particularly vitamin B12, folate, and iron, can predispose individuals to develop ulcers.

3. Stress: Emotional stress and anxiety are known triggers for many individuals.

4. Hormonal Changes: Fluctuations in hormones, particularly in women, can lead to the occurrence of ulcers.

5. Underlying Health Conditions: Conditions such as celiac disease, inflammatory bowel disease, and autoimmune disorders can manifest with oral ulcers as a symptom.

Treatment Options
When it comes to treating oral ulcers, several approaches can be taken to alleviate pain and promote healing:
1. Topical Treatments: Over-the-counter topical medications, such as benzocaine or lidocaine, can provide temporary relief from pain. Prescription medications, including corticosteroids, may be recommended for more severe cases.

2. Mouth Rinses: Antiseptic mouthwashes or medicated rinses can help reduce inflammation and promote healing. A common recommendation is a rinse made from a mixture of salt and warm water.

3. Pain Relief: Non-prescription pain relievers, such as acetaminophen or ibuprofen, can help manage discomfort associated with oral ulcers.

4. Dietary Adjustments: Avoiding spicy, acidic, or abrasive foods can help minimize irritation to the ulcers. Soft foods are often recommended during the healing process.

5. Nutritional Support: If nutritional deficiencies are suspected, dietary changes or supplements may be necessary to address these issues.

Concerns About Oral Health
It is understandable to feel anxious about changes in the oral cavity, especially when new lesions or discolorations appear. The presence of white patches or membranes in the mouth can be concerning, but not all white lesions are indicative of serious conditions. For example, leukoplakia is a condition characterized by white patches in the mouth that can be benign or precancerous, depending on the underlying cause.

If you notice persistent changes in the oral mucosa, such as white patches that do not resolve, it is essential to consult a healthcare professional for a thorough evaluation. A dentist or oral specialist can perform necessary examinations, including biopsies if needed, to rule out more serious conditions.

Conclusion
In summary, oral ulcers can be a painful and distressing condition, but understanding their causes and treatment options can help manage symptoms effectively. If you experience persistent or worsening symptoms, or if you have concerns about the nature of your oral lesions, seeking professional medical advice is crucial. Regular dental check-ups and maintaining good oral hygiene can also play a significant role in preventing the occurrence of oral ulcers and ensuring overall oral health.

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