and Preventing Painful Oral Ulcers: Expert Tips

Mouth ulcers can often be very painful?

Hello Dr.
Zhao, I often experience cracks in my oral cavity, and it hurts a lot when I eat or drink.
How can I prevent this from happening again? I also applied Guangdong herb powder, but it still hurts.
I really want to know if there are effective methods to heal this quickly.
Thank you for your guidance, and I wish you good health.

Lai, 40~49 year old female. Ask Date: 2003/08/05

Dr. Zhao Chongliang reply Internal Medicine

If there are frequent ulcers in the oral cavity, it is likely recurrent aphthous stomatitis, also known as stubborn oral ulcers or canker sores.
The exact cause is currently unclear, but it may be related to individual constitution.
Other factors that can easily trigger recurrent aphthous stomatitis include fever, stress, poor emotional state, insomnia, hormonal changes (such as premenstrual), irregular lifestyle, specific dietary habits, skin diseases, central nervous system disorders, digestive issues, and neurasthenia.
Based on my clinical observations, I believe it is also related to a deficiency in B vitamins.
Therefore, while general practitioners typically treat it with chemical acids or gentian violet (to form a protective membrane to alleviate pain) or corticosteroid oral ointments (to shorten recovery time), I also add B vitamins to the treatment.
In terms of dietary therapy, cocoa can also be effective.
However, it is important to note that if there are ulcers in other mucosal areas (especially in the external genitalia), red eyes, fatigue, or if the ulcers do not heal for a long time, it may not be a simple case of recurrent aphthous stomatitis, but rather a more serious condition such as autoimmune diseases (like Behçet's disease), herpes, or oral cancer (especially in individuals with a habit of chewing betel nut or smoking), and they should seek consultation at a major hospital.

Reply Date: 2003/08/05

More Info

Oral ulcers, often referred to as canker sores or aphthous ulcers, can be a painful and frustrating condition. They can occur for various reasons, including stress, hormonal changes, nutritional deficiencies, and certain medical conditions. Understanding the causes and implementing preventive measures can significantly reduce the frequency and severity of these painful sores.

Understanding Oral Ulcers
Oral ulcers are small, painful lesions that can develop on the soft tissues of the mouth, including the inside of the cheeks, gums, tongue, and lips. While the exact cause of recurrent oral ulcers is not fully understood, several factors may contribute to their development:
1. Nutritional Deficiencies: Deficiencies in vitamins and minerals, particularly B vitamins (such as B12, folic acid, and riboflavin), iron, and zinc, can lead to the formation of ulcers. Ensuring a balanced diet rich in these nutrients can help prevent their occurrence.

2. Stress and Hormonal Changes: Emotional stress and hormonal fluctuations, such as those occurring during menstruation, can trigger the onset of oral ulcers. Managing stress through relaxation techniques, exercise, and adequate sleep may help reduce their frequency.

3. Food Sensitivities: Certain foods, particularly acidic or spicy foods, can irritate the oral mucosa and contribute to ulcer formation. Keeping a food diary to identify potential triggers can be beneficial.

4. Underlying Medical Conditions: Conditions such as celiac disease, inflammatory bowel disease, and autoimmune disorders can predispose individuals to recurrent oral ulcers. If ulcers persist or are accompanied by other symptoms, it may be necessary to consult a healthcare professional for further evaluation.

Preventive Measures
To prevent the occurrence of oral ulcers, consider the following strategies:
1. Maintain Good Oral Hygiene: Regular brushing and flossing can help prevent infections and irritations that may lead to ulcers. Use a soft-bristled toothbrush to avoid trauma to the oral tissues.

2. Stay Hydrated: Drinking plenty of water can help keep the mouth moist and reduce irritation. Avoiding excessive caffeine and alcohol, which can lead to dehydration, is also advisable.

3. Balanced Diet: Incorporate a variety of fruits, vegetables, whole grains, and lean proteins into your diet. Foods rich in vitamins and minerals, particularly B vitamins, can support oral health.

4. Avoid Irritating Foods: If you notice that certain foods trigger your ulcers, try to avoid them. Spicy, acidic, or rough-textured foods can exacerbate the pain and irritation.

5. Stress Management: Engage in stress-reducing activities such as yoga, meditation, or deep-breathing exercises. Finding healthy outlets for stress can help mitigate its impact on your oral health.

6. Topical Treatments: Over-the-counter topical treatments, such as benzocaine or aloe vera gel, can provide temporary relief from pain and promote healing. However, it’s essential to follow the instructions and not overuse these products.

When to Seek Medical Attention
If you experience persistent or unusually severe oral ulcers, or if they are accompanied by other symptoms such as fever, difficulty swallowing, or significant swelling, it is crucial to seek medical attention. A healthcare provider can evaluate your condition, rule out underlying health issues, and recommend appropriate treatments.

In summary, while oral ulcers can be painful and bothersome, understanding their causes and implementing preventive measures can significantly improve your oral health. Maintaining a balanced diet, managing stress, and practicing good oral hygiene are key strategies to minimize the occurrence of these painful sores. If problems persist, consulting a healthcare professional is advisable for further evaluation and treatment options.

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