Oral Ulcers: Causes, Symptoms, and Treatment Options

Oral ulceration

On April 28, I developed a sore in my mouth that kept getting larger, and new ulcers appeared in other areas.
I visited the ENT department on May 3, and on May 4, I experienced a dry and painful throat.
By May 6, I had two ulcers initially, but then two more appeared in different locations.
On the morning of May 7, I noticed two additional ulcers in yet another area, meaning that ulcers continued to develop even while I was taking medication.
On April 26, I had oral sex, and my husband noticed the sore in my mouth afterward.
He mentioned that on the day of oral sex, he observed redness in his corona that resembled broken skin but was not painful.
He went to a dermatologist because it seemed abnormal, and the doctor diagnosed it as a candidiasis infection.

Could you please tell me if a candidiasis infection could cause symptoms like mine? Or could it be a sexually transmitted infection or oral cancer? Should I go to a major hospital for further examination? Which department should I consult? Thank you.

If these ulcers require medical attention, how long does it typically take for them to heal? Thank you.

Additionally, I often accidentally get water in my right ear while showering, which sometimes feels stuffy.
I have had a hearing test that came back normal, and I was told it might be due to Eustachian tube dysfunction.
What further implications could this have? Thank you, doctor.

Lastly, my son has had nasal allergies since childhood and frequently clears his throat, making a hoarse sound.
Does he need to see a doctor? Thank you.

Jia You, 50~59 year old female. Ask Date: 2022/05/07

Dr. Zheng Jueyi reply Otolaryngology

Hello, oral ulcers are often related to infections.
If they persist for more than two weeks without healing, it is recommended to visit the ENT or Infectious Diseases department for examination.
If water accidentally gets into the ear while showering, and hearing tests are normal without any signs of ear discharge or infection, it is generally safe to monitor the situation at home.
For children who have allergies and frequently clear their throats, if it affects their daily activities, it is advisable to seek medical evaluation and treatment.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-yi, Director of the ENT Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2022/05/07

More Info

Oral ulcers, also known as canker sores or aphthous ulcers, are painful lesions that can occur in the mouth, often causing significant discomfort. Understanding the causes, symptoms, and treatment options for these ulcers is crucial for effective management and relief.

Causes of Oral Ulcers
Oral ulcers can arise from various factors, including:
1. Infections: Viral infections, such as herpes simplex virus, can lead to the development of oral ulcers. Fungal infections, like candidiasis (thrush), can also cause similar symptoms.

2. Trauma: Physical injury to the mouth, such as biting the inside of the cheek or irritation from dental appliances, can trigger ulcer formation.

3. Nutritional Deficiencies: Lack of essential vitamins and minerals, particularly vitamin B12, folate, and iron, can contribute to the occurrence of oral ulcers.

4. Stress: Emotional stress and anxiety can weaken the immune system, making individuals more susceptible to developing ulcers.

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

6. Hormonal Changes: Fluctuations in hormones, particularly in women during menstruation or pregnancy, can lead to the development of ulcers.

Symptoms of Oral Ulcers
The primary symptom of oral ulcers is pain, which can be exacerbated by eating, drinking, or even talking. Other symptoms may include:
- Redness and swelling around the ulcer
- A burning or tingling sensation before the ulcer appears
- Difficulty swallowing or speaking
- In some cases, fever or swollen lymph nodes if an infection is present

Treatment Options
1. Topical Treatments: Over-the-counter topical anesthetics, such as benzocaine, can provide temporary relief from pain. Additionally, corticosteroid ointments may help reduce inflammation and promote healing.

2. Oral Rinses: Antiseptic mouthwashes can help keep the area clean and reduce the risk of secondary infections. Rinsing with a saline solution or a mixture of baking soda and water can also soothe the ulcers.

3. Pain Relief Medications: Non-prescription pain relievers like acetaminophen or ibuprofen can help alleviate discomfort associated with oral ulcers.

4. Dietary Adjustments: Avoiding spicy, acidic, or abrasive foods can prevent further irritation. Soft, bland foods are recommended during flare-ups.

5. Addressing Underlying Conditions: If ulcers are recurrent, it may be necessary to investigate potential underlying health issues. Blood tests can check for nutritional deficiencies, while a referral to a specialist may be warranted for autoimmune conditions.

6. Prescription Medications: In severe cases, a healthcare provider may prescribe stronger medications, such as corticosteroids or immunosuppressants, to manage symptoms.

When to Seek Medical Attention
If oral ulcers persist for more than two weeks, worsen, or are accompanied by other concerning symptoms (such as fever, difficulty swallowing, or significant weight loss), it is essential to consult a healthcare professional. A visit to an ear, nose, and throat (ENT) specialist or a dentist can provide further evaluation and management options.

Conclusion
In summary, oral ulcers can be caused by a variety of factors, including infections, trauma, nutritional deficiencies, and stress. While they can be painful and disruptive, several treatment options are available to alleviate symptoms and promote healing. If you experience persistent or recurrent ulcers, seeking medical advice is crucial to rule out any underlying health issues and receive appropriate care.

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