Managing Oral Ulcers and Bad Breath: When to Seek Dental Care

Ulcer, halitosis?

On April 28, I had a mouth ulcer and visited an ENT specialist three times, with the last appointment on May 8.
After finishing the medication, I felt that the ulcer was healing, so I stopped going for follow-ups.
Now, the largest ulcer is no longer painful, but the surface has not completely healed; it has a slight yellowish color and looks different from normal skin.
Should I go for another consultation? I've also had bad breath for at least three days, which was not present when the ulcer was at its worst.
Is it necessary to seek medical attention? I rarely have issues with bad breath, I sleep well, and I haven't eaten anything that could cause heat in my body.
Thank you, doctor.

Jia You, 50~59 year old female. Ask Date: 2022/05/25

Dr. Zeng Guanghui reply Dentistry

1.
If the sore in the mouth is no longer very painful and has a yellowish coating, it indicates that the wound is gradually healing.
As long as oral hygiene is maintained, it should heal slowly.
2.
If there is a persistent problem with bad breath, it may indicate gingival inflammation or even gastrointestinal issues such as acid reflux.
It is advisable to consult a physician for further examination.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/05/25

More Info

Managing oral ulcers and bad breath can be a complex issue, especially when symptoms persist or change over time. Based on your description, it seems that you have been dealing with an oral ulcer since April 28, and while the pain has subsided, the healing process appears incomplete, with a yellowish surface that differs from normal tissue. Additionally, you have been experiencing bad breath for the past three days, which is unusual for you.

First, it’s important to understand that oral ulcers can take time to heal, and their appearance can vary during the healing process. The yellowish color you mentioned could indicate necrotic tissue or a fibrinous coating, which is not uncommon in healing ulcers. However, if the ulcer has not shown significant improvement after several weeks, it may warrant further evaluation.
Regarding the bad breath, it is often associated with oral ulcers due to the presence of bacteria in the mouth, which can proliferate in areas of tissue damage. The fact that you experienced no bad breath while the ulcer was painful suggests that the ulcer may have been more localized and possibly less conducive to bacterial growth at that time. Now that the ulcer is healing but still not fully resolved, the presence of bad breath could indicate that bacteria are thriving in the area, or it could be a sign of another underlying issue, such as gum disease or a systemic condition.

Given that you have already sought medical attention multiple times and have completed a course of medication, it may be beneficial to return to your healthcare provider, especially if you notice any of the following:
1. Persistent Symptoms: If the ulcer has not healed significantly or if the yellowish appearance worsens, it is advisable to have it re-evaluated.
2. Increased Pain or Discomfort: If you experience any resurgence of pain or discomfort, this could indicate an infection or other complications.

3. Changes in Breath: Since you mentioned that the bad breath is a new symptom, it’s worth discussing with your dentist or doctor, as they can assess for any signs of infection or other oral health issues.

4. Systemic Symptoms: If you experience fever, swelling, or any other systemic symptoms, seek immediate medical attention.

In terms of self-care, maintaining good oral hygiene is crucial. This includes brushing your teeth at least twice a day, flossing daily, and possibly using an alcohol-free mouthwash to help reduce bacteria without irritating the ulcer. Staying hydrated and avoiding spicy or acidic foods can also aid in the healing process.

In conclusion, while it is possible that your ulcer is healing normally, the presence of bad breath and the incomplete healing of the ulcer suggest that a follow-up visit to your healthcare provider is warranted. They can provide a thorough examination, possibly perform additional tests, and recommend appropriate treatments to ensure that your oral health is restored. Remember, early intervention can prevent complications and promote faster healing.

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