Oral Ulcers: Causes, Symptoms, and Treatment Options - Otolaryngology

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Oral ulcers, commonly known as canker sores or aphthous ulcers, are painful lesions that can occur in the mouth, often causing discomfort during eating, drinking, or even speaking. Understanding the causes, symptoms, and treatment options for oral ulcers is crucial for effective management and relief.


Causes of Oral Ulcers
Oral ulcers can arise from various factors, including:
1. Trauma: Accidental bites, dental work, or irritation from braces can lead to ulcer formation.

2. Nutritional Deficiencies: Deficiencies in vitamins such as B12, folate, and iron can contribute to the development of ulcers.

3. Stress: Emotional stress has been linked to the onset of canker sores.

4. Hormonal Changes: Fluctuations in hormones, particularly in women, can trigger ulcers.

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

6. Infections: Viral infections, such as herpes simplex virus, can cause painful sores in the mouth.


Symptoms of Oral Ulcers
The primary symptom of oral ulcers is pain, which can vary in intensity. Other symptoms may include:
- A small, round or oval sore with a white or yellow center and a red halo.

- Discomfort while eating, drinking, or speaking.

- Swelling in the surrounding tissues.

- In some cases, fever or swollen lymph nodes may accompany the ulcers, particularly if they are due to an underlying infection.


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

2. Oral Rinses: Antimicrobial mouth rinses can help reduce bacterial load in the mouth and promote healing. Saltwater rinses can also be soothing.

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

4. Nutritional Supplements: If the ulcers are linked to nutritional deficiencies, taking vitamin B12, folate, or iron supplements may be beneficial.

5. Avoiding Irritants: Steering clear of spicy, acidic, or abrasive foods can help minimize irritation and pain.

6. Stress Management: Techniques such as mindfulness, yoga, or counseling can help manage stress levels, which may reduce the frequency of ulcer outbreaks.


When to Seek Medical Attention
If an oral ulcer persists for more than two weeks without improvement, it is advisable to consult a healthcare professional. Persistent ulcers may require further evaluation to rule out underlying conditions or infections. Additionally, if you experience significant pain, difficulty swallowing, or if the ulcer is accompanied by fever or swollen lymph nodes, seeking medical attention is crucial.

In your case, since the ulcer has been present for three weeks and is causing discomfort when your tongue touches it, it would be wise to follow up with your healthcare provider. They may recommend further investigation or a different treatment approach if the ulcer does not show signs of healing.


Conclusion
Oral ulcers can be a source of significant discomfort, but understanding their causes and treatment options can help manage symptoms effectively. Maintaining good oral hygiene, addressing nutritional deficiencies, and managing stress are essential components of prevention and treatment. If symptoms persist or worsen, do not hesitate to seek medical advice for a thorough evaluation and tailored treatment plan.