Oral Ulcers: Causes, Healing Time, and Treatment Options

Q: Oral Ulcers: Causes, Healing Time, and Treatment Options

Confidence： Hello. 1. No healing within two weeks? Where did you hear that? Generally, there is no specific timeframe for healing; it is relative. The key point is that a physician's clinical judgment is the most accurate, regardless of time. 2. Oral lesions c

Oral ulcer

Hello Dr.
Chuang, I do not smoke, drink alcohol, or consume betel nut, and I do not like spicy food, yet I often experience ulcers in my mouth.
In the past, I would sometimes have frequent ulcers, while at other times I would not.
Some ulcers heal quickly, while others take a long time to heal, to the point where I can only find relief after applying medication.
I later noticed that some of these wounds seemed to be caused by accidentally biting myself, which healed faster.
However, if the ulcer appears suddenly without any apparent cause, it takes a very long time to heal (I remember that in the end, they all healed after applying medication).
Last year, I visited a major hospital's oral and maxillofacial surgery department.
The doctor asked if I had any habits of smoking, drinking, or chewing betel nut, and I explained my situation (frequent ulcers and slow healing).
The doctor examined my mouth and seemed to think it was not a significant issue.
I was still concerned, so I went back for two or three more visits (some with different doctors), and the results were generally the same.
I would like to ask the doctor:
1.
Does "not healed within 2 weeks" mean it will only heal naturally (without medication)?
2.
If there is an ulcer or a sore, should I wait about 2 weeks to see if it heals on its own, and if it does not, then go see a doctor to check for possible cancer?
3.
If an ulcer or sore in the mouth or on the tongue persists for about 2 weeks without healing on its own, and then heals only after applying medication, is that considered normal? Could the ulcer be a sign of a problem (like cancer)?
4.
After researching online, I found that the ingredients in oral gels include steroids.
If my mouth ulcers heal only with the use of oral gel, will this lower the immunity of the oral mucosa or tongue, leading to more frequent ulcers?
5.
In the future, if I have an ulcer in my mouth, is it better to apply medication or to let it heal on its own without medication?
Dr.
Chuang, I apologize for having so many questions, and I truly appreciate your help in answering them.
Thank you!

Youxinfen, 20~29 year old female. Ask Date: 2015/05/05

Dr. Zhuang Suhui reply Dentistry

Confidence: Hello.
1.
No healing within two weeks? Where did you hear that? Generally, there is no specific timeframe for healing; it is relative.
The key point is that a physician's clinical judgment is the most accurate, regardless of time.
2.
Oral lesions can be easily diagnosed by experienced physicians through visual examination, and if necessary, a biopsy can be performed for further evaluation.
3.
Applying medication can shorten the healing time of wounds and reduce discomfort and pain.
Again, I emphasize that oral cancer can be easily diagnosed by experienced physicians.
4.
In my personal understanding, the local application of steroids has minimal impact on immunity.
However, since dentistry is not specifically focused on immunology, this is just my personal opinion.
If there are concerns, it is advisable to consult a pharmacist or a rheumatologist.
5.
If you are not afraid of pain, you may choose not to apply medication.
If you are concerned about pain, it is recommended to apply medication.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only serve as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/05/05

More Info

Understanding oral ulcers can be quite complex, as they can arise from various causes and may require different treatment approaches. Oral ulcers, also known as canker sores or aphthous ulcers, are painful lesions that can occur on the mucous membranes inside the mouth. They can be triggered by a variety of factors, including stress, hormonal changes, nutritional deficiencies, and even mechanical trauma from biting the inside of the cheek or tongue.

1. Healing Time: Generally, most oral ulcers will heal on their own within one to two weeks. If an ulcer persists beyond this timeframe without improvement, it is advisable to seek medical attention. The healing process can be influenced by the ulcer's cause; for example, ulcers caused by trauma may heal faster than those related to underlying health issues.

2. Self-Healing vs. Medical Intervention: If you notice a sore or ulcer in your mouth, it is reasonable to monitor it for about two weeks to see if it resolves on its own. If it does not improve or if you experience significant pain, swelling, or other concerning symptoms, it is wise to consult a healthcare professional. This is particularly important if you have risk factors for oral cancer, such as a history of tobacco use or excessive alcohol consumption.

3. Persistent Ulcers: If an ulcer lasts longer than two weeks and eventually heals only after applying medication, it may indicate an underlying issue that needs to be addressed. While many ulcers are benign, persistent lesions can sometimes be a sign of more serious conditions, including oral cancer, especially if they are accompanied by other symptoms like difficulty swallowing, significant pain, or changes in the appearance of the surrounding tissue.

4. Use of Topical Medications: Topical treatments, such as corticosteroid gels, can help reduce inflammation and pain associated with oral ulcers. While these medications can be effective, they should be used judiciously. Prolonged use of corticosteroids may potentially affect the immune response of the oral mucosa, leading to a higher likelihood of developing new ulcers. Therefore, it is essential to follow a healthcare provider's recommendations regarding the frequency and duration of use.

5. Treatment Approaches: When dealing with oral ulcers, the approach can vary. Some individuals may find relief through over-the-counter topical treatments, while others may benefit from prescription medications. In some cases, lifestyle modifications, such as stress management, dietary changes, and improved oral hygiene, can also play a significant role in preventing and managing ulcers.

In conclusion, while many oral ulcers are benign and self-limiting, persistent or recurrent ulcers warrant further investigation. If you experience frequent ulcers or if they do not heal within the expected timeframe, it is essential to consult a healthcare professional for a thorough evaluation. They may recommend additional diagnostic tests, such as blood tests or biopsies, to rule out underlying conditions. Additionally, maintaining good oral hygiene, managing stress, and ensuring adequate nutrition can help reduce the frequency and severity of oral ulcers.

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