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Mouth Ulcers

Dr. HelloDox Care #
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Mouth ulcer
About mouth ulcers
Mouth ulcers are painful sores that appear in the mouth. Although they're uncomfortable, they’re usually harmless and most clear up by themselves within a week or two.

Mouth ulcers are common and can usually be managed at home, without seeing your dentist or GP. Visit your pharmacist first, unless your ulcer has lasted longer than three weeks.

What does a mouth ulcer look like?
Mouth ulcers are usually round or oval sores that commonly appear inside the mouth on the:

cheeks
lips
tongue
They can be white, red, yellow or grey in colour and swollen.

It's possible to have more than one mouth ulcer at a time and they may spread or grow.

Mouth ulcers shouldn't be confused with cold sores, which are small blisters that develop on the lips or around the mouth. Cold sores often begin with a tingling, itching or burning sensation around your mouth.

When to see your pharmacist, dentist or GP
Mouth ulcers can be painful, which can make it uncomfortable to eat, drink or brush your teeth.

It's usually safe to treat mouth ulcers at home. See your GP or dentist if:

your mouth ulcer has lasted three weeks
you keep getting mouth ulcers
your mouth ulcer becomes more painful or red – this could be a sign of a bacterial infection, which may need treatment with antibiotics
Mouth ulcers are also a possible symptom of a viral infection that mainly affects young children, called hand, foot and mouth disease. Speak to your GP or call the NHS 24 '111' service if you're unsure.

Read about the symptoms of hand, foot and mouth disease.

How to treat mouth ulcers
Mouth ulcers don’t usually need to be treated, because they tend to clear up by themselves within a week or two.

However, treatment can help to reduce swelling and ease any discomfort. This may help if you keep getting mouth ulcers or your mouth ulcer affects eating and drinking.

Self care
Things you can do to speed up healing include:

applying a protective paste recommended by your pharmacist
using a soft toothbrush to brush your teeth
using a toothpaste that doesn’t contain sodium lauryl sulphate, as this may be irritating
avoiding hard, spicy, salty, acidic or hot food and drink until the ulcer heals
using a straw to drink cool drinks
avoiding things that may be triggering your mouth ulcers – see causes, below
Pharmacy medicines
You can buy several types of mouth ulcer treatment from a pharmacy. Speak to your pharmacist about the best treatment for you. Options include the following:

Antimicrobial mouthwash may speed up healing and prevent infection of the ulcer. Children under two shouldn't use this treatment. It also contains chlorexidine gluconate, which may stain teeth – but this may fade once treatment is finished.
Painkillers are available as a mouthwash, lozenge, gel or spray. They can sting on first use and your mouth may feel numb – but this is temporary. Mouthwash can be diluted with water if stinging continues. Children under 12 shouldn’t use mouthwash or gel. Mouthwash shouldn’t be used for more than seven days in a row.
Corticosteroid lozenges may reduce pain and speed up healing. These are best used as soon as the ulcer appears, but shouldn't be used by children under 12.
Medicines from your dentist or GP
If necessary, you may be prescribed a course of stronger corticosteroids to help reduce pain and swelling, and speed up healing.

Corticosteroids are available on prescription as tablets, mouthwash, paste or spray, but are not suitable for children under 12.

Is it mouth cancer?
In a few cases, a long-lasting mouth ulcer can be a sign of mouth cancer. Ulcers caused by mouth cancer usually appear on or under the tongue, although you can get them in other areas of the mouth.

Risk factors for mouth cancer include:

smoking or using products that contain tobacco
drinking alcohol – smokers who are also heavy drinkers have a much higher risk compared to the population at large
infection with the human papilloma virus (HPV) – the virus that causes genital warts
It's important to detect mouth cancer as early as possible. If mouth cancer is detected early, the chances of a complete recovery are good. Regular dental check-ups are the best way to detect the early signs.

What causes mouth ulcers?
In many cases, the reason for mouth ulcers is unclear. Most single mouth ulcers are caused by damage to the lining inside of the mouth. For example:

accidentally biting the inside of your cheek or a sharp tooth
poorly fitting dentures
hard food
a defective filling
It’s not always clear what causes mouth ulcers that keep returning, but triggers are thought to include:

stress and anxiety
hormonal changes – some women develop mouth ulcers during their monthly period
eating certain foods – such as chocolate, spicy foods, coffee, peanuts, almonds, strawberries, cheese, tomatoes and wheat flour
toothpaste containing sodium lauryl sulphate
stopping smoking – when you first stop smoking, you may develop mouth ulcers
Your genes are also thought to have a role – around 40% of people who keep getting mouth ulcers to report that it runs in their family.

Medical conditions
Mouth ulcers can sometimes be caused by certain medical conditions, such as:

viral infections – including the cold sore virus, chickenpox, and hand, foot and mouth disease
vitamin B12 or iron deficiency
Crohn's disease – a long-term condition that causes inflammation of the lining of the digestive system
coeliac disease – a common digestive condition where a person has an adverse reaction to gluten
reactive arthritis – a condition that causes inflammation in various places in the body, usually as a reaction to an infection
weakened immune system – for example, due to HIV or lupus
Behçet’s disease – a rare and poorly understood condition that also causes swelling of the blood vessels
Medications and treatments
Mouth ulcers can sometimes be caused by certain medications or treatments, such as:

non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen
nicorandil – a medication sometimes used to treat angina
beta-blockers – used to treat conditions such as angina, high blood pressure and abnormal heart rhythms
a side effect of chemotherapy or radiotherapy – this is known as mucositis

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Cold Soars

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Overview
Cold sores — also called fever blisters — are a common viral infection. They are tiny, fluid-filled blisters on and around your lips. These blisters are often grouped together in patches. After the blisters break, a crust forms over the resulting sore. Cold sores usually heal in two to four weeks without leaving a scar.

Cold sores spread from person to person by close contact, such as kissing. They're caused by a herpes simplex virus (HSV-1) closely related to the one that causes genital herpes (HSV-2). Both of these viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are contagious even if you don't see the sores.

There's no cure for HSV infection, and the blisters may return. Antiviral medications can help cold sores heal more quickly and may reduce how often they return.

Symptoms
A cold sore usually passes through several stages:

Tingling and itching. Many people feel an itching, burning or tingling sensation around their lips for a day or so before a small, hard, painful spot appears and blisters erupt.
Blisters. Small fluid-filled blisters typically break out along the border where the outside edge of the lips meets the skin of the face. Cold sores can also occur around the nose or on the cheeks.
Oozing and crusting. The small blisters may merge and then burst, leaving shallow open sores that will ooze fluid and then crust over.
Signs and symptoms vary, depending on whether this is your first outbreak or a recurrence. They can last several days, and the blisters can take two to four weeks to heal completely. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.

During first-time outbreaks, some people also experience:

Fever
Painful eroded gums
Sore throat
Headache
Muscle aches
Swollen lymph nodes
Children under 5 years old may have cold sores inside their mouths and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren't caused by the herpes simplex virus.

When to see a doctor
Cold sores generally clear up without treatment. See your doctor if:

You have a weakened immune system
The cold sores don't heal within two weeks
Symptoms are severe
You have frequent recurrences of cold sores
You experience irritation in your eyes
Causes
Cold sores are caused by certain strains of the herpes simplex virus (HSV). HSV-1 usually causes cold sores. HSV-2 is usually responsible for genital herpes. However, either type can cause sores in the facial area or on the genitals. Most people who are infected with the virus that causes cold sores never develop signs and symptoms.

Cold sores are most contagious when oozing blisters are present. But you can transmit the virus to others even if you don't have blisters. Shared eating utensils, razors and towels, as well as kissing, may spread HSV-1. Oral sex can spread HSV-1 to the genitals and HSV-2 to the lips.

Once you've had an episode of herpes infection, the virus lies dormant in nerve cells in your skin and may emerge as another cold sore at the same place as before. Recurrence may be triggered by:

Viral infection or fever
Hormonal changes, such as those related to menstruation
Stress
Fatigue
Exposure to sunlight and wind
Changes in the immune system
Risk factors
About 90 percent of adults worldwide — even those who've never had symptoms of an infection — test positive for evidence of the virus that causes cold sores.

People who have weakened immune systems are at higher risk of complications from the virus. Medical conditions and treatments that increase your risk of complications include:

HIV/AIDS
Severe burns
Eczema
Cancer chemotherapy
Anti-rejection drugs for organ transplants
Complications
In some people, the virus that causes cold sores can cause problems in other areas of the body, including:

Fingertips. Both HSV-1 and HSV-2 can be spread to the fingers. This type of infection is often referred to as herpes whitlow. Children who suck their thumbs may transfer the infection from their mouths to their thumbs.
Eyes. The virus can sometimes cause eye infection. Repeated infections can cause scarring and injury, which may lead to vision problems or blindness.
Widespread areas of skin. People who have a skin condition called eczema are at higher risk of cold sores spreading all across their bodies. This can become a medical emergency.
Other organs. In people with weakened immune systems, the virus can also affect organs such as the spinal cord and brain.
Prevention
Your doctor may prescribe an antiviral medication for you to take on a regular basis, if you develop cold sores frequently or if you're at high risk of serious complications. If sunlight seems to trigger your recurrences, apply sunblock to the spot where the cold sore tends to erupt.

To help avoid spreading cold sores to other people or to other parts of your body, you might try some of the following precautions:

Avoid skin-to-skin contact with others while blisters are present. The virus spreads most easily when there are moist secretions from the blisters.
Avoid sharing items. Utensils, towels, lip balm and other items can spread the virus when blisters are present.
Keep your hands clean. When you have a cold sore, wash your hands carefully before touching yourself and other people, especially babies.

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Canker Sore

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Canker sore

Canker sores, also called aphthous ulcers, are small, shallow lesions that develop on the soft tissues in your mouth or at the base of your gums. Unlike cold sores, canker sores don't occur on the surface of your lips and they aren't contagious. They can be painful, however, and can make eating and talking difficult.

Most canker sores go away on their own in a week or two. Check with your doctor or dentist if you have unusually large or painful canker sores or canker sores that don't seem to heal.

Symptoms
Most canker sores are round or oval with a white or yellow center and a red border. They form inside your mouth — on or under your tongue, inside your cheeks or lips, at the base of your gums, or on your soft palate. You might notice a tingling or burning sensation a day or two before the sores actually appear.

There are several types of canker sores, including minor, major and herpetiform sores.

Minor canker sores
Minor canker sores are the most common and:

Are usually small
Are oval shaped with a red edge
Heal without scarring in one to two weeks
Major canker sores
Major canker sores are less common and:

Are larger and deeper than minor canker sores
Are usually round with defined borders, but may have irregular edges when very large
Can be extremely painful
May take up to six weeks to heal and can leave extensive scarring
Herpetiform canker sores
Herpetiform canker sores are uncommon and usually develop later in life, but they're not caused by herpes virus infection. These canker sores:

Are pinpoint size
Often occur in clusters of 10 to 100 sores, but may merge into one large ulcer
Have irregular edges
Heal without scarring in one to two weeks
When to see a doctor
Consult your doctor if you experience:

Unusually large canker sores
Recurring sores, with new ones developing before old ones heal, or frequent outbreaks
Persistent sores, lasting two weeks or more
Sores that extend into the lips themselves (vermilion border)
Pain that you can't control with self-care measures
Extreme difficulty eating or drinking
High fever along with canker sores
See your dentist if you have sharp tooth surfaces or dental appliances that seem to trigger the sores.

Request an Appointment at Mayo Clinic
Causes
The precise cause of canker sores remains unclear, though researchers suspect that a combination of factors contributes to outbreaks, even in the same person.

Possible triggers for canker sores include:

A minor injury to your mouth from dental work, overzealous brushing, sports mishaps or an accidental cheek bite
Toothpastes and mouth rinses containing sodium lauryl sulfate
Food sensitivities, particularly to chocolate, coffee, strawberries, eggs, nuts, cheese, and spicy or acidic foods
A diet lacking in vitamin B-12, zinc, folate (folic acid) or iron
An allergic response to certain bacteria in your mouth
Helicobacter pylori, the same bacteria that cause peptic ulcers
Hormonal shifts during menstruation
Emotional stress
Canker sores may also occur because of certain conditions and diseases, such as:

Celiac disease, a serious intestinal disorder caused by a sensitivity to gluten, a protein found in most grains
Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis
Behcet's disease, a rare disorder that causes inflammation throughout the body, including the mouth
A faulty immune system that attacks healthy cells in your mouth instead of pathogens, such as viruses and bacteria
HIV/AIDS, which suppresses the immune system

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Burning Mouth Syndrome

Dr. HelloDox Care #
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Overview
Burning mouth syndrome is the medical term for ongoing (chronic) or recurrent burning in the mouth without an obvious cause. This discomfort may affect the tongue, gums, lips, inside of your cheeks, roof of your mouth (palate) or widespread areas of your whole mouth. The burning sensation can be severe, as if you scalded your mouth.

Burning mouth syndrome usually appears suddenly, but it can develop gradually over time. Unfortunately, the specific cause often can't be determined. Although that makes treatment more challenging, working closely with your health care team can help you reduce symptoms.

Burning mouth syndrome care at Mayo Clinic

Symptoms
Symptoms of burning mouth syndrome may include:

A burning or scalding sensation that most commonly affects your tongue, but may also affect your lips, gums, palate, throat or whole mouth
A sensation of dry mouth with increased thirst
Taste changes in your mouth, such as a bitter or metallic taste
Loss of taste
Tingling, stinging or numbness in your mouth
The discomfort from burning mouth syndrome typically has several different patterns. It may:

Occur every day, with little discomfort when you wake, but become worse as the day progresses
Start as soon as you wake up and last all day
Come and go
Whatever pattern of mouth discomfort you have, burning mouth syndrome may last for months to years. In rare cases, symptoms may suddenly go away on their own or become less frequent. Some sensations may be temporarily relieved during eating or drinking.

Burning mouth syndrome usually doesn't cause any noticeable physical changes to your tongue or mouth.

When to see a doctor
If you have discomfort, burning or soreness of your tongue, lips, gums or other areas of your mouth, see your doctor or dentist. They may need to work together to help pinpoint a cause and develop an effective treatment plan.

Causes
The cause of burning mouth syndrome can be classified as either primary or secondary.

Primary burning mouth syndrome
When no clinical or lab abnormalities can be identified, the condition is called primary or idiopathic burning mouth syndrome. Some research suggests that primary burning mouth syndrome is related to problems with taste and sensory nerves of the peripheral or central nervous system.

Secondary burning mouth syndrome
Sometimes burning mouth syndrome is caused by an underlying medical condition. In these cases, it's called secondary burning mouth syndrome.

Underlying problems that may be linked to secondary burning mouth syndrome include:

Dry mouth (xerostomia), which can be caused by various medications, health problems, problems with salivary gland function or the side effects of cancer treatment
Other oral conditions, such as a fungal infection of the mouth (oral thrush), an inflammatory condition called oral lichen planus or a condition called geographic tongue that gives the tongue a maplike appearance
Nutritional deficiencies, such as a lack of iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12)
Allergies or reactions to foods, food flavorings, other food additives, fragrances, dyes or dental-work substances
Reflux of stomach acid (gastroesophageal reflux disease, or GERD) that enters your mouth from your stomach
Certain medications, particularly high blood pressure medications
Oral habits, such as tongue thrusting, biting the tip of the tongue and teeth grinding (bruxism)
Endocrine disorders, such as diabetes or underactive thyroid (hypothyroidism)
Excessive mouth irritation, which may result from overbrushing your tongue, using abrasive toothpastes, overusing mouthwashes or having too many acidic drinks
Psychological factors, such as anxiety, depression or stress
Wearing dentures, even if they don't fit well and cause irritation, doesn't generally cause burning mouth syndrome, but dentures can make symptoms worse.

Risk factors
Burning mouth syndrome is uncommon. However, your risk may be greater if:

You're a woman
You're perimenopausal or postmenopausal
You're over the age of 50
Burning mouth syndrome usually begins spontaneously, with no known triggering factor. However, certain factors may increase your risk of developing burning mouth syndrome, including:

Recent illness
Some chronic medical disorders such as fibromyalgia, Parkinson's disease, autoimmune disorders and neuropathy
Previous dental procedures
Allergic reactions to food
Medications
Traumatic life events
Stress
Anxiety
Depression
Complications
Complications that burning mouth syndrome may cause or be associated with are mainly related to discomfort. They include, for example:

Difficulty falling asleep
Difficulty eating
Depression
Anxiety
Prevention
There's no known way to prevent burning mouth syndrome. But by avoiding tobacco, acidic foods, spicy foods and carbonated beverages, and excessive stress, you may be able to reduce the discomfort from burning mouth syndrome or prevent your discomfort from feeling worse.


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Some Best Drinks To Soothe Your Sore And Scratchy Throat

Dr. HelloDox Care #
HelloDox Care
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A sore throat can be very annoying; the itchy feeling that refuses to go away and the constant irritation makes you highly uncomfortable. A sore and scratchy throat occurs as a part of your body's immune response to viral or bacterial infections. Your immune response leads to inflammation and swelling of the mucous membranes in the throat, resulting in soreness. Some of the factors causing sore throat are common cold, flu, allergies, pollutants, smoke, dryness and muscle strain by yelling or talking loudly. Some of the symptoms of scratchy and sore throat may include pain, difficulty swallowing, swollen glands, hoarse voice and swollen, red tonsils. While sore throat can be treated with a few home remedies; however, if it persists for more than a few days, seek medical help, considering it may be an indicator of an underlying health condition.

Home remedies for a scratchy throat include drinking some warm herbal drinks that are said to give instant relief. We have enlisted some essential drinks that you may include in order to get some relief in your throat.

1. Turmeric Milk

According to the book 'The Complete Book of Ayurvedic Home Remedies' by Dr. Vasant Lad, drinking one cup of hot milk boiled with half teaspoon turmeric is helpful in improving the condition. You could also add some ghee to it, which tends to melt and coat your throat, further relieving you of sore throat.

2. Ginger-Cinnamon-Licorice Tea

The book also recommends another remedy that works well is ginger, cinnamon and licorice tea. All you need to do is to take two part ginger, two parts cinnamon and three parts licorice or mulethi. Add one teaspoon of the herbal mixture to glass of water for about five to 10 minutes, and drink up to three times a day.

3. Ginger Tea

Ginger is a spice that contains anti-bacterial and anti-inflammatory properties that may help relieve throat pain. You can simply add ginger to your usual cup of milk tea. Better still, add grated ginger to boiling water and let the water soak all the goodness from it. Add some honey to make it slightly tastier and even more beneficial.

4. Peppermint Tea

Peppermint tea contains anti-inflammatory compounds and is known to be extremely soothing for the throat. Moreover, it can slightly numb your throat, thereby, relieving pain and scratchiness. Add fresh peppermint leaves to boiling water for about three to five minutes and then strain off the leaves. This tea will not only relieve your throat pain, but also replenish your body.

5. Chamomile Tea

Chamomile tea has long been used for medical purposes; thanks to the presence of healing properties. It is believed to promote restful sleep and avoid the constant harsh coughs at night that make you uncomfortable. It anti-bacterial and anti-viral properties help fight against infection, further reducing pain. Make yourself some chamomile tea and drink at least twice a day to get some relief.

Make use of these natural wonders to treat the uncomfortable sore and scratchy throat.

Dr. Smita Shah
Dr. Smita Shah
MD - Allopathy, Obstetrics and Gynecologist, 29 yrs, Pune
Dr. Amol Sonawane
Dr. Amol Sonawane
BHMS, Homeopath, 10 yrs, Pune
Dr. Sonali wagh
Dr. Sonali wagh
BAMS, Ayurveda, 9 yrs, Pune
Dr. Rupesh Khandelwal
Dr. Rupesh Khandelwal
BDS, Dentist, 14 yrs, Pune
Dr. Sujata Bauskar
Dr. Sujata Bauskar
MS/MD - Ayurveda, Ayurveda Panchakarma, 23 yrs, Pune
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