QUESTION: I have been suffering from sores in my mouth for many years now. They look like little craters and are generally very painful. Often the sore starts out as a little pimple, which bursts and then forms a deep sore with a red or white margin. What could this be and how can I treat this problem as it hampers me chewing and eating anything.
ANSWER: Thank you for your question, which I have found to be a very common complaint. The sores you describe can often follow trauma to the oral mucosa – like accidentally biting the inside of your cheek, or a sharp bone scraping the mucosa while eating, and even sports injuries. However, spontaneous lesions can also occur on the undersurface and side of the tongue as well.
Aptheous ulcers are well described lesions associated with various medical conditions.
I see them often in patients who are immunocompromised with a history of being run down, overworked and highly stressed, with accompanying poor sleeping habits and a lack of fresh fruit and vegetables in their diet.
How should I approach the problem?
The worsening of a lesion can be limited by meticulous oral hygiene, including regular flossing and brushing of the teeth, but also gargling rigorously with a chlorehexidine mouthwash.
Symptomatic treatment of these ulcers include home remedies like rubbing the sore with abrasive table salt or even good old whisky, but not for sensitive patients.
I recommend a sticky paste like Orabase that clings to the ulcer and isn’t easily brushed off by the tongue or teeth, used in conjunction with Corsodyl mouthwash. Other remedies include Dequadin and Pyralvex, which have proved useful to some patients.
Follow up and prevention:
Use a gumguard or biting block while sleeping and during sport.
Ensure good oral hygiene, as well as a dietary intake of vegetables and fruit. Sleep enough – at least 7-8 hours per night. If the problem persists you should seek expert medical advice for systemic diseases like Coeliacs disease, Vasculitic or Connective tissue diseases. Recurrent mouth ulcers require further investigation and a medical consultation.
Cape Argus
* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.
He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.
If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.
The advice in this column does not replace a consultation and clinical evaluation with a doctor.