Mouth ulcers

The mucosa of the oral cavity is quite thin and sensitive, so various ulcers in the mouth - not uncommon. In many people, the appearance of such "sores" is associated with a lack of immunity, or with the attachment of viral, fungal, microbial infection. Ulcers can be very painful and cause discomfort, or practically do not bother, reminding of themselves only during meals. The treatment scheme can be built only after clarifying the cause of the problem.

Epidemiology

Oral diseases, including ulcers, can bother people of any age category - starting from the period of newborns and throughout life.

According to statistical studies of two years ago, every second inhabitant of the planet suffers from one or another disease of the oral cavity: tooth decay ranks first, periodontal diseases second. Ulcers of various etiologies occupy only the fourth place in this row, after oncological problems.

The most common root cause of canker sores is an unhealthy diet with an unreasonably high percentage of sugars, as well as smoking and alcohol consumption. In addition, lack of proper hygiene and fluoride deficiency are additional factors, which generally have a negative impact on oral health.

Causes of the mouth ulcers

There can not be any single cause of the formation of ulcers on the oral mucosa. The problem can be provoked by an infectious agent, systemic pathology, mechanical or chemical irritant, allergies. It also happens that the cause can not be determined at all. If we consider the issue globally, we can say the following: constantly produced salivary fluid creates a protective barrier for the mucosal tissue, and any factor that affects the production of saliva, can increase the risk of ulcers.

The following causes are considered to be the most common:

• The presence of a microbial, viral or fungal pathogen;
• mechanical trauma to the inside of the cheeks, palate, tongue, gums;
• chemical or thermal effects on mucosal tissues;
• smoking;
• prolonged use of certain medications, powerful antibiotic therapy, radiation therapy;
• systemic diseases, exhaustion, hypovitaminosis.

In many pathological situations, ulcers become a sign of a serious disease - for example, stomatitis. Further we will discuss the reasons for the appearance of sores on the mucosa in connection with one or another disease.

• Mucous stomatitis mouth ulcers are caused by the fungal infection Candida albicans. This disease is contagious and can be transmitted from one person to another - for example, by kissing, using other people's cutlery, cups and so on. Most often the disease is detected in childhood, against the background of weak immune defense, unstable composition of the flora in the oral cavity. A particular impetus to the development of fungal stomatitis is given by the prolonged use of antibiotics of a broad spectrum of activity. [1]
• Mouth ulcers in HIV are mainly caused by the herpes simplex virus. Frequent and painful recurrences of herpetic stomatitis are characteristic, sometimes without signs of remission. No less often develop and other pathologies such as ulcerative-necrotic gingivostomatitis with a progressive course, aggressive periodontitis, chronic hyperplastic candidiasis. All lesions of the mucous membranes and skin are usually associated with excessively weak immune activity in the body and rapid infection of any wound or defect. [2]
• Ulcers in the mouth in syphilis are caused by the active activity of the pale treponema, which can be in the body in the domestic, sexual or intrauterine way. Predisposing factors are often mucosal defects, gum disease, trauma in the mouth. [3], [4]
• Ulcers in the mouth after chemotherapy are caused by the fact that chemotherapy drugs do not just kill tumor cells, but to varying degrees harm healthy structures of the body, including cells of the oral mucosa. The side effect of chemotherapy is to affect the teeth, gums, salivary glands, oral mucous tissues. Against the background of dry mouth, a general decline in immunity easily develop infectious and inflammatory processes.
• Ulcers in the mouth in chickenpox are formed by the active herpes virus of the third type (its other name is Varicella-zoster). When entering the lymphatic and circulatory system, the virus begins to multiply, and when it reaches the superficial skin and mucosal layers, it manifests itself in the form of rashes known to everyone. Manifestations of chickenpox in the mouth are called enanthema. [5]
• Ulcers in the mouth with cancer are formed against the background of certain precancerous diseases. These are Keir's erythroplasia, Bowen's disease, ulcerative and verrucous leukoplakia. Other factors are often occupational influences, lack of retinol in the body. These causes become triggers and significantly increase the risk of developing a neoplastic process. [6], [7]
• Herpes mouth sores are caused by the viral infection HPV. This disease is also contagious and is transmitted through kissing, skin contact. The ulcer is not the first sign of herpes. At first, a characteristic bubble (tubercle) is formed, which opens and transforms into an ulcerous defect. [8]
• Tuberculous ulcer in the oral cavity develops under the influence of the causative agent - Koch's bacillus. Ulcerative elements are characterized by a secondary nature, since they appear due to the spread of infection and its toxins from open inflammatory foci through the blood and lymphatic systemic pathways. If the patient suffers from a pulmonary form of tuberculosis, then the infection can penetrate the oral mucosa with sputum secretions. This form of ulcerative lesion is not often diagnosed, because usually Koch's bacilli die in the environment of the oral cavity. [9]
• Ulcers in the mouth with sore throat can occur with a combination of inflammatory processes, which in medicine is called stomatitis tonsillitis. Such a disease is most often provoked by the herpes virus, and the trigger is a sharp drop in immunity, avitaminosis, dystrophy or physical exhaustion. [10]
• Ulcers in the mouth with hepatitis are associated with a variety of functions of this organ. The liver is actively involved in digestive and metabolic processes, in particular, in vitamin, trace element, protein, pigment metabolism, and also performs a complex antitoxic function. With liver disease, the salivary glands may malfunction, hypovitaminosis occurs, which often becomes the cause of ulceration of the mucosa in the mouth. Most often such pathology is characteristic of the chronic course of hepatitis. [11]
• The appearance of mouth ulcers after antibiotics is usually associated with too long antibacterial course, with the intake of too strong medications of a broad spectrum of activity. Both the first and the second cause lead to pronounced changes in the composition of the flora in the mouth. Antibiotics inhibit the development of certain varieties of beneficial microbes, making room for the activity of opportunistic and pathogenic flora. As a result, an infectious inflammatory process develops, more often of fungal etiology.
• Mouth ulcers in chlamydia are caused by infection with Chlamydia pneumonia or Chlamydia trachomatis. Only people with genital and extragenital chlamydia become sources of infection. The causative agent of the infection can end up in the oral cavity during oral sexual intercourse with a sick person, or by licking fingers contaminated with pathologic secretions. Children can become ill intrapartum, during childbirth, if the woman is infected with chlamydia.

If mouth sores appear after kissing, this indicates a clear infectious disease, such as herpes virus or candidiasis. In this situation, it is important to treat both partners.

Isolated ulcers located only in the oral cavity, without other pathological signs, in most situations are due to viral infection, or a recurrent form of aphthous stomatitis.

If there are symptoms outside the oral cavity, skin rashes, fever, then such a condition requires mandatory additional diagnostics.

Risk factors

One or a combination of several factors increases the likelihood of pathologic elements in the oral cavity:

• smoking, chewing tobacco;
• alcohol abuse;
• Lack of adequate oral and dental care, wearing dentures, improper placement of dental implants;
• the presence of papillomavirus in the body, HIV;
• red squamous lichen planus;
• acute weakening or chronic weakness of the immune system;
• Malnutrition with low intake of plant foods, lack of antioxidants and vitamins;
• metabolic disorders, endocrine diseases, diabetes;
• oral dysbiosis;
• Regular or prolonged treatment with medication;
• regular consumption of too hot, spicy, acidic food.

Pathogenesis

In the appearance of ulcers in the mouth is most often "to blame" infection. The causative agent may be staphylococci and streptococci, somewhat less often - viruses, fungi, fusiform bacteria.

The mucosal tissue of the oral cavity often acts as an entrance door for infection, for example, in the case of physical injuries or disorders against the background of general infectious pathology. The pathogen enters the mouth by droplet-aerogenic or alimentary (food) routes from sick people or carriers. Under certain conditions - for example, with a general weakening of immune defense, or with poor resistance of mucosal tissues in the mouth, the disease properties of conditionally pathogenic and pathogenic flora are significantly enhanced.

An important role in the appearance of ulcers in the mouth plays allergies, which can be food or drug allergies.

Depending on the prevalence of ulcers, they are pathogenetically subdivided into superficial and deep.

Symptoms of the mouth ulcers

Fibrinous ulcers occur after primary disturbances of blood circulation in the epithelium. Single aphthae appear, covered by a fibrous film. After about 1-2 weeks, epithelialization of the wounds occurs, which are usually located on the inner side of the lips or in the transition zone of the folds.

Aphthous-necrotic ulcers that appear against the background of primary epithelial destruction, accompanied by signs of dystrophy, necrosis and necrobiosis of the epithelium. Such a problem is often found in people with serious somatic pathologies or blood diseases. Wounds can be practically painless, prone to deepening. The duration of the healing process varies from 14 days to 4 weeks.

Grandular ulcers occur when the ducts of the minor salivary glands are dysfunctional. The disease occurs with glandular hypofunction, and mucosal defects are formed in close proximity to the glands. The wounds are quite painful, healing takes place within 7-21 days. The recurrence of the disease is not excluded against the background of a sharp drop in immunity, pulmonary pathologies, relapses of chronic infectious processes.

Deforming ulcers are characterized by a severe course, wounds have a persistent character. Epithelialization is slow, with varying degrees of tissue deformation.

Mouth ulcers vary in appearance and size, depending on many factors and causes. They can affect almost any area of the oral mucosa, including the lips.

The first signs are often expressed in the appearance of limited edema and redness of the mucosal tissue, sometimes formed tubercles or blisters, which later transform into more or less painful ulcers.

In general, an ulcer can be characterized as a defect formed in the superficial tissues of the oral cavity when the upper cellular layer is destroyed. Most ulcers have a reddish tint, but there are also whitish and grayish wounds, the color of which is due to the presence of dead cells in the central part, or food particles. Some of the pathological elements rise above the surface, may be filled with liquid content like blisters. General examination of the oral cavity reveals no other abnormalities, or there are signs of inflammation of the gums, tongue, tonsils, etc.

In the benign course of the process, pain is usually present until complete epithelialization of the defect. Painful sensations often cause loss of appetite: the patient loses body weight, becomes weak, lethargic, irritable.

Some wounds have a tendency to recur.

Additional symptoms may include the following:

• burning sensation, itching;
• increased saliva production;
• bad breath;
• Hyperthermia (up to 38-39°C);
• thickening, soreness of nearby lymph nodes.

If additional painful signs appear, or if the ulcer does not heal within a week, a medical professional should be consulted.

Mouth ulcers in adults

Irritation and ulceration of the oral mucosa in adults can be associated with a variety of causes and diseases. And more common are stomatitis, candidiasis, herpes and leukoplakia. The manifestations of each disease are different, as well as treatment, so it is not recommended to refuse to go to the doctor. It should be taken into account and the fact that many pathologies are capable of acquiring a chronic course. Therefore, the earlier you take action, the better the prognosis will be.

The basic principles of treatment of ulcers in adults are as follows:

• elimination of general symptoms (pain, burning, hyperthermia);
• Accelerating the healing of wounds, preventing the multiplication of pathogens;
• eradicating the cause of the pathology.

It is obligatory to choose a suitable diet, if necessary - correction of the bite (or denture), therapy of concomitant diseases, sanitation of the oral cavity (neutralization of existing foci of infection).

Mouth ulcers in pregnancy

Carrying a baby is a time of powerful hormonal restructuring in the female body, which directs all its forces to preserve the fetus, to ensure its viability. During pregnancy, the activity of the immune system decreases, which often causes the development of inflammatory processes, including in the oral cavity.

Lowering immune protection doctors consider the main provoking factor, because there is a suppression of natural defense mechanisms that can react incorrectly to fetal tissues, do not accept them. All this gives impetus to the activation of multiplication of opportunistic flora and the formation of ulcerative inflammatory foci.

What should a future mom do to protect herself from such a problem?

• Control the state of the digestive tract, choose the right diet.
• Eliminate flour products and sweets.
• Give up bad habits (which in pregnancy goes without saying).

Self-medication should be excluded completely: medications should be prescribed only by a doctor who is aware of the "interesting position" of the patient.

Sores in the baby's mouth

When ulcerated foci appear inside the child's oral cavity, it is desirable to immediately contact your local pediatrician, or a pediatric dentist. The problem can arise for a variety of reasons. So, the "culprit" often becomes gingivitis, stomatitis, thrush, as well as chicken pox, allergic processes and hypovitaminosis.

Almost any type of ulcer gives the baby a pronounced discomfort, and it is noticeable: children refuse to eat, sleep restlessly (or do not sleep at all), show irritability, crying, cranky.

The most common root cause of the problem doctors consider prolonged drug treatment, which is very weakening the immune system: we are talking about taking antibiotics or corticosteroid drugs, chemotherapy. In very young children ulcers can appear due to teething: in this period, the mucous tissues are particularly sensitive, and the baby "pulls" in the mouth everything that falls into his hand.

Despite the fact that mouth ulcers rarely become dangerous, it is always better to start treatment in time. Therefore, it is not worth delaying a visit to the doctor.

Stages

An oral ulcer has several stages of development:

• Acute stage: the wound is a defect of mucosal tissue, with different sizes, shape and depth. Most often the ulcer has a round or oval configuration, clear hyperemic and edematous edges.
• Inflammatory process subsides: hyperemia and swelling decrease, the wound becomes flatter, clears and heals.

Forms

These ulcerative lesions of the oral cavity are the most common:

• Aphthous stomatitis is regularly appearing white ulcers in the mouth, small in size and depth. Their location varies: on the upper palate, the inside of the cheeks, on the mucous tissues of the lips and tongue. Gums are usually not involved in the process. Ulcer on the palate in the mouth usually passes for a week, but subsequently can appear again, since the disease is characterized by a recurrent course. The lesion on the tongue heals somewhat longer, within 7-10 days, sometimes up to two weeks. Especially painful are considered wounds under the tongue. Ulcers on the cheek in the mouth can also occur in a recurrent form, with a regularity of exacerbations from once a month to 1-2 times a year. In many patients, recurrences are seasonal.
• Ulcerative gingivitis is a disease in which an ulcer appears in the mouth on the gum, and the inflammatory process spreads not to all the soft tissues of the oral cavity, but is limited to the gum tissue. Ulcerative gingivitis can be accompanied by fever, general discomfort, lethargy. Gingival tissues bleed, swell, ache. Most often such a disease is a consequence of catarrhal gingivitis, which was not adequately treated.
• The infectious inflammatory process is often accompanied by symptoms such as mouth ulcers and fever. In this case, the most common causative agent is the herpes virus, in which a mouth ulcer may appear on the lip (on the outer or inner side). Such a virus usually leads to the development of recurrent infection, with lesions not only in the oral cavity, but also in the skin, eyes and so on. At the beginning of the disease, a painful blister is formed, one or more, which later transforms into an equally painful ulcer.
• Canker sores are well-known ulcers in the corners of the mouth, the appearance of which may be associated with different causes. Thus, sores develop with hypovitaminosis, with a sharp weakening of the immune system, with a broken bite. In most cases, the problem resolves itself after some time.
• Hyperthiform stomatitis is characterized by the appearance of numerous small ulcers, like herpetic rashes. If the patient complains that the mouth ulcer located under the tongue hurts, it is most often about this form of the disease.
• Decubital ulcer in the oral cavity is formed as a result of the damaging effect on the oral mucosa of a constant traumatic factor - for example, when rubbing with dentures, orthodontic brackets, tooth fragments, etc. At first there is infiltration of the superficial layer of the mucosa. Then the infection joins, the inflammatory process starts. The formation of whitish purulent plaque is possible.
• Trophic ulcer in the oral cavity is formed for any of the pathological reasons in patients suffering from decompensated form of cardiovascular, pulmonary diseases, as well as in other pathologies accompanied by trophic disorders and local neurovascular disorders. Trophic ulcers are more often diagnosed in elderly patients.
• Molluscum contagiosum, a disease associated with the activation of fungal infection, is characterized by the appearance of whitish sores covered with a plaque or film. Ulcers and breath odor occur more often in childhood, against the background of prolonged therapy with antibiotics, or in patients with weakened immune defense.
• Wensan stomatitis is an infectious pathology in which a purulent ulcer is formed in the mouth. The causative agent is a fusobacterium or spirochete. At the beginning of the infectious process, redness is observed, soft tissues begin to bleed, saliva secretion increases, temperature rises, general well-being and appetite suffer. After a few days, purulent ulcers with greenish-gray plaque are formed, which, when attempting to remove, exposes a bleeding wound. The disease is dangerous with deepening necrosis of tissues to muscles and even bones.
• Oral tuberculosis may be primary or secondary, e.g. In advanced pulmonary tuberculosis. A slit-shaped or round wound with loose contours is formed: it is painful, bleeding, and grayish-yellowish nodules are visible in its depth. Over time, a rather large ulcer in the mouth forms from a multitude of miliary elements, and the process spreads to the tongue.
• A traumatic mouth ulcer is caused by damage to the mucous tissues - for example, by a mechanical irritant (denture, tooth splinter, etc.). If such an irritant is not eliminated, the wound will expand and worsen. Do not expect that the ulcer from the denture in the mouth will heal on its own: the mucosa can not "get used to" the constant irritation, so it is necessary to consult a specialist and correct the denture.
• Xerostomia is a pathological condition caused by a reduction in saliva production by the glands involved. Permanent dryness of the mucosa provokes a number of unfavorable symptoms: these include speech and swallowing problems, dry mouth and ulcers, which are particularly pronounced along the gum line. The diagnosis of xerostomia can be made by a dentist.
• Seton's aphthosis is a type of recurrent stomatitis. Aphotic ulcers of the oral cavity are found, which are characterized by sharp painfulness, but they heal within a couple of weeks. Recurrences are frequent: up to six times a year. Aphthae are usually covered with a fibrinous film, have a tendency to deepen. After epithelialization, a scar forms at the site of the wound.
• Necrotic form of gingivostomatitis is acute and represents one of the variants of viral infection. The patient has bloody ulcers in the mouth: the bottom of the wounds bleed, the gums look swollen. As with thrush, bad breath is possible. However, if in candidiasis it is sour, in this case it has a putrid tinge. Red ulcers in the mouth can be covered with a greenish plaque. Their most common localization is the inner surface of the cheeks, tonsils and palatine palate.
• Ulcerative sore throat is an atypical inflammation of the palatine tonsils, in which ulcers are formed on the mucous tissue. The causative agent is a fusospirochete infection, but sometimes coccal flora is also isolated. Patients complain that the throat hurts and ulcers in the mouth or on the tonsils. There may be a putrid odor and increased salivation.
• Oral cancer is a malignant process involving the lips, inner surface of the cheeks, pharynx, tonsils, salivary apparatus. The most obvious sign of the disease is a non-healing black ulcer in the mouth, loss of sensation, numbness of the tongue or lips. The main risk factor here is bad habits: smoking and alcohol abuse.
• In oral syphilis, malignant processes may appear painless ulcers in the mouth. Ulcers can be located singly or multiple, more often have the form of a rounded elevation with diametric dimensions of up to 5-10 mm. Shankr is not accompanied by pain, its center is prone to necrotization: a crater is formed, covered with a yellow-gray greasy film. Both syphilis and malignant tumors are characterized by enlargement of cervical, mandibular and occipital lymph nodes.

Psychosomatics for mouth ulcers

The mucous membrane in the mouth often becomes a reflection of the "well-being" of all organs and systems in the body. The mucous tissue is constantly affected by various external factors, often pathogenic in nature, with which the defense system, called immunity, cannot cope.

To date, ulcerative lesions of the mucosa are considered by many specialists from a general perspective, since no one doubts that such pathological processes are closely related to changes in the body as a whole. The trigger mechanism may be a specific disease of any organ, as well as metabolic disorders, malfunction in the cardiovascular, digestive, hematopoietic system. Huge influence and such unfavorable factors as stressful situations, psychological trauma, chronic fatigue. All that we have indicated, is directly related to the suppression of local and general immune defense. It is important to detect and identify these factors, which will help to develop the correct therapeutic and preventive tactics.

Complications and consequences

Lack of timely treatment measures in the appearance of ulcers in the mouth can lead to the development of various complications. For example, unfavorable consequences can be as follows:

• infection, suppuration of ulcerous and erosive wounds;
• disturbed chewing process, lack of appetite, which, in turn, negatively affects the entire digestive tract (there are diarrhea, constipation, impaired digestion);
• irritability, psycho-emotional instability, sleep disturbances.

Of course, sometimes the problem disappears on its own, even without any treatment.

But if for a long time does not pass ulcer in the mouth, or aggravated, or accompanied by other painful symptoms, then consultation with a doctor should be mandatory. First of all, should be alerted to such accompanying signs:

• enlargement of the submandibular lymph nodes;
• rashes, blisters;
• blood coming out of the ulcers;
• a rise in temperature.

Any of these symptoms combined with ulcerative lesions of the oral mucosa is a reason to see a specialist - such as a dentist or general practitioner - as soon as possible.

Diagnostics of the mouth ulcers

At the first diagnostic stage, the doctor asks the patient about his or her state of health, existing diseases, and symptoms that are bothering him or her today. No less important may be information about dietary habits, occupational activity, bad habits. The doctor should find out whether there is no exposure to any of the factors that can cause the development of an ulcerous process in the mouth. In addition, it is necessary to collect an anamnesis of the sexual life of the patient.

The next step is to conduct a physical examination, with close inspection of the mouth, skin, eyes, and sometimes the genitals (if a sexually transmitted disease is suspected).

If necessary, the doctor prescribes blood tests, seeding or biopsy of damaged tissues. Such a need arises if the specialist detects some suspicious or unclear signs that require laboratory clarification. For other patients, such tests are not mandatory.

Instrumental diagnosis is performed when the causes of ulcers are suspected to be systemic diseases.

Differential diagnosis

Differential diagnosis is sometimes difficult, as mouth ulcers can be a sign of a number of diseases, and even such serious diseases as tuberculosis, human immunodeficiency virus, syphilis. If tuberculous and syphilitic ulcers have their own characteristic features, which the practitioner will immediately distinguish, then patients with HIV often develop ordinary thrush or stomatitis, with further complications in the form of deep erosions. It should be borne in mind that in serious pathologies, damage to mucosal tissues is not just deep: the process can spread to the bone tissue inclusive.

Treatment of the mouth ulcers

Depending on the cause of appearance, different types of ulcers require a different approach to treatment. The doctor must first examine the wounds, conduct a bacteriological analysis and only then prescribe certain therapeutic procedures. For long-term non-healing and chronic processes are necessarily applied measures to strengthen the immune system, prescribed vitamins.

Treatment procedures should be comprehensive, external treatment is complemented by general, systemic treatment. The assistance of a surgeon is required only in deep, neglected painful processes.

Treatment of bacterial infections is always accompanied by antibiotic therapy: drugs are selected according to the causative agent of the disease. Mechanical damage to the mucosa heals on its own, provided that the damaging factor is removed (broken tooth, improperly installed dentures, too hot food, etc.). In stomatitis and herpes also prescribe treatment corresponding to the diseases.

Depending on the infection that provoked the appearance of ulcers, antifungal agents (Fluconazole, Ketoconazole), antimicrobials (Stomatidine, Chlorhexidine, Inhalipt), etc. Are prescribed. Special lubricants, such as gels, are used to relieve pain.

Patients with tuberculosis or syphilis are treated with systemic therapy, and HIV patients are supplemented with antiviral medications.

Medicines that your doctor can prescribe

• Analgesics, anesthetic drugs:
  • Anesthesin in tablets is a local anesthetic analgesic, which quickly relieves painful sensations. Ulcers are sprinkled with crushed powder obtained from Anesthesin tablets. It is also allowed to use the same remedy in the form of ointment. Frequency of application - three times a day. If an allergy to the drug develops, its use is stopped.
  • Hexoral tablets - an effective antibacterial anesthetic, the action of which is due to the active ingredients chlorhexidine and benzocaine. Tablets are resorbed behind the cheek or under the tongue, no more than eight pieces per day, one piece at an interval of 2 hours. Tablets are contraindicated in children under four years of age. Possible side effects: numbness of the tongue, change in taste sensations, reversible discoloration of mucous membranes.
  • Lidocaine asept spray - a local anesthetic drug, which is used carefully and if possible in minimal doses. It is optimal to carry out 1-2 injections per day. Caution: allergic reaction may occur.
• Antiseptic, anti-inflammatory drugs:
  • Sprays - Ingalipt, Hexoral - are means of combined action. Before use, the mouth is rinsed with warm water, then irrigate the affected area of the mucosa, three or four times a day. The duration of treatment is usually 1-1.5 weeks. Means can cause an allergic reaction, so the first use should be careful.
  • Holisal gel for the oral cavity has anti-inflammatory, analgesic and antiseptic properties. The gel is applied to the affected area and gently rubbed for two minutes. Repeat two to three times a day. Do not eat or drink for half an hour after the procedure. In some patients, the gel can cause irritation of the mucosa, which is a reason to cancel the drug.
  • Ingafitol - a medicinal collection that is used for mouth rinses: 2 tablespoons of raw materials are poured 200 ml of boiling water, covered with a lid, kept until cooling. Then the infusion is filtered and used for gargles, three or four times a day, after meals. The resulting remedy is stored in the refrigerator for no more than two days. Before use, it is brought to a warm state.
  • Stomatidine is a solution of hexetidine, a known antimicrobial and antiseptic agent. Use for rinsing the oral cavity 2-3 times a day, 15 ml per procedure. Swallowing the remedy is not allowed!
  • Cameton spray based on chlorobutanol, camphor and menthol. It has antiseptic and local anesthetic effect, reduces swelling. The spray can be used in children from the age of five. The duration of therapy is determined individually, but it should not exceed 14 days. Frequency of use - up to four times a day. Possible side effects: shortness of breath, allergic reaction, itching.
• Antifungal, antiviral, antihistamine agents:
  • Zovirax is an antiviral agent in the form of tablets and cream. It is actively used to treat ulcers that are caused by the herpes simplex virus. The dosage is determined individually.
  • Tavegil - antihistamine systemic agent. Appointed 1 tablet in the morning and at night, before meals. Possible side effects: drowsiness, a feeling of fatigue.
  • Nystatin - tablets with antifungal effect. Take one tablet up to 4 times a day, therapeutic course of 1-2 weeks. The drug is prescribed for the treatment of adults and children from the age of six years. Probable side effects: nausea, a feeling of bitterness on the tongue, photosensitization phenomena.
• Preparations with healing effect:
  • Sea buckthorn oil is a natural remedy to stimulate reparative processes. Use for application to mouth ulcers, 3-4 times a day, until complete regeneration of tissues. Caution: the oil can cause allergies.
  • Proposol spray - antiseptic, wound-healing preparation in the form of a spray. It can be used by adults and children from 12 years of age, 1-3 times a day, depending on the severity of the disease process. Duration of treatment - up to one week. Do not use the remedy if there is an allergy to bee products.
  • Vinylin (another name - Shostakovsky balm) - a remedy with a pronounced bacteriostatic, analgesic and healing properties. Usually Vinilin is applied to the affected areas once a day, at night. Duration of use - up to 20 days. The drug is well tolerated by the body, side effects have not been detected.

What to cauterize a mouth ulcer with?

This is what you use to cauterize mouth ulcers at home:

• with hydrogen peroxide;
• with calendula tincture;
• with propolis tincture;
• baking soda;
• with chlorhexidine;
• with Miramistin.

Wounds are treated pointwise, trying not to get on the surrounding healthy mucosa. The optimal number of treatments is 2-3 times a day, until persistent healing.

Keep in mind that if the ulcers do not heal within 10 days, you should seek help from a medical professional.

Mouthwash for ulcers.

Reliable and effective home remedies for mouth ulcers are mouthwashes:

• baking soda solution (dissolve 1 tablespoon of baking soda in 200 ml of warm water);
• boric acid solution (dilute 1 teaspoon of the remedy in 150 ml of water);
• hydrogen peroxide solution (mix 1 teaspoon of peroxide in 100 ml of water);
• with a weak solution of potassium permanganate (a pinkish colored liquid should be obtained);
• with furacilin solution.

Some patients add a few drops of iodine, honey, aloe juice to the rinse liquid. In addition, with ulcers effectively rinse the oral cavity with an infusion of chamomile, calendula, sage, decoction of oak bark.

Ointments and gels for mouth ulcers

For fungal, traumatic, viral and bacterial ulcers, topical application of gels or ointments directly to the wound surfaces is often prescribed:

• Solcoseryl gel is applied to the wound in a thin layer, after pretreatment of the ulcer with antiseptic and drying with a gauze napkin. Application is repeated up to three times a day. After each procedure, do not eat, drink and gargle for three hours.
• Nystatin ointment is applied with great care to avoid getting the product on the surrounding tissue. Application is repeated morning and evening, for no more than two weeks. It is important to be sure of the fungal etiology of ulcers before starting treatment.
• Miconaz oral gel is an antifungal preparation based on miconazole - used for the treatment and prevention of oral candidiasis. The gel is smeared on wounds in the mouth four times a day, for 1-2 weeks. It is necessary to try to keep the drug on the oral mucosa as long as possible, as its effectiveness depends on it.
• Lidohlor is a dental gel that has a local anesthetic effect. The gel is applied to wounds in severe pain, to relieve negative sensations. The drug is symptomatic, does not have an antibacterial effect, so it is additionally necessary to use appropriate medications.
• Camistad gel is a preparation with lidocaine and chamomile extract. It has analgesic, anti-inflammatory and antimicrobial effect. The product is applied to the affected area of the mucosa three times a day after meals, until the wounds heal.
• Acyclovir ointment is an antiviral agent that is successfully used for infections caused by the herpes simplex virus. The ointment is applied to the affected areas of the mucosa in a thin layer, up to five times a day with an interval of four hours. The minimum duration of treatment is five days, and the maximum is ten days.

Carotolin oil

Carotolin is a pharmacy preparation, which is an oil extract of carotenoids from rosehip berries. Additional components are tocopherol, unsaturated fatty acids, etc.

Carotolin oil is used externally: directly on the ulcers apply a couple of drops of the drug and hold for a few minutes. It is possible to put in the oral cavity turundas or small napkins soaked in oil.

The procedure is repeated three times a day, after meals. The last time must be before going to bed. Discontinue treatment after the wound is completely healed.

Chlorhexidine

Mouthwash with chlorhexidine - or, more precisely, its 0.1% aqueous solution - is often prescribed for gingivitis, periodontitis, stomatitis, mucosal injuries and even sore throat. Chlorhexidine is a well-known antiseptic, highly active against various bacteria, protozoa and herpes virus. This drug is available under different names, but the active ingredient must be the same: chlorhexidine bigluconate.

How to rinse the oral cavity correctly with this drug to cure ulcers? First rinse with ordinary drinking water. Then dial one tablespoon of chlorhexidine and hold the liquid in the area of the damaged mucosa, about 30 seconds. Rinses are repeated three times a day. After each procedure, do not additionally practice rinsing with water, drink and eat for 60-120 minutes.

It is not allowed to swallow the treatment solution. The total duration of treatment with the drug is not more than three days.

Betadine

Antiseptic Betadine is a medicinal combination of iodine and polyvinylpyrrolidone, with a concentration of active iodine from 0.1 to 1%. The product is characterized by a wide range of effects, causing the death of microbes, fungi, spores, protozoa and viruses (in particular, human immunodeficiency virus).

The solution is used for external treatment of wounds on the mucosa, as well as for rinsing the oral cavity:

• wounds are spot cauterized with concentrated 10% solution, 1-2 times a day, after meals;
• rinse the inner surface of the cheeks and gums 1% solution: pre-diluted concentrated drug in a ratio of 1:10, after meals, three times a day (the last time - at night).

If the patient is hypersensitive to iodine, Betadine cannot be prescribed. Another safe antiseptic agent should be selected.

Is it okay to put green on an ulcer in the mouth?

The solution of diamond green, which is sold in any pharmacy, well dries wounds, accelerating their healing, and at the same time does not adversely affect the surrounding tissue. But can you use zelenka to treat the oral mucosa? You can, but very carefully and cautiously.

The solution is applied directly to the ulcers, completely coloring them. Repeated treatment is carried out only after complete absorption of the product, when the damaged and treated areas acquire their natural color.

For the treatment of children alcoholic solution of diamond green is undesirable to use, it is better to look for an aqueous analog of the drug.

Furacilin

Furacilin solution is an excellent remedy for fighting mucosal ulcers in the early stages of their development. How to prepare the solution correctly?

Furacilin tablets dissolve poorly in water, so it should be heated, because this way the dissolution process will go faster. For an adult patient, two tablets will be enough, and for a child - one (per 200 ml of water). The drug is crushed, pour hot water and stir well until it is completely dissolved. Then the solution should be cooled to a warm state and used to rinse the oral cavity, after meals, at least three times a day.

Doctors advise alternating rinses with furacilin and baking soda. This will affect the wounds in a complex way, which will accelerate healing.

Hydrogen peroxide

The use of hydrogen peroxide to get rid of mouth ulcers is a recipe for folk medicine rather than traditional medicine. It is especially important to use hydrogen peroxide for fungal etiology of the disease.

Here's how the procedure works:

• wash their hands thoroughly with soap and water;
• wrap absorbent cotton around the index finger and secure with a bandage;
• soak the bandaged finger liberally in peroxide;
• wipe the mucosa in such a way as to get rid of white plaque and treat all wounds.

The treatment is repeated several times a day, until a steady improvement of the condition.

Vitamins

There is a fairly well-founded version of the fact that mouth ulcers appear as a result of an unbalanced or incorrect diet. Most often the "culprits" are deficiencies of B-group vitamins, folic acid, as well as iron, zinc, selenium.

In dental practice widely used preparations that improve healing of erosive and ulcerative lesions, correcting the degree of moisturization of the mucosa. Such preparations contain a large proportion of carotene and vitamin E: keratolin, sea buckthorn and rosehip oils.

In bleeding ulcers, Dicumarol and Warfarin - vitamin K antagonists, as well as ascorbic acid, which has antiscingotic ability, are prescribed.

Physiotherapy treatment

Physiotherapy procedures can be prescribed to increase nonspecific immunity in acute herpetic stomatitis, candidiasis, ulcerative-necrotic stomatitis, herpes, contact or drug inflammation, cheilitis, aphthous stomatitis. Thanks to such treatment, the defenses are increased, the immunological reactivity of the body is strengthened, the sympathetic-adrenal system and glucocorticoid activity are stimulated.

The most common therapeutic procedures and methods used are:

• general galvanization, galvanic collar (course of 15-20 procedures);
• General ultraviolet irradiation (daily or every other day, up to 15-20 procedures with a repeat course in 2-3 months);
• ultraviolet irradiation of reflexogenic zones (two to five biodoses with an interval of 1-2 days, for a course of treatment - five procedures);
• electrophoresis with dimedrol, calcium, pipolfen on the reflexogenic zone (at a current strength of 0.3-0.5 mA, duration up to 20 minutes, therapeutic course of 10-15 sessions);
• impact of ultrasound on the area of cervical sympathetic nodes and the projection area of the adrenal glands (duration - 2-4 minutes, daily, therapeutic course of 10 sessions);
• electrophoresis of magnesium on the collar zone (at current strength of 6-16 mA with a further increase of 2 mA, therapeutic course up to daily 20 procedures for 6-16 minutes);
• electrophoresis with magnesium (at current strength of 10-15 mA, with a session duration of up to 20 minutes and a treatment course of up to 15 procedures);
• electrophoresis with vitamin _B1, bromine, trimecaine on the reflexogenic zone (at current strength of 0.3-3 mA, duration of exposure up to 20 minutes, with a therapeutic course of up to 15 procedures);
• general franklinization (10-15 daily treatments of up to 15 minutes);
• hydrotherapy, showers, radon, sulfide, iodobromic, sodium chloride baths.

Treatment of mouth ulcers at home

Treatment is optimal to start as early as possible, as the early stages of ulcers are successfully cured and at home. The main thing is to follow certain rules:

• avoid smoking and alcoholic beverages at least for the duration of treatment;
• temporarily refuse spicy, too acidic and salty dishes, as well as sweets;
• Carefully observe oral hygiene, brush teeth 2-3 times a day, rinse with drinking water after each meal;
• If there are pockets of decay or visible deposits on the enamel of the teeth, you should visit a dentist and have the potential hazards removed.

Nowadays, there are many different ways to heal ulcers in the mouth as soon as possible. However, the first point of treatment should be to find out the cause of the problem, because only then it will be possible to draw conclusions about the most optimal scheme of therapy.

It is better to approach the issue holistically: for example, to involve drug treatment and supplement it with recipes of folk medicine, homeopathic remedies and so on.

Folk treatment

Cure of mouth ulcers can be significantly accelerated, if you involve folk medicine. It is no secret that there are a lot of remedies - for example, herbal remedies - that have wound-healing and anti-inflammatory properties. So, if the ulcers hurt and interfere with the consumption of food, experts advise to use the following recipes:

• Grate a peeled raw potato on a fine grater, apply it to the damaged mucosa for five minutes, then spit it out. Do not eat or drink after the procedure for half an hour. Repeat twice a day, for a week.
• Prepare strong green tea without sugar, insist until cool. Use to rinse the mouth 4 times a day, for several days in a row.
• Chop or crush 3-4 garlic cloves, mix with two teaspoons of fresh kefir. The resulting mass is applied to the affected mucosa, hold for a few minutes. Repeat twice a day.
• Make a thick porridge of baking soda and water, apply it to the erosion (after eating). After five minutes rinse the inner surface of the cheeks and gums with warm water. Repeat 3-4 times a day.
• Apply a small amount of toothpaste to the ulcer, hold for five minutes, trying not to allow saliva to get on the wound. Rinse with warm water. Repeat the procedure 3-4 times a day.

Herbal treatment

Chamomile flowers - an excellent natural anti-inflammatory agent, which will help and the appearance of ulcers in the mouth. Take 1 tsp. Dried flower, brewed in 200 ml of boiling water and leave to cool. Then add 1 tbsp. Of honey to the infusion and use for gargling 4 times a day.

Yarrow is a plant that helps not only with ulcerative processes in the mouth, but also with periodontal diseases, gingivitis. One tablespoon of the plant is brewed with 200 ml of boiling water, insist a quarter of an hour. Used for gargling up to four times a day.

And another effective recipe: take 1 tbsp. Oak bark, pour 200 ml of water and put on low heat. Bring to a boil, boil for 10 minutes, cover with a lid. Remove from the fire and insist until warm. Use the decoction for gargling 5-6 times a day.

Homeopathy

Every year more and more people prefer homeopathy to conventional medication. Most often this is due to the fact that homeopathic medicines are safer, do not cause side symptoms and can be used even in children. And another "trump card" efficiency, which is achieved due to the impact of homeopathy on the cause of the problem, not on the effect.

Among other things, natural preparations strengthen the body's defense function and prevent the recurrence of the disease.

There are several known remedies that are most often prescribed for the treatment of mouth ulcers:

• Borax - a preparation of sodium boric acid - accelerates wound healing, helps regulate saliva secretion, improves taste perception. Excellent healing of erosions on the inside of the cheeks and on the mucosa of the larynx.
• Calium bichromicum - will not fail in an intense inflammatory process in the oral cavity, which is accompanied by the development of deep ulcers.
• Kalium muriaticum - accelerates the tightening of ulcers, improves blood circulation in mucous tissues.
• Arsenicum - suitable for the treatment of small erosions accompanied by pain and discomfort when eating.

Combinations of homeopathic remedies are possible - for example, Borax is successfully combined with Mercurius. In pediatric practice, Arsenicum albumin and Acidum nitricum are most often prescribed.

Surgical treatment

The surgeon's help is not used in all cases of mouth ulcers. Only rarely - for example, if conservative treatment is ineffective, or if the process is malignant - does surgery become necessary.

Non-healing and sluggish ulcerations are removed by excision: the surgical intervention lasts about 10-15 minutes, using local anesthesia. If there is a locally invasive growth with deep penetration of the ulcer, the surgical field becomes wider: the surgeon captures the adjacent bone tissue, untouched by the pathological process.

Surgery for malignant disease is performed only by a surgeon-oncologist in inpatient conditions of a specialized institution.

Prevention

Sores in the mouth will appear much less often, or stop bothering at all, if you follow these important recommendations:

• a full and balanced diet;
• Limit the amount of sugar consumed, favoring plant-based foods;
• treat dental caries and other diseases of the teeth and gums in a timely manner;
• no smoking, no alcohol abuse;
• prevent injuries to teeth, tongue, oral mucosa;
• timely treat any inflammatory diseases and allergic processes, do not take antibiotics and other medications unnecessarily, do not self-medicate;
• to take care of your oral hygiene, brush your teeth regularly.

Forecast

The quality of the prognosis depends on the initial cause of ulcers, as well as on how fast and quality treatment of the problem became. Of no small importance is also the state of the patient's body, his immune defense, the extent of medical or surgical intervention. In most cases, mucosal ulcers heal without adverse effects within 1-4 weeks, and the patient's ability to work is not impaired.

If the patient has previously suffered from stomatitis or sexually transmitted diseases and has been treated accordingly, he or she may become infected again through contact with a sick partner. In the case of herpes, the disease can remain dormant for a long time and then become active again - for example, if the immune defense is weakened.

You can protect yourself from mouth ulcers if you follow hygienic rules, follow a healthy lifestyle, eat good quality and healthy food, practice safe sexual relations.