A sore sight

dr Vikas Sharma

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Mouth ulcers are small sores (white to red) or patches inside the mouth.

Nearly everyone gets them at some point in life. But it becomes a cause of worry, and a sign to launch a comprehensive investigative search if such ulcers tend to persist for more than 3 weeks, or if one keeps getting bouts of mouth ulcers every few months, weeks, or even every few days.

Oral mouth ulcers may be a result of local skin or mucosal disease, but in many cases it is a major sign of an internal systemic disease or even a malignancy. So, these must never be ignored.

n Broadly, the recurrent mouth ulcers are of three main types, depending on how big they are and where exactly in the mouth one gets them. Minor, major mouth ulcers and Herpetiform ulcers are the three main kinds of ulcers which occur if the immune system is not working properly. They all increase the amount of inflammation in the body and can cause ulcers.

n People infected with HIV, which causes AIDS, often get problems with ulcers.

n If a mouth ulcer doesn’t heal up, it may not be a mouth ulcer at all. It could be the start of a type of skin cancer called Squamous cell carcinoma.

n Having these recurrent ulcers in the mouth can cause a lot of pain, especially if they are major ulcers. The affected person is unable to eat and drink enough. There is also a problem in talking and thus affecting the entire lifestyle.

n The diagnosis is based on the history, clinical features and specific tests. Any patient with a single ulcer lasting for more than 2–3 weeks should be regarded with suspicion and investigated. Biopsy is indicated when the common causes are ruled out.

n To try to prevent recurrence of common minor mouth ulcers, one should keep a clean oral hygiene and avoid fizzy drinks.

n Avoid spicy food.

n Learn to relax. Stress can lead to mouth ulcers.

n Avoid alcohol and smoking.

(Dr Sharma is a Chandigarh-based dermatologist)