Mouth ulcers RTS

Question 1

What you need to know

Answer 1

Age: Child, adult
Nature of the ulcers: Size, appearance, location, number
Duration
Previous history
Other symptoms
Medication

Question 2

Mouth ulcer symptoms

Answer 2

Minor ulcers
- Occur in crops of 1 - 5
- May be up to 5mm in diameter
- Appear as white or yellow centre with an inflamed red outer edge
- uncomfortable but eating not affected

Question 3

Red flag symptoms

Answer 3

• Bleeding, painful gums
• Painful ulcers
• Receding gums in between your teeth
• Bad breath
• Metallic taste
• Excess saliva
• Difficulty swallowing
• High temp
• Rash
• Diarrhoea
• Associated weight loss

Question 4

Where do mouth ulcers commonly appear?

Answer 4

Common sites are the tongue margin and inside the lips and cheeks.

Question 5

How long do mouth ulcers last?

Answer 5

5 to 14 days
Usually heal in 1 week

Question 6

Common causes of mouth ulcers

Answer 6

Stress
Hormone imbalance
Stopping smoking.

Question 7

Treatment for mouth ulcers

Answer 7

Corsodyl
Bonjela adult
Iglu
Anbesol teething gel (see teething pain in children)

Question 8

Corsodyl

Answer 8

• Chlorhexidine
• Control mouth ulcers
• Use twice a day, continue to use 2 days after healing
• 12 +

NOT SUITABLE FOR:
- Anywhere other than mouth
- Immediately after brushing your teeth

Question 9

Bonjela

Answer 9

Choline salicylate
- relieve the pain and discomfort of common mouth ulcers and cold sores.
- Short acting
- Can be repeated after 3 hours
- 16+

NOT SUITABLE FOR:
- preg + bf
- methotrexate, anticoagulant

Question 10

Iglu gel

Answer 10

Lidocaine + aminoacridine
SUITABLE FOR:
- elderly
- 7+
- Sugar free (safe in diabetics)

No specific restrictions on use in pregnancy/BF, but potential risks are unknown.

Question 11

Corsodyl SFx

Answer 11

• Can cause reversible brown staining of the teeth
• Discolouration of the tongue
• Possible taste disturbances
• Brushing teeth before chlorhexidine may help reduce the staining.
• Rinse mouth thorough thereafter as toothpaste can inactivate chlorhexidine

Question 12

Deficiency and mouth ulcers

Answer 12

• Deficiency of iron, zinc, vitamin B12 can cause increased ulcers

Question 13

Referral criteria

Answer 13

• Duration of longer than 3 weeks
• Treatment failure - no response in week
• Involvement of other mucous membranes or eyes
• Suspected adverse drug reaction

Question 14

Lifestyle advice

Answer 14

• Soft bristled toothbrush
• Eat soft foods
• Regular dental check ups
• Healthy balanced diet
• Avoid spicy/salty food
• Avoid rough crunchy food e.g. toast and crisps