Mouth sores are like little cuts or ulcers in
the mouth. Various types of sores can appear anywhere within the mouth,
including the inner cheeks, gums, tongue, lips, or palate.
Some sores may be raised, usually filled with fluid (in which case they
are called vesicles or bullae, depending on the size), whereas others may
be ulcers. An ulcer is a hole that forms in the lining of the mouth
when the top layer of cells breaks down and the underlying tissue shows
through. An ulcer appears white because of the dead cells and food
debris inside the hole.
Types-
Canker sores. Small ulcers with a white or gray base and a red border.
They are also known as apthous ulcers. Unlike cold sores, canker sores
appear inside the mouth. And, they are not contagious. There may be
only one canker sore or several and they often return. Their exact
cause is uncertain but some experts believe that immune system
problems, bacteria or viruses may be involved.
Cold sores. Cold sores can usually be found on or around the lips, and
sometimes on the cheek, nose or even the eyes. Cold sores are itchy,
painful blisters that eventually burst and scab. They last for about
1-2 weeks but usually reoccur.
Leukoplakia - Leukoplakia is a whitish patch that can be found on the
inside of the cheeks, on the gums or on the tongue. Leukoplakia is due
to an excess of cell growth which can be caused by a number of factors
including tobacco smoking or chewing, the habitual chewing the inside
of the cheeks, dentures or braces that do fit properly or any other
constant irritation to the inside of the mouth.
Candidiasis - Candidiasis is also known as thrush or moniliasis, and is
a fungal or yeast infection of the mouth caused by yeast reproduction
in the mouth. People with dry mouth can easily contract Candidiasis due
to lack of saliva which helps kill certain bacteria in the mouth.
Candidiasis forms as small whitish bumps on the inside of the mouth.
Causes-
1. Trauma
Minor physical injuries
Trauma to the mouth is a common cause of oral ulcers. A sharp edge of a
tooth, accidental biting (this can be particularly common with sharp
canine teeth, or Wisdom teeth), sharp, abrasive, or excessively salty
food, poorly fitting dentures, dental braces or trauma from a
toothbrush may injure the mucosal lining of the mouth resulting in an
ulcer. These ulcers usually heal at a moderate speed if the source of
the injury is removed (for example, if poorly fitting dentures are
removed or replaced).
It is also common for these ulcers to occur after dental work, when
incidental abrasions to the soft tissues of the mouth are common. A
dentist can apply a protective layer of petroleum jelly before carrying
out dental work in order to minimize the number of incidental injuries
to the soft mucosa tissues.
Chemical injuries
Chemicals such as aspirin or alcohol that are held or that come in
contact with the oral mucosa may cause tissues to become necrotic and
slough off creating an ulcerated surface. Sodium lauryl sulfate (SLS),
one of the main ingredients in most toothpastes, has been implicated in
increased incidence of oral ulcers.
2. Infection
Viral, fungal and bacterial processes can lead to oral ulceration. One
way to contract pathogenic oral ulcerations is to touch your chapped
lips without having washed your hands first. The reason that this
happens is that the bacteria from your hands sinks into the tiny, open
cuts caused by your chapped lips.
Viral
The most common is Herpes simplex virus which causes recurrent
herpetiform ulcerations preceded by usually painful multiple vesicles
which burst. Varicella Zoster (chicken pox, shingles), Coxsackie A
virus and its associated subtype presentations, are some of the other
viral processes that can lead to oral ulceration. HIV creates
immunodeficiencies which allow opportunistic infections or neoplasms to
proliferate.
Bacterial
Bacterial processes leading to ulceration can be caused by
Mycobacterium tuberculosis (tuberculosis) and Treponema pallidum
(syphilis).
Opportunistic activity by combinations of otherwise normal bacterial
flora, such as aerobic streptococci, Neisseria, Actinomyces,
spirochetes, and Bacteroides species can prolong the ulcerative process.
Fungal
Coccidioides immitis (valley fever), Cryptococcus neoformans
(cryptococcosis), Blastomyces dermatitidis ("North American
Blastomycosis") are some of the fungal processes causing oral
ulceration.
Protozoans
Entamoeba histolytica, a parasitic protozoan is sometimes known to
cause mouth ulcers through formation of cysts.
3. Immune system
Many researchers view the causes of aphthous ulcers as a common end
product of many different disease processes, each of which is mediated
by the immune system.
Aphthous ulcers are thought to form when the body becomes aware of and
attacks chemicals which it does not recognize.
Immunodeficiency
Repeat episodes of mouth ulcers can be indicative of an
immunodeficiency, signaling low levels of immunoglobulin in the oral
mucous membranes. Chemotherapy, HIV, and mononucleosis are all causes
of immunodeficiency with which oral ulcers become a common
manifestation.
Autoimmunity
Autoimmunity is also a cause of oral ulceration. Mucous membrane
pemphigoid, an autoimmune reaction to the epithelial basement membrane,
causes desquamation/ulceration of the oral mucosa.
4. Allergy
Contact with allergens such as amalgam can lead to ulcerations of the
mucosa.
5. Dietary
Vitamin C deficiencies may lead to scurvy which impairs wound healing,
which can contribute to ulcer formation.[2] Similarly deficiencies in
vitamin B12, zinc have been linked to oral ulceration.
A common cause of ulcers is Coeliac disease, in which case consumption
of wheat, rye, or barley can result in chronic oral ulcers. If gluten
sensitivity is the cause, prevention means following a gluten-free diet
by avoiding most breads, pastas, baked goods, beers etc. and
substituting gluten-free varieties where available. Artificial sugars
(Aspartame/Nutrisweet/etc) such as those found in diet cola and
sugarless chewing gum, have been reported as causes of oral ulcers as
well.
6. Flovent
Use of flovent without rinsing the mouth out afterwards may cause oral
ulcers.
7. Cancer
Oral cancers can lead to ulceration as the center of the lesion loses
blood supply and necroses. Squamous cell carcinoma is just one of these
by tobacco.
8. Medical conditions associated with mouth ulcers
The following medical conditions are associated with mouth ulcers:
Behçet's disease
Bullous pemphigoid
Celiac disease (gluten sensitivity)
Crohn's disease
Gingivostomatitis
Leukoplakia
oral lichen planus
Lupus erythematosus
Neutropenia
Oral thrush
Ulcerative colitis
Infectious mononucleosis
Symptoms-
Symptoms usually begin with pain or burning, followed in 1 to 2 days by
an ulcer. There is never a blister. Pain is severe-far more so than
would be expected from something so small-and lasts 4 to 7 days. The
ulcers almost always form on soft, loose tissue such as that on the
inside of the lip or cheek, on the tongue, the floor of the mouth, the
soft palate, or in the throat. Ulcers appear as shallow, round or oval
spots with a yellow-gray center and a red border. Most ulcers are
small, less than ½ inch (1¼ centimeters) in diameter, and often appear
in clusters of two or three and usually disappear by themselves within
10 days and do not leave scars. Larger ulcers are less common; these
are irregularly shaped, can take many weeks to heal, and frequently
leave scars.
People with a severe outbreak may also have a fever, swollen lymph
nodes in the neck, and a generally run-down feeling.
Treatment-
Symptomatic treatment is the primary approach to dealing with oral
ulcers. If their cause is known, then treatment of that condition is
also recommended. Adequate oral hygiene may also help in relieving
symptoms. An age old remedy is applying a small amount of vinegar to
the ulcer, this relieves pain for a short amount of time. Ulcers
persisting longer than three weeks may require the attention of a
medical practitioner.
Role of homoeopathy
There are many homeopathic medicines for the treatment of them
depending on the cause and severity of the condition. It can deal very
well in cases and also help in reducing recurrences.
Homoeopathic medicines help in boosting the natural healing processes of the
patient to treat and prevent them. Moreover, homeopathy can treat diseases
harmlessly for keeping us in good health.
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