Mouth Ulcers

DESCRIPTION
Recurrent oral canker sores (aphthous stomatitis) are a common condition affecting about 20% of the US population. Outbreaks vary from a single lesion, two or three times a year, to an uninterrupted succession of multiple lesions. While neither cancerous nor herpes infections (with which they are often confused), these small, shallow mouth ulcers are painful and quite bothersome. They appear either singly or in clusters on the lips, gums, inner cheeks, tongue, palate and/or throat. Ulcerations typically heal without scarring within 7–21 days.

FREQUENT SIGNS AND SYMPTOMS

• Ulcers are sometimes preceded by a feeling of tingling or burning for 24 hours.
• Ulcers are small, shallow, very painful, and covered by a grey membrane. Borders are surrounded by an intense red halo.
• Ulcers may appear anywhere in the oral cavity: lips, gums, inner cheeks, tongue, palate and/or throat.
• Typically only two or three ulcers appear during an attack, but episodes with 10–15 ulcers are not uncommon.
• Ulcers may be so painful during the first 2–3 days that they interfere with eating or speaking.

CAUSES

• Food sensitivities or allergies (especially to milk and gluten): microscopic evaluation of lesions plus elevated levels of allergy-induced white blood cells and antibodies confirm a causal link between recurrent canker sores and allergens in many cases. Gluten, a protein found in grains, is often the culprit. Patients with celiac disease, a condition characterized by diarrhoea and malabsorption due to gluten sensitivity, have a high frequency of recurrent canker sores.
• Environmental allergens: preservatives such as benzoic acid, methylparaben, dichromate, and sorbic acid commonly induce canker sores.
• Nutrient deficiency: due to the rapid rate of turnover in the cells that line the surfaces of the mouth and throat, the oral lining is often the first place where the effects of a nutrient deficiency become visible. A number of nutrient deficiencies can lead to canker sores. Several studies have clearly demonstrated a causal association between thiamin deficiency and recurrent canker sores. Other studies show nutrient deficiencies – including not only thiamin, but also iron, folate, vitamin B12, riboflavin, and pyridoxine – are much more common in recurrent canker sore sufferers than in the general population
• Stress: often a precipitating factor in recurrent canker sores, stress may disrupt normal immune function and/or result in damage to the integrity of the mucosal lining.
• Trauma: injury to the mucosal lining caused by rough dentures, excessively hot food, tooth brushing or dental work, or irritation from frequent or prolonged consumption of highly acidic (vinegar, pickles) or salty (salted nuts, popcorn, potato chips) foods.

RISK INCREASES WITH

• Recent dental treatment
• Emotional or physical stress, anxiety or premenstrual tension
• Frequent consumption of processed foods containing numerous preservatives

PREVENTIVE MEASURES

• Brush teeth thoroughly, but not abrasively, at least twice a day and floss regularly to keep the mouth clean and healthy.
• Check dentures and mouth guards for proper fit and smoothness.
• Avoid consumption of excessively hot, acidic or salty foods.

Expected outcomes

Eliminating food allergens, sources of gluten, and nutritional deficiencies results in complete cure within 1 month in most cases.

 
TREATMENT

Diet

• Evaluate for potential allergens and gluten sensitivity and, if indicated, remove all allergens and gluten sources (grains) from the diet. The best method of diagnosing sensitivity to gluten is to measure the level of antibodies against gluten in the blood, a test called the alpha-1-gliadin antibody assay.
• Consume a nutrient-dense diet rich in whole, unprocessed, preferably organic foods, especially plant foods (fruits, vegetables, beans, seeds and nuts), and cold-water fish, and low in animal products.

Nutritional supplements

• A high-potency multiple vitamin and mineral supplement: this should provide all of the known vitamins and minerals.
• Vitamin C: necessary for the production of healthy collagen used to form connective tissue, repair wounds, improve gum and mucosal health, and reduce bruising.
• Quercetin: a bioflavonoid known to inhibit mast cells from releasing inflammatory compounds and causing symptoms of allergy. The anti-allergy drug, sodium cromoglicate, which has been shown to increase the number of canker sore-free days, is similar in structure and function.

Botanical medicines

• Deglycyrrhizinated licorice (DGL): a special licorice extract with anti-inflammatory, antiallergic activity, DGL accelerates the growth and regeneration of mucosal cells. In a study of 20 patients with canker sores given DGL as a mouthwash, 15 of the 20 experienced 75% improvement within 1 day, and complete healing of the ulcers by the third day. Tablets, being a more concentrated form, may produce even better results.

Drug–herb interaction cautions

None.

 
Physical medicine

• Learn how to cope effectively with stress. Use stress management techniques such as abdominal breathing, progressive relaxation, meditation or guided imagery.

ICIM Medics Approach

If you feel that this article relates to you then please make an appointment to see one of ICIM Medics Natural Medical Practitioners.

Some tests may be prescribed such as the ICIM Allergy Assessment http://icimmedics.com/medical-assessments/allergy-assessment/ or the ICIM Stress Assessment http://icimmedics.com/medical-assessments/stress-assessment/ depending upon your individual case, the results from these can be used by one of our Natural Medical Practitioners who will help you with your individualised treatment plan. This may include dietary, nutritional and/or botanical advice.

This article is not meant to be used for treatment but for information purposes only. If you feel that this approach is appropriate for you please contact ICIM Medics on 045 844 819 or www.icim.ie e-mail : info@icim.ie  Appointments can be arranged for you.

Tags: Aphthous Stomatitis, Canker Sores, Mouth Ulcers