Oral ulcers

This is the 4797th article of Da Yi Xiao Hu

It is said that "toothache is not a disease, but it is really painful when it occurs". There is also a disease in the mouth that is just like toothache. Once it occurs, the pain is unbearable. The place where it appears is also irregular. If it is unfortunately located in "tricky" places such as the gums, tongue, and throat, it will not only hurt, but even normal eating and talking will be affected. And it will "come back". Sometimes, after you have finally recovered, you will eat something spicy or stay up late, and the white spots in your mouth will pop up like mushrooms after a rain... Countless people are tortured by this disease. In severe cases, they even spend most of the year fighting this disease... Today, we will take a closer look at this "annoying" disease: oral ulcers.

Introduction to Oral Ulcers

Oral ulcers, commonly known as "mouth sores", are a common ulcerative lesion that occurs in the oral mucosa. They are often seen on the lips, tongue, and the inner wall of the mouth. The ulcer surface is generally round or oval, sunken, with a white or yellow center, and slightly red and swollen surrounding congestion, and the pain is severe. Although oral ulcers are self-limiting and most patients will recover on their own within 1 to 2 weeks, the most important feature of recurrent oral ulcers (recurrent aphthous ulcers, frequent oral ulcers) is repeated attacks. The "Guidelines for the Diagnosis and Treatment of Recurrent Aphthous Ulcers (Trial)" issued by my country in 2012 shows that 10% to 25% of the population in China suffers from recurrent oral ulcers, and the prevalence rate in women is higher than that in men. And the disease can occur all year round, so there is a phenomenon of "continuous" oral ulcers. Severe recurrent oral ulcers will cause great pain and mental stress to patients, and are a health threat that cannot be ignored.

What are the causes of oral ulcers?

The cause of oral ulcers is still unclear. It can be induced by a variety of factors, including genetic factors, dietary factors, immune factors, etc., and there are obvious individual differences.

Genetic factors

Oral ulcers are closely related to genetics. Surveys show that about 40% of patients have a family history of oral ulcers.

Dietary factors

Picky eating can lead to an unbalanced intake of nutrients such as vitamins (iron, zinc, folic acid and vitamin B) in the human body, thus causing oral ulcers. For example, zinc is an important component of many enzymes in the body, which can affect cell division and regeneration, reduce the synthesis of oral mucosal digestive mucus proteins, and cause oral mucosal exfoliation and disease.

Immune factors

Decreased immunity makes the body vulnerable to invasion by pathogens, leading to the occurrence of oral ulcers; at the same time, immune proteins are consumed during the immune response process, which disrupts the immune balance of the oral cavity and accelerates the occurrence of oral ulcers.

Psychological factors

When people are under great mental stress, they are prone to negative emotions such as irritability, anxiety and tension, poor sleep quality, decreased immune function, and susceptibility to viral infection, which can cause oral ulcers.

Traumatic factors

When eating sharp foods (such as potato chips, fish bones, shellfish, etc.), it is easy to scratch or wear the oral mucosa. Accidental biting of one's own teeth, wearing braces for dental correction, scratches from a toothbrush, etc. can easily damage the oral mucosa and cause oral ulcers.

Treatment of mouth ulcers

Generally, oral ulcers can heal on their own in about a week. If they recur, last too long, or are numerous or large, you should go to the oral mucosal disease department or stomatology department of a hospital to seek professional help.

The treatment of oral ulcers is mainly to eliminate the cause, strengthen the physical fitness, and treat symptoms. The treatment method should adhere to the combination of systemic treatment and local treatment, the combination of Chinese and Western medicine, and the combination of physiological and psychological treatment. The treatment of recurrent oral ulcers is mainly based on local anti-inflammatory, relieving oral pain, and promoting ulcer healing. The purpose of systemic treatment is to prolong the interval period. Mild oral ulcers are generally treated with local medications and appropriate adjustments to lifestyle habits. Long-term or recurrent oral ulcers require both local and systemic treatments.

What are the medical treatments for mouth ulcers?

Searching for oral ulcers on the Internet, you will find a wide variety of drugs for treating oral ulcers. In addition to the commonly used drugs such as benzocaine gel, watermelon frost, and ice penicillin powder, there are also magical "folk remedies" such as "eating kiwis like crazy" and "sprinkling salt on the ulcers", as well as various "magic drugs" that claim to be effective in treating oral ulcers. In fact, due to large individual differences, there is no absolute best, fastest, and most effective drug. In addition to commonly used over-the-counter drugs, you should choose the most appropriate drug under the guidance of a doctor and fully combine your personal situation. Don't blindly try the so-called "folk remedies" on the Internet, which will cause the ulcer to worsen or even ulcerate, causing greater pain and risks.

How to treat oral ulcers with traditional Chinese medicine?

What we often call "getting angry" is just a relatively general cause of oral ulcers. According to the four examinations and eight principles of traditional Chinese medicine theory, the syndrome differentiation and treatment of oral ulcers include spleen and stomach heat accumulation, heart fire inflammation, liver depression and heat accumulation, yin deficiency and hyperactivity of fire, spleen deficiency and dampness, qi and blood deficiency, etc. In clinical treatment of oral ulcers, it is necessary to select different traditional Chinese medicine prescriptions for treatment according to different syndromes under the doctor's syndrome differentiation and combined with the specific conditions of the patients, and make appropriate additions and subtractions to significantly improve the complex condition.

What other treatments are there for mouth ulcers?

Physical therapy

Laser irradiation can help mucosal regeneration, reduce inflammatory response, and promote ulcer healing.

Psychotherapy

Negative emotions such as mental stress and anxiety can cause oral ulcers. You should adjust your mentality, keep a happy mood, and avoid pessimism and negativity.

How to prevent oral ulcers?

The specific cause of oral ulcers is still unclear, but good living habits can enhance our immunity and maintain physical and mental health, which is crucial for preventing and alleviating oral ulcers, a self-limiting disease.

Eat healthy and maintain regular dining habits. Avoid local irritants in the mouth, avoid eating hard, sharp (such as potato chips, fish bones, shelled seafood, etc.) and overly hot foods, eat less barbecued, pickled, spicy and other foods that are easy to "get angry" and cause oral ulcers, and eat more vegetables and fruits rich in minerals and vitamins, such as kelp and mushrooms. The decrease of female estrogen can cause oral ulcers, so women should pay more attention to daily maintenance, eat less raw and cold food; eat a moderate amount of protein, eat foods that naturally contain estrogen such as soybeans and onions; maintain normal estrogen secretion levels.

Maintain a regular work and rest schedule, stay up late less, and ensure good sleep quality.

Stay optimistic and avoid negative emotions such as anxiety and tension.

Keep your bowel movements regular and eat more fiber-rich foods.

Proper exercise: Do appropriate physical exercise to enhance your immunity.

Author: Shanghai University of Traditional Chinese Medicine, School of Rehabilitation Medicine

Rehabilitation Occupational Therapy

Chen Kexin

Student ID: 2022441006