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Oral Health
Understanding Chronic Mouth Ulcers
Date: 02/10/08
Keywords: Oral Health, Mouth ulcers
Recurrent aphthous stomatitis (RAS) – better know as chronic mouth ulcers – is a common oral mucosal disorder which affects around 20 per cent of the EU population. RAS is more prevalent in females and occurs most often during spring or winter times.I have a friend who is as fit as a fiddle, yet he tends to gets large painful mouth ulcers sporadically. Some of these ‘canker sores’ are sometimes so large and tender that it stops him from eating and drinking. Normal over-the-counter remedies don’t seem to have an effect on it...
Recurrent aphthous stomatitis (RAS) – better know as chronic mouth ulcers – is a common oral mucosal disorder which affects around 20 per cent of the EU population. RAS is more prevalent in females and occurs most often during spring or winter times.
Symptoms and causes
RAS appears alone or in clusters as shallow, painful erosions in the mucous membrane inside the mouth. They typically have raised, yellowish borders surrounded by a red zone which is covered with a yellowish opaque material. Fatigue, fever and swollen glands may be present in a severe outbreak.
Primarily it is believed that the main cause for RAS is heredity and an autoimmune mechanism was also long suspected. Recently other initiating factors have also been confirmed to involve nutritional deficiency, stress, certain therapeutic interventions and food sensitivity.
* Nutritional deficiency: In about 15 per cent of cases nutritional deficiencies have been linked to RAS. It may be useful to supplement with a B-complex (B1, B2, B6 & B12), Folic acid, Iron and Zinc. Once the nutritional deficiencies have been corrected you may find that complete remission will follow. (Note: Iron deficiency should be tested by a healthcare professional to determine the right levels of supplementation.)
* Stress: Can also be a contributing factor as it usually will point to the breakdown of the body’s natural defences, especially when you are under stress for a long period of time.
* Food and the environment: Your mouth is the first point of contact for allergens that are either inhaled or ingested. It may be good discuss the option of a FACTest blood test with your doctor. The FACTest (Food Allergen Cellular Test) will help to determine specific foods you may be allergic to, which can then be avoided through an elimination diet. You may also find that you are sensitive to gluten, which has been associated with recurrent mouth ulcers in some people. In such a case you could benefit greatly from a gluten-free diet.
* Therapeutic interventions: Radiation therapy and chemotherapy can also cause chronic mouth ulcers.
Helpful Hints
In many cases RAC can be so severe that medical treatment is sought. Because RAS is not linked to any fungal, viral or bacterial infection you will probably end up with a prescription for corticosteroids, which have adverse health complications such as a weakened immune system. It is probably a treatment to avoid if you can. However there are a few things you can do to alleviate the symptoms of RAS.
* Avoid toothpaste with sodium lauryl sulphate (SLS) as a component. SLS removes a protective coating (mucin) in the mouth and increases the risk of mouth ulcers. In fact, try to avoid bringing the ulcer in contact with toothpaste at all as brushing will be painful and will only aggravate and sometimes enlarge the ulcer.
* As mentioned above, supplement with vitamin B-complex, Folic acid and Zinc. A preliminary trial has found that supplementing with 150mg Zinc per day reduced recurrences of ulcers by 50-100 per cent.
* Acidic foods such as tomatoes kiwis and bananas will put you in a lot of pain when consumed.
* Ginkgo biloba: preparations that contain ginkgolic acids and ginkols are known to trigger RAS. If you are using ginko products, don’t use more than 5ppm (parts per million) ginkolic acid, per day.
* Use deglycyrrhizinated liquorice (DGL): It has potent wound healing and soothing components. Make your own mixture of 200mg DGL and 200ml warm water. Swish the mixture in your mouth for 2-3 minutes and then spit out. Chewable DGL tablets are an acceptable substitute.
* A strong tea made from camomile tincture can be used as a mouth rinse, before swallowing, three to four times a day. (Camomile has a soothing effect on mucous membranes and the lining of the mouth.)
* Some herbalists suggest mixing 200-300mg of myrrh extract or 4ml of myrrh tincture with warm water to use as a mouth rinse before swallowing; this can be done 2-3 times a day.
* Olive Leaf Extract is a broad spectrum, natural antibiotic with anti-oxidant effects and is an excellent natural remedy for mouth ulcers.
Sources:
‘Chronic Mouth Ulcers’ by Herald Gaier, What doctors don’t tell you, October 2008, vol19 no7
‘Recurrent Recurrent aphthous stomatitis: Treating Mouth Ulcers with Olive leaf extract’, published online 07/12/2007, associatedcontent.com
‘Recurrent aphthous stomatitis’ published online at healthmantra.com
‘Mouth Ulcers’ by G. Baldwin and Co, published online 2008, baldwins.co.uk
‘Recurrent aphthous stomatitis’ by S.R. Porter, C.Scully and A. Pederson, published online 1998, crobm.iadrjournals.org
‘Six common mistakes parents make feeding their children’ by Tara Parker Pope, The New York Times 14/09/2008, nytimes.com
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