DEAR DOCTOR,

I have sores in my mouth, what worries me is that I had them last year. Could this be an infection? What is causing the sores?

Lina

DEAR LINA, 

Repeated sores within the mouth can simply be due to minor irritation and injury. This can be due to using tooth brush with hard bristles, accidentally biting the tongue, e.t.c. situations. Tooth pastes or mouth washes that contain sodium lauryl sulphate can cause mouth sores.  Constant irritation inside the oral cavity  as due to lose tooth or denture or keeping something like chewing gum, candy, e.t.c.  in mouth for long time continuously also results in recurrent sores. There can be associated ulcer due to breach in the inner protective layer of the mouth.

Recurrent sores in mouth commonly occur due to viral infections. Herpes simplex is the virus most commonly implicated. The virus enters the mouth through tiny, even microscopic abrasions in the skin or inner protective layer of oral cavity. It causes sores or ulcers with or without small painful bumps on the lips, inside cheeks or roof of the mouth. Due to shedding of virus it can be recurrent. Epstein barr virus is yet another virus that can cause cracking   and sores around and within the mouth. Anerobic bacteria may also cause sores within the mouth, if left untreated, it can be recurrent. 

Very hot food or liquids like tea/coffee can also result in sores. Very spicy food also leads to formation of sores within mouth.Allergy to some food substance can manifest as sores within the mouth. Protein rich food like cheese, pea nuts, beans, are commonly implicated in causing such allergy. Fast, ready to use foods often contain chemicals as preservatives, coloring or flavoring agents. These can cause allergy, manifesting as sores within the oral cavity. 

It can be due to iron or vitamin B.complex  deficiency. Regular alcohol consumption depletes the body of vitamin B.complex, resulting in sores and or ulcers. Hormonal changes in the body as around puberty, pregnancy, menopause, are known to cause mouth sores. It can be due to stress. Uncontrolled diabetes makes one more vulnerable to infections, resulting in recurrent sores within the oral cavity. Some auto immune diseases cause mouth sores as one of the manifestations.

Cure lies in identifying and  treating the underlying cause. Use of local anesthetic agents helps ease the pain. Using a rinse of salt water and soda is also useful. Placing paste of baking soda or milk of magnesia over the sores also helps to give relief in the pain and swelling. Alternately one can use a paste of steroids to reduce the local inflammation.

Prevention lies in avoiding irritation within the oral cavity. This can be done by avoiding very hot  food/drinks,or spicy food, using tooth brush with soft bristles, getting lose tooth or denture fixed. If any sign of infection appears, it should be treated early. Avoid fast food with chemicals. Taking supplements of vitamin B.complex is also useful.

Dr. Rachna Pande is a specialist in internal medicine.

rachna212002@yahoo.co.uk