• Immune system dysregulation: This might result in the erroneous targeting of the cells lining the oral cavity (mouth).
• Genetic factors
• Injury: Rough brushing, dental braces, or biting the inside of the cheek can trigger an ulcer.
• Hormonal changes
• Nutritional deficiencies: Insufficient iron, zinc, folic acid, or vitamin B12 levels can result in the development of recurrent ulcers.
• Emotional stress
• Food sensitivities: Certain foods, such as acidic fruits (e.g., oranges, tomatoes), spicy foods, chocolate, or coffee, may trigger or aggravate ulcers in some individuals.
• Underlying health conditions: Conditions like celiac disease, HIV/AIDS, and autoimmune diseases can cause or exacerbate recurrent mouth ulcers.
• Medications: Certain medications, e.g., beta-blockers and NSAIDs like aspirin (and some antibiotics) may trigger mouth ulcers.

• Painful red sores: Usually round/oval sores with white/yellowish centres and red borders are observed.
• Soreness: The ulcer may make eating, drinking, and talking painful.
• Swelling: The ulcer may cause swelling in the affected area.
• Recurrence: These sores tend to come back after subsiding.

• Physical examination: A thorough examination of the mouth and affected areas is performed to investigate the appearance, size, and location of the ulcers.
• Exclusion of other conditions:
  • Laboratory tests: Blood or allergy tests may be performed to exclude infections, nutrient insufficiency, or other underlying conditions, such as HIV/AIDS or celiac disease.
  • Biopsy: If the ulcers are unusually large, persistent, or have atypical (unusual features), a biopsy may be recommended to rule out more serious conditions, like oral cancer or other mucosal diseases.
  • Immunological tests: In cases where autoimmune or inflammatory conditions are suspected (e.g., Behçet’s disease), additional tests might be performed to check for specific markers.

Recurring ulcers of the mouth can be treated and managed using both medical and homemade concoctions. A few treatment strategies have been enumerated below.

• Topical medications:
  • Hydrocortisone: Topical corticosteroid creams can reduce inflammation and pain.
  • Benzocaine: An over-the-counter topical anaesthetic (such as Orajel) can numb the area to relieve pain.
• Over-the-counter remedies:
  • Saltwater rinse
  • Antiseptic mouthwashes
  • Aloe vera gels
  • Baking soda paste.
• Prescription treatments: In cases of frequent and severe ulcers, oral medications, such as colchicine, tetracycline, or other immunosuppressive drugs, may be recommended.
• Nutritional supplements: If a nutritional deficiency is identified, supplements (iron, vitamin B12, folate, or zinc) may help prevent recurrence.
• Avoiding triggers: Identifying and avoiding specific triggers (e.g., certain foods, stress, or injury) can reduce the frequency of ulcer occurrence.

• The ulcers are unusually large, persistent, or painful.
• In addition to ulcers, you have other symptoms, such as fever or swollen lymph nodes.
• You experience ulcers frequently (more than three times a year).
• You have difficulty eating or drinking due to pain.
• The ulcers don’t heal within 2 weeks.

• Preventing oral trauma: Using a soft-bristled toothbrush for brushing teeth may prevent trauma to the inside of the mouth.
• Dietary adjustments: Avoiding foods that trigger ulcers or are acidic and ensuring that one is getting adequate vitamins and minerals can help prevent ulcer occurrence.
• Protective mouth guards: If you have dental braces, a mouth guard can help reduce irritation that can subsequently cause ulcers.
• Stress management: Techniques like meditation or yoga that help relieve stress can help prevent ulcer occurrence.