Mouth Ulcers (Aphthous Ulcers)
Managing painful oral ulcers — and knowing when to refer for cancer exclusion
Aphthous ulcers are the most common cause of recurring oral ulceration, affecting up to 20% of the population. They are painful, round or oval ulcers that typically heal within 7–14 days. Treatment is focused on symptom relief and accelerating healing. Crucially, any ulcer that does not heal within 3 weeks must be urgently referred to exclude oral cancer.
What Are Mouth Ulcers?
Mouth ulcers are small, painful sores that develop on the inside of the cheeks, lips, tongue, or gums. They are very common and usually harmless, healing on their own within one to two weeks. They can be triggered by stress, injury to the mouth, or certain foods.
How Are They Managed?
Most mouth ulcers do not need treatment and resolve on their own. Over-the-counter gels, mouthwashes, and lozenges can help reduce pain and speed up healing. Avoiding known triggers such as spicy or acidic foods and maintaining good oral hygiene can help prevent them from recurring.
When Should You See a Doctor?
A mouth ulcer that has not healed after three weeks should always be assessed by a dentist or doctor. While most ulcers are harmless, a persistent ulcer can occasionally be a sign of something more serious that needs investigation. Any ulcer with hard or irregular edges, or associated with a lump in the neck, should be reviewed urgently.