What Are Mouth Ulcers? Abrasive, Canker and Cold Sores Explained

Sores in and around your mouth can be painful, unsightly, or both! Mouth ulcers can be caused by a variety of different things like stress, infection, or trauma.

Keep reading to learn more about the different types of mouth ulcers and how to treat them.

What Are Mouth Ulcers?

Several different types exist and their etiology depends on the cause and location of the sore.

In general, mouth ulcer symptoms include areas of irritation or blistering that are mildly to significantly painful. Depending on the type of ulcer, they can even bleed a little bit.

What Are the Types of  Mouth Ulcers

Abrasive Sores/Injuries

These are small irritated areas that may appear white or red in any part on the inside of your cheeks, gums, or lips.

Abrasive sores
Abrasive sores

If you have ever had dental braces or  accidentally bit the inside of your cheek, you’ve likely already experienced this type of mouth ulcer.

Canker Sores (aphthous stomatitis)

They may look similar to injury types of sores, being red or white in appearance and fairly shallow.

Canker sore
Canker Sore

However, they usually appear on the inside of the cheek, or tongue, on the base of the gums, but not on the roof of the mouth or on the lips.

Cold Sores (Herpetic Stomatitis)

This type of mouth ulcers is commonly called cold sore. These sores often appear on the outside of the mouth. They resemble blisters around the lips, and can be painful.

Cold sore
Cold sore

Be careful because these types of sores are contagious. Do not share your chopstick or kisses with someone when you have a cold sore.

Medication-Induced Oral Mucositis

These painful sores can cover the inside of a patient’s mouth, esophagus and even down into their gut! They may look like canker sores, but are usually bigger and more likely to bleed and get infected.

Oral mucositis
Oral mucositis

If you have medication induced mouth ulcers, talk to your physician for treatment.

Other Diseases

Diseases like Crohn’s disease, lupus, HIV, oral cancers, and sexually transmitted diseases like syphilis and gonorrhea can all cause mouth ulcers.

Go to a physician immediately if you have a mouth sore that does not fit into the categories listed above.

Mouth Ulcer Causes

Abrasive Sores/Injuries

Anytime you break or cut your skin, you expose your blood and tissue to germs living in that area. And guess what? Everyone’s mouth is a germ factory!

Burns, usually from eating or drinking food that is too hot, can get infected and blister over just like a burn on any other part of your skin. If you burn your mouth severely, consider going to a physician to avoid getting an infection.

Although I’ve never been in a fist fight myself, our Emergency Department is full of people on Saturday morning who were on the receiving end of a solid jab to the cheek the night before.

Their teeth sometimes cut the inside of their mouth.

If the area is inflamed and very painful, we usually give a dose of antibiotics to decrease the risk of further infection.

Cankers Sores

These mouth ulcers only occur in some individuals. The reasons why some people get canker sores and some don’t is still unclear, but there are a few triggers for canker sore sufferers:

  • Small injuries to the inside of the cheek.
  • A diet deficiency of iron, folic acid, vitamin B12, and zinc.
  • Emotional stress.
  • Hormonal changes (around menstruation and menopause).
  • Food sensitivities to things like chocolate, pineapple, eggs, nuts, cheese, coffee, and acidic or spicy food.
  • Sodium lauryl sulfate found in some toothpastes and mouthwashes.
  • H. Pylori (a type of bacteria).
  • Allergies.

Cold Sores

These sores are caused by HSV-1 virus and can appear when a person’s immune system is weakened.

Once a person contracts the virus, it lives in the body permanently. The body always keeps the virus in check unless the immune system is too weak to fight it.

What causes a weakened immune system?

Usually another disease: if you’re already ill with the flu or cold, your body is busy fighting that infection and can’t also fight the HSV-1 virus.

Sometimes when people get a head cold, they find themselves stuck with a cold sore for the next 8-12 days. That’s how they got their name! And also because herpetic lesion (the actual name) is kind of hard to say.

Emotional stress or poor sleep can also weaken the immune system, so people may be more likely to get cold sore during final exams week, or after all nighters.

Mouth Ulcer Treatments

The treatment for mouth ulcers depends on what caused it.

Abrasive Sores/Injuries

Avoid putting hot or cold food in that area of your mouth.

You can try using Cepacol spray or Lozenges to decrease the pain, as long as the sore is no longer open. But remember that saliva is the best cure for this mouth ulcer!

Canker Sores

Check your diet, and start taking a multivitamin if you keep getting canker sores with no explanation.

Other treatments include topical products found at your local pharmacy. These creams usually have all, or some of the following ingredients:

  • Benzocaine
  • Fluocinonide
  • Hydrogen peroxide

Cold Sores

When you feel one appear (called the “prodrome”) consider using an anti-viral cream with the active ingredient of docosanol. This can decrease the duration of the mouth ulcer by about a day.


What strategies have you used in the past to help cure your mouth ulcer?


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