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Mouth ulcers are definitely no laughing matter.
Also sometimes known as canker sores, mouth ulcers are small lesions in the mouth.
They often occur on or under the tongue, inside the lips or cheeks, the roof of the mouth or at the base of the gums.
They’re not contagious, but they can be surprisingly painful and can make it difficult to eat and even to talk.
Mouth ulcers should resolve on their own in a week or two.
If yours are larger than 1cm in size, extremely painful or don’t go away within three weeks, consult your GP or dentist.
Mouth ulcers are very common, with around 20% of the UK suffering regularly from mouth ulcers.
We always take an evidence-based approach and aim to provide you with actionable knowledge and tips to help you on your journey to optimal health.
Let’s take a look at some common causes of and triggers for mouth ulcers as well as natural remedies aimed at decreasing healing time and alleviating pain.
What Causes Mouth Ulcers?
Scientists don’t completely understand what causes mouth ulcers.
Their development often accompanies some sort of adverse functioning of the immune system alongside other factors which destroy the protective mucosal layer in the mouth.
There are a variety of triggers which differ from person to person.
Sufferers often experience repeated occurrences of mouth ulcers, which usually last around 7-10 days.
Mouth Ulcer Triggers
- Injury to Gums or Mouth
Your gums and mouth are delicate and easily injured, even by brushing your teeth too vigorously.
More commonly damage is caused by a bite to the inside of the cheek while sleeping or eating, or friction damage from dental braces.
- Plaque Bacteria
We all naturally play host to a wide variety of different species of bacteria in our mouths, some beneficial and some not so beneficial.
Poor oral hygiene and eating sugary foods can lead to an overgrowth of the wrong type of bacteria in your mouth.
Plaque itself is made up of a mass of bacteria and many of the bacteria which reside in the oral cavity emanate from plaque which has built up on teeth.
If the oral mucosa becomes thin or damaged, the bacteria can then cause an infection and mouth ulcers can be the result.
- Food Sensitivities and Allergies
A food allergy or intolerance can occur because the immune system reacts against proteins found in food.
These can upset the immune response in the mouth.
The most common culprits are gluten-containing foods, strawberries, acidic fruits like citrus fruits, cinnamon, pineapple, eggs, chocolate and walnuts.
If you suspect food sensitivities may be sparking off your mouth ulcers, try keeping a food diary to see if there is any pattern to your attacks.
- B Vitamin Deficiency
Low levels of vitamins B1, B2 and B6 (1) were found in one study to be linked to recurrent mouth ulcers.
Supplementation of these B vitamins to those affected was found to reduce the incidence of ulcers.
Other research has found supplementation with 1000mcg vitamin B12 (2) reduced the severity and duration of recurrent mouth ulcers in 75% of subjects who took the supplement.
It’s thought low levels of B vitamins can result in a thinning of the mucosal layer in the mouth and therefore an increased susceptibility to mouth ulcers.
B vitamins are water-soluble, which means they are excreted out of the body in the urine so it’s necessary to replenish our levels constantly.
Some people have difficulty in absorbing B12 from the diet, particularly if their stomach acid is low.
This is often the case with older people who tend to produce less stomach acid. Vegans are also at risk of low B12 status.
It’s best to take B vitamins in a complex, as the level of one B vitamin can alter levels of the others.
- Low Iron Status
Iron-deficiency anaemia can lead to a sore mouth and mouth ulcers because oxygen transport to the body cells is reduced.
One study (3) found almost 70% of people suffering from recurrent ulcers were low in iron.
Iron deficiency is common in women of menstruating age.
If you suspect your iron levels are low, have them checked before supplementing as too much iron can also be problematic for the body.
- Hormonal changes
Many women find they tend to suffer from mouth ulcers before and during menstruation.
This is thought to be because hormone levels appear to affect the mucosal barrier of the mouth.
In one study, it was noted females had fewer mouth ulcers during the latter part of their cycle.
Progesterone peaks at around day 10 of a woman’s monthly cycle and then drops prior to menstruation.
So it seems progesterone levels may play a role in how susceptible we are to developing ulcers – although science doesn’t really know why.
It could be progesterone causes oral mucosal tissue to swell and encourages the growth of certain bacteria in the mouth, or because progesterone suppresses immune function slightly.
On the other hand, high oestrogen can reduce B vitamin and folate levels.
- Smoking
Smokers are more prone to suffering from mouth ulcers and smoking can slow healing time.
Smoking depletes vitamin C levels (4), adversely affecting the immune system, and hot smoke can damage mouth tissue.
- Alcohol
Alcohol and spirits (5) can damage the protective oral mucosa, predisposing us to mouth ulcers.
According to Drinkaware (6), recurrent ulcers can very occasionally be an early sign of mouth cancer, so always check with your GP if you’re concerned.
- Acid Reflux
If acid from the stomach makes its way into the mouth, this can weaken the protective mucosal layer in the mouth and predispose you to mouth ulcers.
- Sodium Lauryl Sulphate (SLS)
This chemical is often added to toothpastes and mouthwash to make them foam.
Studies have linked SLS (7) to outbreaks of mouth ulcers.
It appears SLS can damage the intestinal mucosa.
Switch to a toothpaste free from SLS if you are prone to mouth ulcers.
- Stress
We all experience stress, but if stress overwhelms you, it can weaken your immune system, making you more prone to mouth ulcers.
Mouth ulcers also can also occur alongside chronic health conditions, such as coeliac disease, inflammatory bowel disease, diabetes or any other condition which adversely affects immunity.
Natural Remedies for Mouth Ulcers
If you’re prone to frequent bouts of mouth ulcers, why not try some of the following natural remedies which are aimed at decreasing healing time and alleviating pain.
- Saltwater Rinse
Saltwater is a natural disinfectant and can relieve pain as well as speed healing.
At the first sign of a mouth ulcer, dissolve one teaspoon of natural salt such as sea salt in 100ml warm water.
Swish the solution around in your mouth for 30 seconds.
Spit, and then rinse your mouth with fresh water.
- Sodium Bicarbonate
Often known as baking soda, sodium bicarbonate is alkaline and can neutralise acids as well as killing bacteria in the mouth (8).
Rinse your mouth with a solution of one teaspoon baking soda in 100ml warm water or cover the ulcer with a paste made of baking soda and a little water.
- Honey
As a natural antibacterial agent, honey can be an effective remedy for mouth ulcers.
It can also help to keep the area moist. In one study (9), volunteers who were suffering from sore mouth and mouth ulcers as a side-effect of cancer treatment were advised to apply honey to their ulcers.
The honey resulted in faster healing and less pain.
Use raw honey and apply it to the ulcer. Mix in a little anti-inflammatory turmeric to help healing.
Apply every few hours.
- Coconut Oil
Coconut oil contains a type of fatty acid called lauric acid.
This has been found to be anti-inflammatory (10) and antibacterial.
Apply a small amount of virgin coconut oil to your ulcers. Repeat every few hours and just before bed.
Alternatively, why not try oil pulling?
This ancient practice originated from Ayurvedic medicine and involves swishing a tablespoon of oil around your mouth for 15 minutes or so before spitting it out.
The oil is thought to draw harmful bacteria out of the mouth and may therefore promote healing of mouth ulcers.
Coconut oil is especially suited to oil pulling because of its anti-bacterial properties.
In one study, (11) oil pulling with coconut oil for 10 minutes a day was found remove a significant amount of Streptococcus Mutans bacteria, an overgrowth of which can contribute to mouth ulcers.
In fact, it was as effective as a commercial medicinal mouthwash.
- Clove Oil
Clove oil contains a substance called eugenol, which acts as a natural pain reliever (12).
Cloves have been used for many years as a natural analgesic to relievecarvacrol toothache.
Holistic dentist Dr Steven Lin recommends applying clove oil directly to mouth ulcers by adding half a teaspoon olive oil to a cotton wool ball, then adding 4-5 drops clove oil.
Hold against your mouth ulcer for up to ten minutes.
Or make a mouth rinse from clove oil and water.
- Oregano Oil
Oregano oil contains a polyphenol called carvacrol, which acts as a potent antibacterial (13).
Don’t use undiluted oregano oil because when it’s applied directly to mucus membranes it can result in a burning sensation.
Dilute one drop of oregano oil with four drops organic olive oil, put on the end of your finger and apply to your mouth ulcer.
Or use as a gargle by adding five drops of oregano oil to a small amount of water.
Swoosh the mixture around your mouth, then spit it out.
- Apple Cider Vinegar
Apple cider vinegar contains acetic acid. It’s thought this may help to reduce undesirable bacteria and support a healthy bacterial balance in the mouth.
Use apple cider vinegar in salad dressings, or make a mouthwash by mixing one tablespoon of apple cider vinegar with half a cup of water.
Swish the solution around your mouth for a few minutes, morning and evening, then spit out the solution.
Afterwards, rinse your mouth with water.
- Garlic
Garlic is a versatile natural antimicrobial.
It contains a substance called allicin which has been found to be effective at reducing the size of and pain associated with mouth ulcers (14).
Rub a cut garlic clove gently over your ulcer. Rinse your mouth with water after half an hour.
- Aloe Vera
Aloe vera has natural anti-inflammatory properties and may reduce healing time as well as pain (15).
Rinse your mouth with aloe vera juice a couple of times per day, or better still apply aloe vera gel directly to your ulcers.
- Sage
Sage is naturally antibacterial (16) and anti-inflammatory.
Make a sage mouth rinse by steeping two teaspoons dried sage or a handful of fresh sage in one cup of boiling water.
Allow to cool and use twice or three times per day.
- Fenugreek
Fenugreek has been traditionally used for its healing and anti-microbial properties (17).
Place one teaspoon of fenugreek seeds into a cup of cold water and swish this mixture around your mouth.
Alternatively, make a gargle by adding two tablespoons seeds to one litre water and simmer for 30 minutes.
Cool, strain off the seeds and use as a gargle.
- Basil
Studies have shown this common store cupboard ingredient has anti-microbial properties (18).
Chew on basil leaves, or soak some leaves in hot water, allow to cool then use as a mouthwash.
- Cayenne
Even though your first instinct when you are suffering from mouth ulcers will be to avoid spicy foods, mixing cayenne pepper powder with a little water can actually soothe the pain.
It contains an ingredient which can temporarily desensitise the nerves which cause the pain of mouth ulcers (19).
Cayenne pepper contains a substance called capsaicin, which appears to have an anti-inflammatory action.
Studies have shown it can also inhibit bacterial growth (20).
Make a paste and apply directly to your mouth ulcer twice per day.
- Black Tea
Black tea contains tannins, which are thought to have pain-relieving properties (21).
Place a damp tea bag on your mouth ulcer to help soothe the pain.
- Chamomile Tea
Chamomile contains compounds with antiseptic and soothing properties, which may speed the healing of mouth ulcers.
Studies have shown chamomile can help reduce inflammation in the oral mucosa (22).
Drink warm chamomile tea or place a chamomile teabag on the ulcer.
- Vitamin C
Low levels of vitamin C can be linked to poor immune function.
If you are prone to mouth ulcers, it’s usually a sign your immune system could do with a little support.
As well as making sure you are including plenty of vitamin C rich foods in your diet like kiwi, citrus fruits, mango, berry fruits, kale and papaya, you may benefit from taking extra vitamin C as a supplement.
Choose one that’s gentle on your stomach, such as one containing magnesium ascorbate.
- Zinc
Researchers found giving a zinc supplement to people with low blood zinc levels was shown to reduce the number of times they suffered from mouth ulcers by 50-100% (23).
Zinc plays a role in immune function because it is an essential component of many enzymes which are involved in the development of immune cells.
Zinc lozenges can be helpful as they deliver zinc to the tissues of the mouth.
Summary
When a mouth ulcer strikes, find relief with one of the natural remedies we’ve talked about in this article.
If you suffer from recurrent mouth ulcers, this could be an indication your immune system is struggling.
Did you find this article useful?
Do you have any other suggestions that have helped you find relief from mouth ulcers?
We’d love to hear from you.
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