Oral ulcers and sores are a common symptom in lupus patients. Whilst they are not life-threatening they can be exceptionally uncomfortable and so any measure to prevent or treat them can be very beneficial.
Lupus can cause recurrent mouth ulcers, but it is not the only cause. There are a number of factors that may increase your chances of getting a mouth ulcer.
-Stress and anxiety
-Oral trauma – this could be caused by chewing sharp/hard food or excessively brushing teeth
-Changes in hormones – it has been observed that some women develop mouth ulcers during their period. This is due to changes in the hormone levels during the menstrual cycle
Recurrent mouth ulcers may also be caused by other/related medical conditions;
-Vitamin B12 deficiency
-Coeliac disease (Gluten Intolerance)
-Immunodeficiency (perhaps caused by lupus medication)
If you are experiencing recurrent ulcers perhaps you could ask for blood tests to see if you might be experiencing one of these conditions.
***It is not advisable to add supplements to your diet without first consulting a medical professional.***
Occasionally mouth ulcers can be a side effect of medication that you may be taking for your lupus. A couple of the medications that can cause mouth ulcers are;
-Non-steroidal anti-inflammatory drugs (NSAIDs)
*Often mouth ulcers are only a temporary effect of these medications
There are some things that you can do to decrease the likelihood of getting mouth ulcers, or to help your ulcer heal more quickly. You should;
-Use a soft toothbrush
-Avoid eating hard/sharp foods such as toast. Stick to soft foods that are easier to chew
-Avoid eating foods that have been known to cause ulcers in the past, until the ulcer has completely healed
-Try to avoid stressful situations and reduce your stress levels by doing relaxing activities. For tips on relaxation you can read January’s blog here - bit.ly/yN5iEO
-If you smoke, give up or at least cut down (this may trigger ulcers in the short term, but you should see an improvement in the long run)
-Have a healthy lifestyle (eat healthily, balanced diet, regular exercise)
-Have good dental hygiene – make sure teeth are healthy by regularly visiting your dentist
You may find that a change in your diet could help to decrease the likelihood of developing mouth ulcers. Certain foods have been identified as increasing the risk of developing mouth ulcers in some people. These include;
There are also some foods that are best to avoid in order to prevent yourself aggravating an ulcer and making it sting. These include;
-Anything with a rough texture (such as crispy toast)
There are many different products and home remedies for treating mouth ulcers, so we asked you to provide your tips.
We had a few people discussing Cordsyl mouth wash. It seems that there are mixed responses to the product.
“I’ve just been diagnosed and have had bad mouth ulcers since Xmas! Bonjella is fab but definitely avoid corsodyl mouth wash!”
“I use corsodyl mouth wash and find it helps keep the ulcers at bay…”
“Anbesol works well dabbed on and Cordsyl for the hard to reach ones….”
“I used to use corsydol, but that seemed to make my mouth and gum ulcers worse, I now use steroid tablets which dissolve in your mouth and difflam mouth wash”
Another product that many people seem to have tried is Difflam Oral rinse
“When I have ulcers I use a medicated mouthwash called Difflam Oral Rinse. It tends to numb the whole mouth, which gives me a little relief from the pain.”
“I use Difflam as well, I get it on script from the dental hospital and I’d recommend it. It helps get rid of ulcers quite quickly and you can use it frequently throughout the day.”
There were also a few toothpastes/mouthwashes that were suggested.
“Please look at getting Biotene toothpaste and mouthwash, it was recommended by an oral consultant and it has controlled my sore mouth and ulcers. It is a little expensive but worth every penny.”
“Biotene (toothpaste, gel and spray) are very good and help the saliva problem. They are also products to keep gums healthy”
“…sensodyne toothpaste, I’ve tried other toothpastes for sensitive teeth but I always go back to sensodyne because of my ulcers.”
“I use BioXtra toothpaste and mouthwash, both on prescription and my mouth has felt a lot cleaner since. The mouthwash is a moisturiser.”
“Cepacaine. It’s an anaesthetic mouth wash that numbs the mouth and throat. It's my security blanket and must have when I have flares. My mouth ulcers are tiny but cover every single part of my mouth and throat.”
A few other suggestions we were given were:
“I keep my lips moist with lip balm and clean my tongue. I know it sounds barmy but with the meds we take, my tongue furs up and if I’m not careful, ulcers appear. I was told to do this by my pharmacist and it works. You can get toothbrushes with dual-heads just for this reason.”
“…I swear by using good old fashioned “TCP”….yuck, yuck, yuck a lot of people say! I find if used properly, diluted and swilled in the mouth 3 times a day, it really does ease the discomfort of the ulcers…”
“I have tried a range of products from bonjela to chlorhexadine, but I find salt just as good.”
“As painful as it is, salt is the best thing, directly on the ulcer is the best thing.”
“Liquorice helps the pain, also the ulcers seem to go quicker.”
“Keep an eye on Vitamin C levels. Dissolve some powder 100mg in a glass with a drop of honey. Drink with water at meals.”
“I use Aloe Vera Gel...a small 'dollop' on ulcer at bedtime = much better by the morning”
“Iglu cream. Works really well and doesn't taste all that bad either. It's the only thing that works when I get ulcers on my lip.”
Ani Kowal shared a couple of articles that she has written on mouth ulcers with us. The first is about natural approaches to treating mouth ulcers (especially liquorice) and can be read here - bit.ly/xqmvTh
The second article is about Vitamin B12 deficiency and mouth ulcers and can be read here - bit.ly/yPVIYa
We’d like to thank everybody that submitted their tips for this topic. The amount of feedback was fantastic and we really hope this article will be useful to some people. Apologies to anybody who’s tips weren’t included in this article; unfortunately we didn’t have space for everyone.
If you try any of the tips given in this article then please let us know how it goes, whether it helps you or not.
***Please note that this article is written for informational purposes only and should not be a substitute for professional medical advice or treatment. Do not delay seeking or disregard medical advice based on information here. Always seek the advice of your local family physician or other qualified health professional before starting any new treatment or making any changes to existing treatment. It is also advised to consult a medical professional before making any changes to diet or starting alternative remedies, which may interact with other medications.***