Oral ulcers problem since childhood

Dear Dr Donya

My girlfriend, 23, has suffered from oral ulcers since she was a child. She has an ulcer for maybe 21 days each month. She is 160 centimeters tall. What is the cause? How can it be prevented?

Thank you very much.

--Chrisnanda

Dear Chrisnanda,

Thank you for your question and I am sorry that I am unable to see what your girlfriend's oral ulcers look like. The most common cause is aphthous ulcer or canker sores. There may be other causes of mouth sores such as herpes (fever blisters and cold sores), trauma, syphilis or drug allergies.

Other causes can include unlikely diseases and medications.

Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time, aggravating factors, relieving factors, and associated complaints occurring alone or in combination with other problems.

I would guess that your girlfriend has an aphthous ulcer, which is a benign sore in the mouth, appearing as a painful white or yellow sore surrounded by a bright red area. They occur in women more often than men. They may occur at any age, but usually first appear between the ages of 10 and 40. The cause is unknown.

There may be an inherited predisposition to their development, it may be an immune system link or they may develop in response to a mouth injury such as dental procedures or aggressive tooth cleaning.

Canker sores usually appear on mouth tissue including the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums. They can also be triggered by stress, dietary deficiencies (especially iron, folic acid or vitamin B12), menstrual periods, hormonal changes and food allergies.

They may occur with no identifiable cause. While it is not known for sure, canker sores may not be caused by a virus, but may be the result of a temporary malfunction of the immune system. Women are more likely to get cankers than men, but anyone can get them for no apparent reason.

They usually begin with a tingling or burning sensation, followed by a red spot or bump that ulcerates. Pain spontaneously decreases in seven to 10 days, with complete healing in one to three weeks. Occasionally, a severe occurrence may be accompanied by nonspecific symptoms of illness such as fever or malaise. Recurrence is common and may continue for years.

So, the way to prevent ulcers depends on the cause. It may be helpful to eat nutritious food, avoid trauma to the mouth and avoid stress.

--Dr. Donya