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When mentioning “mouth ulcers,” most people would immediately think of “canker sores” because it is a common and easily occurring condition in all ages and genders. However, in reality, “mouth ulcers” do not always mean “canker sores.” They could be symptoms of other diseases that may be more dangerous. Therefore, it is important to have knowledge and understanding about mouth ulcers to be able to assess whether the ulcers occurring are just ordinary canker sores or warning signs of other diseases.
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<h2>Common Mouth Ulcers to Know and Recognize as Warning Signs</h2>
Since mouth ulcers can be caused by various factors and their symptoms differ, to assess the risk and recognize the severity of your own mouth ulcers, here are the 4 most common types of mouth ulcers you should be familiar with.
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<ol>
<li>Self-biting ulcers such as accidentally biting your own lip while eating or ulcers caused by wearing braces. These ulcers appear as white sores resembling pus. Initially, the ulcer starts as a red spot and then gradually turns pale white or gray.</li>
<li>Canker sores or Aphthous Ulcers are mouth ulcers that occur individually and may be hereditary with no clear cause. They often appear when we lack sleep, do not rest enough, or consume a large amount of fried foods. The ulcers can be single or multiple spots.</li>
<li>Herpes or Herpes Simplex is a contagious skin disease caused by the HSV-1 or HSV-2 virus, resulting in ulcers at one spot in the mouth but not spreading throughout the mouth.</li>
<li>Allergic mouth ulcers can be caused by allergies to food or chemicals in oral products such as lipstick, toothpaste, or certain fruits sprayed with chemicals. Early allergic symptoms include redness in the mouth or blister rupture followed by white patches. In severe cases, bleeding may occur.</li>
</ol>
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<h2>Which Mouth Ulcers Are Dangerous and Require Immediate Medical Consultation</h2>
Common mouth ulcers often share similar characteristics, which can confuse many people about how dangerous they are. To determine whether you should see a doctor urgently, observe these 3 important factors:
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<ol>
<li>Number of ulcers: Having more than one ulcer in the mouth is suspicious.</li>
<li>Size of the ulcer: Ulcers larger than 5 millimeters are considered risky and should be monitored.</li>
<li>Duration of the ulcer: If the ulcer does not heal or improve within 1 week or worsens, it is a risk that should not be ignored.</li>
</ol>
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If the mouth ulcer meets all three criteria, it may be a warning sign of serious diseases such as cancer, immunodeficiency diseases, SLE (Systemic Lupus Erythematosus), AIDS, Behçet’s disease, and others. All these diseases are serious and require urgent diagnosis and treatment planning because delaying treatment increases the risk of life-threatening complications.
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<h2>Who Is at Higher Risk of Developing Mouth Ulcers</h2>
Eating habits and lifestyle are important factors that increase the risk of mouth ulcers. People who are at higher risk include those who like to eat raw foods, very spicy or very hot foods. Risky dishes that can easily cause mouth ulcers include spicy papaya salad with lots of chili, mala (spicy Sichuan seasoning), chili paste, grilled dishes, and various fermented foods that may be contaminated with toxins or pathogens.
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Additionally, people who regularly consume alcohol and smoke have a much higher risk of mouth ulcers than the general population. Even e-cigarettes are as harmful as regular cigarettes. Although they may not have the typical cigarette smell, they contain nicotine, a carcinogen, which can also cause mouth ulcers.
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<h2>Diagnosis and Treatment of Mouth Ulcers</h2>
Diagnosing mouth ulcers is simple; the doctor will directly examine the oral cavity and palpate to check for any lumps, as sometimes lumps may be hidden beneath the ulcer. If it is a typical canker sore, palpation may not be necessary. However, if the ulcer looks suspicious, the doctor will perform additional palpation. In cases of chronic mouth ulcers lasting more than 2 weeks, the doctor may consider a biopsy to examine the tissue further, as there is a risk of cancer or other diseases.
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Treatment approach for mouth ulcers includes anti-inflammatory medication, which may be topical or use trichloroacetic acid (TCA) to treat canker sores, combined with anti-inflammatory oral sprays. Medication is continued until the ulcer heals, usually within 2 weeks. For patients suspected of infection, antibiotics and pain relievers may be prescribed, available as oral medication or sprays. If symptoms do not improve or heal within 2 weeks and worsen within 1 week, a biopsy may be necessary to rule out cancer.
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<h2>How to Prevent and Care for Yourself to Stay Away from Mouth Ulcers</h2>
Everyone can prevent mouth ulcers from occurring in themselves and their loved ones by maintaining good oral hygiene, regularly checking the condition of the mouth at least once a month for any abnormalities. When brushing teeth, brush properly and carefully to avoid trauma that may cause ulcers. Also, choose clean and safe foods, avoid very spicy and very hot foods. Following these steps effectively reduces the risk of mouth ulcers.
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Mouth ulcers may seem like ordinary canker sores that heal on their own, but when considering the ulcer’s characteristics, duration, and other symptoms, they may be warning signs of more dangerous diseases. Therefore, if you or someone close to you has mouth ulcers that persist for more than 1 week without improvement or worsen, do not ignore them. Seek medical advice promptly for accurate diagnosis to identify the warning signs of any disease, leading to appropriate treatment planning and timely disease control.
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<h2 style="text-align: center">“Mouth ulcers are not as hard to prevent as you think. Just regularly observe any abnormalities and be suspicious. If you find chronic ulcers resembling canker sores that do not heal within one week, maintain strict oral hygiene, urgently change your eating habits. Avoid spicy foods and very hot drinks. Say goodbye to them, and turn back to build a strong protective barrier for a healthy mouth.”</h2>

Mouth ulcer symptoms can be caused by various factors, and the characteristics of the symptoms vary. This allows us to assess the risk and be aware of how severe our own mouth ulcer symptoms are.

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Mouth ulcers are not just canker sores: a close danger you should be aware of.

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