Sore mouth
I have a white sore patch on my gum — is it a mouth ulcer, and what helps?
It is usually a mouth ulcer, and they hurt far more than they are serious. Dabbing vitamin E oil on it soothes the raw surface and helps it settle faster. Anything still there after three weeks needs looking at.
What a white sore patch on the gum usually is
Most of the time it is a mouth ulcer: a small break in the lining with a pale yellow or white floor and a red rim around it. They turn up on the gum, the inside of the lip and cheek, and under the tongue, and they are sore out of all proportion to their size — eating, brushing and even talking can catch them.
Some come from an obvious knock: a toothbrush slip, a sharp crisp, a cheek bitten while eating, a denture or brace rubbing. Others arrive for no reason you can point to, often when you are run down, stressed, unwell or after a change in medication. Both kinds behave the same way and both are managed the same way.
The ordinary ones settle by themselves in one to two weeks. What you do for them is about comfort and about not making it worse while it heals.
When a white patch is not an ordinary ulcer
The dividing line is time. An ulcer that is healing gets less sore and smaller within a week or so. One that is still there after three weeks — even a painless one — should be looked at, and promptly. That is not because it is likely to be serious; it is because the small number of things that are serious announce themselves by not going away, and there is no way to tell by looking at home.
Come in sooner than three weeks if the patch is getting bigger rather than smaller, if there are several at once, if it will not stop bleeding, if you feel unwell with it, if it followed a new medicine, or if you cannot eat or drink properly because of it.
A white area that has always been there and does not hurt is a different question from one that appeared last week and does. Both are worth mentioning at your next visit; the second is worth an appointment.
If you use tobacco in any form, or drink heavily, a white patch that lingers should be checked without waiting the three weeks.
How vitamin E oil helps, and how to use it
Vitamin E oil is what the practice suggests for an ordinary ulcer. It coats the raw surface, which is most of the immediate relief — the pain of an ulcer is largely the exposed base being caught by food, tongue and toothbrush — and the published work on mouth ulcers and on chemotherapy-related mouth soreness suggests it also shortens how long they take to settle.
Use it neat. Dry the area first with a clean tissue, then dab a small amount straight onto the patch with a clean fingertip or a cotton bud. A vitamin E capsule pierced with a pin works as well as a bottle of the oil. Repeat a few times a day, and always after eating and last thing at night, when it has the longest undisturbed stretch to work.
Try not to eat or drink for twenty minutes afterwards, or you will simply wash it off. It is not a numbing gel and it will not stop the pain outright, but it takes the edge off within minutes and most people notice the ulcer settling sooner than it usually would.
- Dry the patch, dab vitamin E oil straight on, a few times a day
- Always after eating and at bedtime
- A pierced capsule works as well as the bottled oil
- Nothing to eat or drink for twenty minutes afterwards
Vitamin E soothes and supports healing. It is not a treatment for an infection, and it will not make a patch that should be examined into one that should not.
What else helps while it heals
Keep brushing, including near the ulcer — a soft brush, gently. People avoid the sore area, plaque builds up around it and the gum gets more inflamed, which slows the whole thing down. A warm salt-water rinse a few times a day is worth doing and costs nothing: half a teaspoon in a cup of warm water, swill, spit out.
Give it a break from what is irritating it. Sharp, salty, acidic and very hot food will find an ulcer. So will strongly flavoured toothpaste — if ulcers are a regular thing for you, a paste without sodium lauryl sulphate is worth trying, as some people get noticeably fewer without it.
If the same spot keeps ulcerating, something is probably rubbing it. A sharp edge on a tooth or filling, a denture that no longer fits, a brace bracket — all of them are quick to find and quick to smooth, and it stops the cycle rather than treating it over and over.
Common questions
How long should a mouth ulcer take to heal?
An ordinary one settles in one to two weeks, getting less sore and smaller as it goes. Anything still present after three weeks should be looked at promptly, even if it does not hurt.
Can I put vitamin E oil on an ulcer inside my cheek or under my tongue?
Yes — it works the same way anywhere in the mouth. Dry the area, dab it on, and leave it twenty minutes before eating or drinking.
Is a white patch on the gum always an ulcer?
No. It can also be a rubbed area from a denture or brace, a fungal infection, or occasionally something that needs proper examination. Time is what separates them: an ordinary ulcer is clearly improving within a week.
Why do I keep getting mouth ulcers?
Recurrent ulcers can follow stress, illness or being run down, and are sometimes linked to low iron, vitamin B12 or folate, to some medicines, or to sodium lauryl sulphate in toothpaste. If you get them often it is worth mentioning, as some of those are simple to check.