See someone urgently if
- Any ulcer lasting longer than three weeks, whether or not it is painful
- An ulcer with raised, rolled or hardened edges, or one that bleeds easily
- A red or white patch in the mouth that does not rub off
- A lump in the neck, persistent hoarseness, or difficulty swallowing
- Ulcers with fever, rash, eye inflammation or genital ulceration
Otherwise, book in the normal way. Call +91 83036 12717.
What causes it
Aphthous ulcers
The everyday mouth ulcer: round or oval, yellow-grey centre with a red rim, on the inside of the lip, cheek or under the tongue. They recur in some people throughout life and are not infectious. The cause is not fully understood, though stress, minor trauma and hormonal cycles all appear to trigger episodes.
Trauma
A sharp tooth edge, a broken filling, a denture rubbing, orthodontic brackets, or an accidental cheek bite. Traumatic ulcers sit exactly where the irritant is, which is what identifies them, and they heal once it is removed.
Nutritional deficiency
Iron, vitamin B12 and folate deficiency all provoke recurrent ulcers, and this is worth checking with a blood test in anyone getting them repeatedly. It is a common and easily corrected cause in India.
Viral infection
Herpes simplex causes clusters of small blisters that break down into ulcers, usually on the gum and palate, and in children often with fever. Hand, foot and mouth disease produces a similar picture. These are self-limiting.
Underlying medical conditions
Coeliac disease, inflammatory bowel disease, Behçet's disease and some medications all cause recurrent oral ulceration. Ulcers that keep coming back, particularly with symptoms elsewhere, deserve investigation beyond the mouth.
Oral cancer, the one to rule out
This is why the three-week rule exists. An early oral cancer can look like an ordinary ulcer and is frequently painless, which is precisely why it gets ignored. Tobacco in any form, including gutkha and khaini, and areca nut chewing raise the risk substantially, and both are common in Uttar Pradesh.
What helps before you are seen
Topical gels
Benzydamine or a protective paste applied to the ulcer reduces pain and lets you eat. They ease symptoms without shortening healing time, which is a reasonable trade while it heals.
Salt water or bicarbonate rinses
Warm salt water several times a day keeps the area clean and is genuinely soothing. Simple and effective.
Avoid what provokes it
Spicy, acidic, salty and very hot food all sting an open ulcer. Sodium lauryl sulphate in many toothpastes aggravates recurrent aphthous ulcers, and switching to an SLS-free paste helps some frequent sufferers noticeably.
Fix the sharp edge
If an ulcer keeps recurring in exactly the same spot, something is rubbing it. Smoothing a sharp cusp, replacing a broken filling, or adjusting a denture resolves it permanently, and no gel will.
How it is treated
Examination and history
How long it has been there, whether it recurs, whether it always appears in the same place, and any tobacco or areca nut use. That history does most of the diagnostic work.
Removing the local cause
Smoothing a sharp tooth, replacing a failing restoration, or adjusting a denture. Small, quick and definitive where trauma is the cause.
Blood tests for recurrent ulceration
Iron, B12, folate and coeliac screening where ulcers keep returning. Correcting a deficiency often stops the cycle entirely.
Topical steroids for severe recurrent cases
Prescribed where ulcers are frequent, large or disabling. These reduce both severity and duration and are used in short courses.
Biopsy for anything persisting past three weeks
This is not an alarming step, it is the standard one. A small sample settles the question definitively, and early diagnosis of oral cancer changes the outcome more than any other factor.
Mouth ulcers: common questions
How long should a mouth ulcer take to heal?
Seven to fourteen days for an ordinary aphthous ulcer. Larger ulcers can take up to three weeks. Anything still present after three weeks needs examining, whether or not it is painful, and painless persistence is more concerning rather than less.
When should I worry about a mouth ulcer?
If it has lasted more than three weeks, has raised or hardened edges, bleeds easily, or sits alongside a red or white patch that does not rub off, a neck lump, hoarseness or difficulty swallowing. Any tobacco or areca nut use lowers the threshold for getting it checked.
What causes recurrent mouth ulcers?
Commonly iron, B12 or folate deficiency, which is worth a blood test. Also stress, hormonal cycles, sodium lauryl sulphate in toothpaste, and repeated trauma from a sharp tooth or denture. Less commonly coeliac disease, inflammatory bowel disease or Behçet's disease.
Do mouth ulcers need antibiotics?
No. Aphthous ulcers are not bacterial infections and antibiotics do nothing for them. Treatment is topical relief while they heal, plus correcting any underlying deficiency or removing the physical cause.
Can gutkha or paan cause mouth ulcers?
Yes, and more importantly they cause oral submucous fibrosis and oral cancer. Areca nut and smokeless tobacco are major risk factors, and their use is high across Uttar Pradesh. Any persistent ulcer or patch in someone who uses them should be examined promptly rather than watched.
Medically reviewed
Reviewed by Dr. Dhanya Saxena, BDS, MHA, FMC, FAOI, oro-dental surgeon and aesthetic physician at Redefine Dental and Facial Aesthetic, Indira Nagar, Lucknow. Dental Council registration 20935. Last reviewed 30 August 2026.
This page is general information, not a diagnosis. Prices are prevailing Lucknow market ranges, not a quotation. If you have facial swelling, difficulty swallowing or difficulty breathing, seek emergency medical care rather than a routine appointment.