Mouth ulcers (aphthous ulcers)

For a lay person:

Aphthous ulcers are small, painful, round sores inside the mouth that are not contagious. They are very common, often recur, and usually heal by themselves within one to two weeks; triggers include minor injury, stress, hormonal changes and certain foods.

For a trained medical person:

Recurrent aphthous stomatitis is an immune-mediated ulceration of non-keratinised oral mucosa, classified as minor, major or herpetiform. Diagnosis is clinical; frequent or severe ulcers warrant screening for iron, B12 or folate deficiency, coeliac disease, inflammatory bowel disease, Behçet's disease and HIV. Management is topical analgesics, antiseptic mouthwashes and topical corticosteroids, correcting deficiencies and treating underlying disease.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Upward-Blazing Heart Fire; Spleen and Stomach Heat Accumulation; Yin Deficiency with Deficient Fire; Spleen Deficiency with Damp Retention. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: See a doctor or dentist for an ulcer that has not healed within three weeks, which needs checking for mouth cancer, or for ulcers with fever, weight loss, diarrhoea or genital sores.