A traumatic ulcer is a localized break in the oral mucosa, the delicate lining of the mouth, that results from a physical injury. This type of sore is extremely common, often appearing as a singular lesion adjacent to the site of trauma. Traumatic ulcers are generally benign and represent the body’s normal response to injury, differing from other types of mouth sores. They typically resolve completely once the source of the mechanical irritation is removed, making them a temporary but often uncomfortable oral health concern.
Common Sources of Oral Trauma
The majority of traumatic ulcers arise from mechanical injury, where physical forces damage the soft tissues inside the mouth. Accidental biting of the cheek, lip, or tongue during eating or speaking is the most frequent cause. Dental hardware is another common source of chronic irritation, particularly from ill-fitting dentures, orthodontic brackets, or wires that continuously rub against the mucous membrane.
Sharp edges from a broken tooth, a rough filling, or hard, abrasive foods can also create micro-lacerations that develop into an ulcer. The oral mucosa can also be damaged by thermal and chemical means. Thermal injuries occur when hot foods or liquids cause a burn, while chemical irritation results from substances like aspirin held directly against the tissue or the improper use of strong mouthwash.
Identifying a Traumatic Ulcer
A typical traumatic ulcer presents with specific visual features that help distinguish it from other oral lesions. The sore is usually round or oval, featuring a central yellowish or grayish layer. This central membrane is composed of fibrin and necrotic tissue, which protects the underlying layers as they heal.
The membrane is surrounded by a distinct red halo, indicating inflamed tissue bordering the injury. Traumatic ulcers are most frequently found on soft, mobile tissues, such as the tongue, the inner lining of the cheeks (buccal mucosa), and the lips. The primary symptom is localized pain or tenderness, which often worsens when the area is touched or during activities like eating and speaking.
Self-Care and Promoting Recovery
Removing the Cause
The first step in promoting healing is identifying and removing the source of the trauma to prevent continuous irritation. If the cause is a sharp dental edge or appliance, professional dental adjustment is necessary. Simple causes like cheek biting require increased awareness to avoid repeating the action. Most ulcers begin to heal and become painless within three days after the causative factor is eliminated.
Pain Management
Pain can be managed using over-the-counter topical treatments, such as benzocaine or other numbing gels, which provide temporary relief when applied directly to the lesion. Protective pastes are also available that coat the ulcer, shielding it from saliva, food, and further friction. Rinsing the mouth with a warm salt water solution can help reduce inflammation and maintain a clean environment, supporting the natural healing process.
Dietary Modifications
Dietary modifications are highly effective in reducing irritation and discomfort during the healing phase. Avoiding foods that are spicy, acidic, salty, or very hard prevents further damage to the exposed tissue. Opting for softer foods and cool drinks protects the ulcer and minimizes the mechanical stress of chewing. Most traumatic ulcers will resolve completely within seven to fourteen days.
Signs That Require Medical Evaluation
Although most traumatic ulcers are self-limiting, certain signs indicate the need for a professional dental or medical evaluation. The most significant red flag is an ulcer that persists and shows no sign of healing after two to three weeks. This non-healing nature is a differentiating factor, as chronic irritation can sometimes mask or mimic more serious pathology, including oral cancer.
A prompt evaluation is warranted if the ulcer presents with concerning symptoms:
- Firm or hard tissue (induration) around its borders.
- Continuous growth in size.
- Spreading redness or increased pain.
- Development of a fever, signaling a secondary infection.
- Easy bleeding or causes numbness.
- Associated symptoms elsewhere in the body.