Mouth ulcers - or aphthae in doctorese - are shallow painful ulcerations in the soft tissue inside the mouth. Although they normally heal within a week to 10 days, for many people, they are recurring and persistent.

In girls, there seems to be a relationship between recurrences and menstruation; persistent cases often improve during pregnancy. Certain drugs, such as sulphonamides, gold, penicillamine, barbiturates, cytotoxics, carbimazole and sulphasalazine, can predispose you to mouth ulcers.

Coeliacs and Crohn’s disease sufferers are prone to mouth ulcers, and ulcers are also common in conditions like Reiter’s syndrome (inflammation of the urethra, conjunctivitis and arthritis), Behçet’s disease (chronic inflammation of the small blood vessels), systemic lupus erythematosus, mononucleosis (glandular fever), tuberculosis, syphilis, Wegener’s granulomatosis and Schultz’s syndrome (agranulocytosis).

When not caused by a specific condition, mouth ulcers can often be related to food sensitivities or nutritional deficiencies (Oral Surg, 1982, 54: 388-95; BMJ, 1975; 2: 490-3).

Food and environmental allergens
Following a diet or programme to eliminate allergens (using, for example, the food elimination diet or the pulse test for allergies) has been shown to have good therapeutic results in the control of recurring mouth ulcers (Oral Surg, 1984; 57: 504-7).

In my own practice, I have often found dental metals or acrylics to be the sensitising agents in some cases of recurrent mouth ulcers. Suspect this cause if the onset of the problem was relatively soon after any dental work and if the ulcers appear mostly in the vicinity of the new dental material.

Gluten sensitivity
Switching to a gluten-free diet can result in complete remission or much improvement of recurrent mouth ulcers in coeliacs (Gut, 1980; 21: 223-6; J Dent Res, 1979; 58 [Special Issue C]: 1271).

Supplements
In one study of 330 individuals with recurrent mouth ulcers, 14.2 per cent proved to be deficient in iron, folic acid and/or vitamin B12. As soon as their deficiencies were eliminated by supplements, the majority achieved a complete remission (J Oral Path, 1978; 7: 418-23). For patients who are deficient in zinc, taking extra zinc supplements has proved effective (BMJ, 1975; 2: 490-3).

In cases where mouth ulcers have resulted from allergies, a combination of flavonoids has been shown to have anti-allergy effects as well as relieved symptoms (J Allergy Clin Immunol, 1984; 73: 819-23, 801-9).

Traditional Chinese Medicine
The rhizome of Cimicifuga foetida (bugbane; sheng ma in Chinese) will clear toxins from the superficial parts of the body, such as your gums.

Other effective remedies include the rhizome of Anemarrhena asphodeloides (zhi mu in Chinese) and Mirabilitum (mang xiao in Chinese; Bensky D, Gamble A, Chinese Herbal Medicine: Materia Medica, Seattle, Washington: Eastland Press, 1993: 50-1, 56-7, 117-8).

Folk remedies
Several teas, taken freely, have a long history of curing mouth ulcers. These include ladies’ bedstraw tea (Galium verum, or cheese rennet), made with 1-2 teaspoons of tea to each cup of boiling water and infused for 15 minutes, and wild strawberry tea (Fragaria vesca), made with two teaspoonfuls of dried leaves to each cup of boiling water and infused for 10 minutes. (Note: cultivated strawberry leaves do not possess the same properties; Bartram’s Encyclopaedia of Herbal Medicine, London: Robinson Publishing, 1998: 53, 406).

Homoeopathy
A single, controlled proving of Beryllium metallicum performed 50 years ago managed to produce small ulcers in the mouths of all seven healthy volunteers participating in the proving (Br Hom J, 1953; 43: 79, 84). (In homoeopathy, a remedy is said to be ‘proved’ when the full potency of the substance produces the very symptoms that are to be treated.) I have found low potencies of this homoeopathic medicine to be very reliable in treating common mouth ulcers.

Harald Gaier
Harald Gaier is a registered homoeopath, naturopath and osteopath.