Mouth sores (ulcers) are a very common problem and can be distressing.
Mouth ulcers appear as white circles with a red halo.
Mouth sores are not caused by germs.
I have been getting recurrent mouth sores with whitish discolouration. A friend suggested that I could be having Vitamin B deficiency. What are the tell-tale signs of Vitamin B deficiency? Can I eat some foods that are very rich in these vitamins to avoid the sores?
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Mouth sores (ulcers) are a very common problem and can be distressing. Most people, however, confuse mouth ulcers with cold sores. Although both affect the mouth, their origin and treatment is very different.
Mouth ulcers versus cold sores
• Mouth ulcers appear as white circles with a red halo. They often plague the inner part of your lips and cheeks. Cold sores are normally fluid-filled blisters that occur on the outer part of your lips and the corners of your mouth. • Contrary to popular belief, mouth ulcers aren’t contagious. Cold sores, however, are very contagious. • Mouth sores are not caused by germs unlike cold sores which are caused by a virus (HSV-herpes simplex virus).
In your case, the mouth sores you have described are known as ‘aphthous ulcers.’
What causes mouth ulcers?
If mouth sores are not caused by germs, what exactly causes them?
Trauma: This is common amongst people who repeatedly bite the inside of their mouths or have poorly fitting dentures.
Vitamin deficiency: As you have mentioned in your question, vitamin B complex deficiencies have been associated with mouth ulcers.
Mineral deficiency: Zinc and iron deficiency cause mouth sores. Iron is crucial for healthy blood formation. Zinc is found in cells throughout the body. It helps the immune system fight off infections. Zinc also helps wounds heal and is important for proper senses of taste and smell.
Low immunity: If your immunity is low (for example if you have been on anti-cancer therapy or steroids or have infections such as HIV), you are more prone to mouth ulcers.
Digestive tract disease: Coeliac disease and inflammatory bowel diseases (specifically Crohn’s disease) cause mouth ulcers.
Cancer: Occasionally, persistent mouth ulcers are a manifestation of oral cancer. For this reason, any non-healing mouth ulcer must be reviewed by your doctor.
Medications: Some pain killers (known as NSAIDs) and even some hypertension and heart medication can cause mouth ulcers. This side effect is, however, not seen in every user of these drugs.
Tobacco products: Chewing tobacco products and smoking can cause mouth cancers which can present as ulcers.
Smoking cessation: Although smoking cessation is good for your overall health, some people may develop mouth ulcers when they first stop smoking.
Family: Occasionally, you may find that mouth sore susceptibility may be inherited, and people in a particular family may get them more often. What symptoms does vitamin B insufficiency cause?
Vitamin B complex (B1, B2, B3, B6, B9, B12) is a large family and it can give a variety of symptoms if deficient. These include mental/mood changes, dry skin, heart problems (palpitations and shortness of breath), mouth sores, a smooth tongue, loss of appetite, constipation, numbness or tingling of the limbs, muscle weakness and in severe cases, problems walking.
Can you test for vitamin B insufficiencies?
If you suspect that your mouth ulcers may be due to vitamin B insufficiency, you can ask your doctor to test your blood. The laboratory is also able to check for iron deficiency. During this hospital visit, your doctor can also assess other health conditions that may put you at an increased risk of getting recurrent mouth ulcers.
Should you take vitamin supplements?
If you don’t have any deficiencies, you really don’t need to take vitamin tablets. With proper diet, you should be able to get all your nutrients from your food. If you take vitamin B supplements yet your ulcer is due to a different health issue, you will not get an improvement in your symptoms.
Dos and don’ts of mouth ulcers
Most mouth ulcers heal on their own within a week or two. You can, however, help speed up their healing by avoiding things that may irritate your ulcer. Do: • Control pain: Most people avoid eating whilst dealing with mouth ulcers due to pain. Pain can be controlled using topical anaesthetic gels or oral pain killer tablets/syrups. All these are available over the counter.
• Check your dentures and bridges: go for a check-up with your dentist to assess if your fittings are correct. If not, have them adjusted.
• Brush your teeth: most people avoid brushing their teeth when having mouth ulcers due to pain. This only worsens the situation as bacteria in your mouth will thrive and can lead to gum disease.
• Change your toothbrush: use a soft bristled toothbrush.
• Use antiseptic mouth wash: it helps clean the area around the mouth sore as you may not be able to adequately brush due to discomfort.
• Eat a balanced diet rich in vitamins and minerals.
• Keep drinking: fluids ingested should either be cool or lukewarm – use a straw if need be to avoid irritating the sore further. Don’t: • Drink very hot fluids. Some acidic drinks, such as fruit juice, may also irritate your sore. • Eat very spicy or salty food • Use toothpaste containing sodium lauryl sulphate
Foods rich in ‘anti-ulcer’ vitamins and minerals
Vitamin B complex rich foods include organ meats such as liver, kidney and gizzards. Other animal products such as eggs, milk, cheese, milk products, meat, fish, shell-fish and poultry are also a good source of these nutrients.
Dark green vegetables (sukuma wiki, spinach, asparagus, broccoli and brussels sprout), avocado, beans, peas and lentils are also good sources of vitamin B complex.
Iron-rich foods include lean meats, organ meat like liver, eggs, legumes, nuts, dried fruit and whole grain. Some companies produce iron-fortified breakfast cereals and bread.
Foods high in zinc include sea food like oysters, nuts, seeds (like pumpkin, watermelon and squash seeds), legumes, spinach, mushroom and lean meats.
