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Causes of Recurrent Mouth Ulcers

Aug 24, 2022 Source: Cainiu Health
Dr. Zhang Liwen
Introduction
The most common type of oral ulcer is the aphthous ulcer, also known as recurrent aphthous stomatitis (RAS). The precise etiology of RAS remains unclear but is generally attributed to a triad of factors: genetic predisposition, environmental triggers, and immune dysregulation. In genetically susceptible individuals, environmental factors can provoke an aberrant immune response, leading to the characteristic lesions of oral ulcers—namely, the interplay between genetic and environmental factors.

Recurrent oral ulcers are quite familiar to most people; however, many individuals remain unaware of their underlying causes—and lack of clarity regarding etiology can significantly impact treatment efficacy. So, what causes recurrent oral ulcers?

Causes of Recurrent Oral Ulcers

The most common type of oral ulcer is the aphthous ulcer—also known as recurrent aphthous stomatitis (RAS). The precise clinical etiology of RAS remains unclear but is generally attributed to a triad of factors: genetics, environment, and immunity. In genetically predisposed individuals, environmental triggers may provoke abnormal immune responses, leading to the characteristic lesions of oral ulcers. These contributing factors include both genetic susceptibility and environmental influences. Environmental factors encompass constitutional and psychobehavioral elements—including mental and physical health status, psychological state, lifestyle, occupational stress, and broader sociocultural conditions.

Patients with oral ulcers may benefit from supplementation with B-complex vitamins, vitamin C, folic acid, iron, or zinc—but such supplementation should only follow proper diagnostic evaluation. Treatment must be individualized based on the patient’s specific clinical presentation. Patients are advised to consult a dentist or a specialist in oral mucosal diseases for thorough assessment and evidence-based management under professional guidance.

Dietary measures can also support healing: patients should consume fresh vegetables and fruits rich in vitamins and trace elements. Recommended vegetables include spinach, cucumber, tomato, cabbage, eggplant, and potato; recommended fruits include pear, persimmon, papaya, apple, and grape. We hope this information proves helpful. Wishing you optimal health and joyful living!


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Recurrent oral ulcers are often caused by deficiencies of trace elements such as vitamin B and vitamin C in the patient’s body. In such cases, patients should consume more foods rich in vitamins to replenish these essential micronutrients and thereby address the underlying cause. Additionally, some patients may develop recurrent oral ulcers due to excessive daily stress or poor mental health.
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The exact cause of oral ulcers remains unclear; however, the majority of cases are associated with psychological factors such as mental stress, anxiety, and poor sleep. Additionally, local irritants—including residual tooth roots or crowns, ill-fitting dental restorations, and dental calculus—can also contribute. Trauma is another potential cause: for instance, accidentally biting the lip mucosa may lead to ulcer formation at the site of the wound.
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Frequent oral ulcers may result from either hyperactive autoimmune responses or, more commonly, severe immune dysfunction. In addition, recurrent oral ulcers are often primarily caused by infections with certain bacteria, viruses, and other microorganisms. Patients with systemic diseases are prone to developing oral ulcers, mainly due to immune system impairment.
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Immune dysfunction: This may involve either hyperactive autoimmune responses or, more commonly, severe autoimmune deficiency. Infections caused by certain microorganisms—such as bacteria and viruses—have been reported as likely primary causes of recurrent oral ulcers. Patients with systemic diseases are prone to developing oral ulcers, primarily due to immune system impairment. Oral ulcers versus gastric ulcers.
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First, traumatic factors should be considered—trauma can also cause oral ulcers. For example, accidentally biting the lip mucosa while eating may lead to an oral ulcer developing from the resulting wound. Second, vitamin deficiency may be a contributing factor; insufficient intake of certain trace elements increases the risk of developing oral ulcers. Additionally, prolonged, excessive physical labor leading to inadequate rest can also trigger oral ulcers.
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What Causes Recurrent Mouth Ulcers?
Recurrent oral ulcers in patients are often associated with immune dysfunction, bacterial or viral infections, and irregular lifestyle habits. Additionally, deficiencies in vitamins and trace elements, malnutrition, and consumption of greasy, fried, or spicy/irritating foods may also contribute to oral ulcer development. Poor dietary habits and inadequate oral hygiene can likewise lead to recurrent oral ulcers.
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Causes of Recurrent Oral Ulcers in Children: Deficiency of Trace Elements Many children have underdeveloped immune systems and prefer sweet, cold, spicy, or fried foods, while consuming insufficient amounts of vitamin-rich foods such as vegetables and fruits. This dietary imbalance may lead to deficiencies in vitamin A and vitamin B₂. Additionally, inadequate intake of red meat and animal liver—key sources of essential trace elements—further contributes to trace element deficiencies in children.
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