What should I do for severe oral ulcers?

Aphthous ulcers (canker sores) are common ulcerative lesions occurring on the oral mucosa, frequently affecting areas such as the inner lip, tongue, ventral surface of the tongue, buccal mucosa, vestibular groove, and soft palate—regions where the mucosa lacks or has poor keratinization. During an outbreak, patients experience severe pain and marked local burning sensation; in severe cases, eating and speaking may be significantly impaired, causing considerable disruption to daily life. So, what should one do when aphthous ulcers become severe? Below is an overview.

What to Do When Aphthous Ulcers Are Severe

1. Pharmacological Treatment

Aphthous ulcers can be treated with both topical and systemic medications. Commonly used drugs include analgesics, anti-inflammatory agents, and wound-healing promoters. Analgesics provide rapid relief from pain; anti-inflammatory agents help prevent infection and inflammation at the lesion site; and wound-healing promoters accelerate tissue repair. For patients with severe, recurrent aphthous ulcers, combined topical and systemic therapy may be required. Systemic treatment typically involves oral immunomodulators, which enhance cellular and overall immune function—addressing the underlying cause of recurrent aphthous ulcers.

2. Dietary Adjustment

Symptoms of aphthous ulcers can be improved through dietary modifications. Patients should consume foods rich in vitamin C and vitamin B₂. Vitamin C promotes ulcer healing and enhances immunity, thereby helping prevent recurrence; vitamin B₂ supports recovery from oral ulcers. Foods high in vitamin C include kiwifruit, lemons, oranges, hawthorn berries, strawberries, and tomatoes; foods rich in vitamin B₂ include animal offal, nori (laver), kelp, mushrooms, and oranges.

3. Traditional Chinese Medicine (TCM) Therapy

According to TCM principles—including the “Four Diagnostic Methods” (inspection, auscultation and olfaction, inquiry, and palpation) and the “Eight Principles”—aphthous ulcers fall under the category of “oral sores” (kou chuang). TCM holds that heat and toxicity are invariably involved, though differentiation is made between excess-heat and deficiency-heat patterns. Initially, patients often present with excess-heat syndromes—for example, stomach fire or damp-heat in the spleen and stomach. However, individuals with recurrent, non-healing ulcers may have an underlying constitution characterized by deficiency-cold. If pharmacological intervention is needed, consultation at a reputable TCM hospital is strongly recommended; self-medication should be avoided.

The above outlines management strategies for severe aphthous ulcers. Severe cases can be effectively addressed through pharmacological treatment, dietary modification, and TCM therapy. We hope this information proves helpful.