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Ever noticed that just when you’re beginning to feel on the verge of a cold, you break into mouth ulcers? You’re not the only one, says writer Kat Storr.

I always know when I’ve been burning the candle at both ends. It’s not just the tiredness that hits me but, and this sounds weird, my tongue will let me know. It will start with a little bump on the end which then turns into an ulcer. I usually end up with at least one other at the side further back too.

Those little ulcers are my body’s way of telling me to slow down and look after myself. And after talking to my female friends, it seems that this is a symptom a lot of us experience when we’re run down.

And weirdly enough, while these friends just accept this as a regular annoyance, mouth ulcers are something that my husband and male friends rarely get – even when they’re also working too hard or exhausted. 

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I’m 38 and have three young children so being run down, tired and stressed is part and parcel of life right now. If I have a few late nights, too much sugar or too much wine with friends, I can almost guarantee that I will wake up with a bump on my tongue which will then turn into an ulcer.

I’ve had ulcers since I was quite young, but they became worse when I entered puberty, which also coincided with the time I had braces on my teeth. The metal train tracks on my upper and lower canine teeth would rub on the inside of my mouth. It was agony. Today, they’re inexplicably linked with stress. 

What are mouth ulcers?

A mouth ulcer will appear inside the mouth on the tongue, cheek or lips. It may start as a scratch or cut, for example if you bite your lip, before turning into a sore white spot which can last for a number of days. Ulcers aren’t contagious but they can be really sore, particularly when you’re eating or speaking. And if you’re really run down, you can end up with a mouth full of them.

Amanda Sheehan, dental therapist for oral health brand TePe, says that as well as being a symptom of being tired or stressed there are many other causes of mouth ulcers. These include having braces, rough fillings or badly fitting dentures, food intolerances and allergies, or damaging your teeth or gums with a toothbrush or crunchy food.

A 2018 study in Saudi Arabia on female dental students found that recurrent aphthous stomatitis (RAS) – the scientific name for mouth ulcers which keep coming back – was linked to high levels of stress and anxiety in sufferers.

But these factors are not gender specific, so why is it that women seem to get more mouth ulcers than men?

Sheehan says: “One of the reasons why we get ulcers is a change of hormones, therefore some women may develop ulcers just before menstruation, during pregnancy or after the menopause. Iron deficiency, another common cause of ulcers, is also more likely in women of reproductive age.”

An increase in progesterone levels can cause your gums to become inflamed but it can also lead to swollen salivary glands and mouth ulcers. Women who take birth control pills that contain progesterone may also experience more mouth ulcers than others. The study in Saudi Arabia found that 47.1% of the subjects had also noticed a relationship between the onset of ulcers and menstruation.

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Mother-of-one Charlotte Burns, 36, says: “When I’m feeling run down or unwell (which is a lot of the time with a toddler in nursery), I tend to find my tongue gets covered in tiny but painful mouth ulcers. It’s the awful icing on a miserable cake.

“Sometimes I know that illness is knocking before I’ve noticed I’m unwell because ulcers pop up, and there’s no avoiding or ignoring a tongue ulcer – they demand to be acknowledged.

“I don’t know why I get them, although I think it’s an age thing. I don’t remember finding it an issue in my 20s – but then again, I wasn’t so tired and run down then.”

According to the NHS around 40% of people who regularly get mouth ulcers say that it runs in their family. My mum has suffered badly from mouth ulcers for as long as I can remember so it was no surprise when I started getting them too.

Medical conditions such as Crohn’s disease, coeliac disease, vitamin B12 or iron deficiency and viral infections like hand, foot and mouth and chicken pox can also cause mouth ulcers. 

How to prevent mouth ulcers?

If, like me, you know the triggers for your mouth ulcers then there are clear ways to try to prevent them. That might mean prioritising sleep or eating regular meals rather than relying on overly salty or sweet snacks to keep you going all day.

Dentists 92 Dental, based in Hammersmith, recommend avoiding overly sweet, sour or spicy foods, switching to a soft-bristled toothbrush and drinking as little alcohol as possible. They also say it’s important to maintain good oral hygiene and stay well hydrated to allow the body to flush out any toxins.

If you are struggling with the pain, which is common if you have more than one bothering you, 92 Dental say you can take anti-inflammatories such as ibuprofen or aspirin.

Speak to your GP or dentist if an ulcer lasts longer than three weeks, keeps coming back, grows bigger than usual or bleeds or becomes more painful and red.

Images: Getty

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