😖 Chronic Mouth Ulcers That Keep Coming Back? Causes, Symptoms, and Treatment
Understanding recurrent canker sores and chronic stomatitis — and how to treat them
“Painful sores keep showing up in my mouth — they go away, but always return.”
If you frequently suffer from painful ulcers inside your mouth, it might be more than just stress or fatigue. You could be dealing with chronic recurrent mouth ulcers, also known as chronic stomatitis.
In this article, we break down the common causes of chronic mouth ulcers, how to identify and treat them, and what lifestyle changes can help prevent future flare-ups.
🩺 What Are Chronic Mouth Ulcers?
Mouth ulcers (also called canker sores or aphthous ulcers) are painful, inflamed lesions on the mucous membranes inside your mouth. Typically, they heal within 1 to 2 weeks.
However, for some people, ulcers become chronic, meaning they either recur frequently or persist longer than 3 weeks.
✅ According to the Korean Association of Oral Medicine, chronic stomatitis affects 10–20% of the population repeatedly.
🔍 Common Symptoms of Chronic Mouth Ulcers
- Recurring small ulcers on the inner cheeks, lips, tongue, or gums
- Round or oval sores with a white or yellow center and red border
- Pain when eating, speaking, or brushing teeth
- Sores that recur within 2–4 weeks of healing
- In some cases: fatigue, fever, or swollen lymph nodes
🔬 What Causes Them to Come Back?
1. Immune Dysfunction
- Could be a sign of autoimmune diseases like Behçet’s disease or lupus
- The immune system mistakenly attacks healthy mouth tissue
2. Vitamin and Mineral Deficiencies
- Low levels of vitamin B12, iron, or zinc can impair mucosal healing
- Common in people with poor nutrition, vegetarians, or frequent dieters
3. Stress and Sleep Deprivation
- Chronic stress lowers immunity and slows recovery
- Lack of rest increases recurrence risk
4. Hormonal Changes
- Many women report more ulcers before menstruation or during pregnancy
5. Underlying Medical Conditions
- Conditions like Helicobacter pylori infection, Crohn’s disease, or ulcerative colitis may trigger mouth ulcers
6. Poor Oral Hygiene
- Overgrowth of bacteria or minor injuries (e.g., from harsh brushing) can aggravate sores
🧪 How Are They Diagnosed?
A proper diagnosis typically involves:
- Visual examination of lesions
- Medical history and symptom discussion
- Lab tests if deficiencies or autoimmune causes are suspected
- Biopsy in chronic or severe cases
Differential diagnosis includes:
- Recurrent aphthous stomatitis
- Fungal or viral infections
- Autoimmune mucosal diseases
💊 Treatment Options
1. Medications
- Topical corticosteroids (e.g., triamcinolone), anti-inflammatory gels, or anesthetic mouth rinses
- In cases of secondary infection, antibiotics or antifungals may be prescribed
2. Lifestyle Changes
- Avoid spicy, acidic, or hot foods
- Manage stress through relaxation techniques
- Ensure adequate vitamin B, iron, and zinc intake
3. Treating Underlying Conditions
- Referral to specialists (e.g., rheumatologist or gastroenterologist) if autoimmune or GI disorders are suspected
✅ Prevention Tips for Frequent Sufferers
- 🪥 Use a soft-bristled toothbrush and mild toothpaste
- 🧂 Choose alcohol-free mouthwash
- 🍽️ Rinse your mouth after eating
- 🧘♀️ Practice mindfulness and light exercise to boost immune function
📚 References & Sources
- Korean Association of Oral Medicine. “Clinical Guidelines for Recurrent Aphthous Stomatitis”, 2021
- Seoul National University Dental Hospital – Oral Mucosal Disease Center
- Medscape. “Chronic Recurrent Aphthous Stomatitis: Diagnosis and Treatment”, 2023
- Mayo Clinic. “Canker Sores (Aphthous Ulcers): Causes and Treatments”
This article was compiled by ChatGPT (GPT-4.5, as of May 2025).
Korean