Mouth Ulcers Definition Also Known As Aphthous Ulcers, Mouth Ulcers Are Painful, Clearly Defined, Round, Or Oval Sores Which Form in the Mouth

Mouth ulcers Definition Also known as aphthous ulcers, mouth ulcers are painful, clearly defined, round, or oval sores which form in the mouth. Description of  Looking at its appearance, a mouth ulcer will be: symptoms  round, or oval, in shape  pale yellow, or grey in colour  inflamed around the edge.  Most mouth ulcers usually occur on:  the inside of the lips,  the inside of the cheeks,  the floor of the mouth, or  the under surface of the tongue.  An ulcer can cause pain and discomfort, particularly when eating, drinking or brushing teeth. Criteria for Children over 12 years old and adults INCLUSION Criteria for Children under 12 years old EXCLUSION Patients with immunodeficiency, coeliac disease, Crohn’s disease, Vit B12 deficiency, severe iron deficiency Advice to be given Leaflet Use a soft toothbrush when brushing teeth. Avoid eating hard foods, such as toast. Try to stick to foods which are softer and easier to chew. Try to reduce stress levels Many people find that eating certain foods, such as chocolate, coffee and peanuts can make them more prone to developing an ulcer. If your ulcer has a specific cause, such as a sharp tooth, then it will normally heal naturally once the cause has been treated, visit the dentist. OTC medication Choline salicylate 8.7% oral gel 15g (sugar-free) -Apply ½-inch of gel with gentle massage not more often than every 3 hours max. 6 applications daily- NOT TO BE SUPPLIED TO ANYONE UNDER 16 YEARS OF AGE.

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Chlorhexidine gluconate 0.2% mouthwash 300 mL -Rinse mouth with 10mL for about 1 minute twice daily NOT TO BE SUPPLIED TO ANYONE UNDER 12 YEARS OF AGE. When to refer  Duration longer than 3 weeks  Associated weight loss  Suspected ADR (e.g. immunosupressants)  Presence of diarrhoea Frequency of  One per month consultation Number of  ONE only. products allowed in one consultation Leaflets and http://www.cks.nhs.uk/aphthous_ulcer (CKS) resources Mouth ulcers (BBC Health)

For use as guidance in the Pharmacy First Service NHSLC Updated March 2013 Review date March 2014