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Oral Ulcers, Mouth Sores: Battling Lupus Symptoms

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Mouth ulcers and oral sores are a common symptom of lupus, affecting around 50% of Lupus Warriors. These symptoms aren’t just painful. They may indicate increases in disease activity or even a coming flare.

A mouth ulcer or canker sore is a shallow injury in the cheeks, tongue, or other soft parts of the mouth. It is often surrounded by a “halo” of swollen skin. These ulcers, canker sores, and other injuries in the mouth are common, but they occur more frequently in people with autoimmune diseases like lupus.

Though not usually harmful, mouth ulcers are still wounds. They can get infected and provide an entry point for bacteria. Even outside of this, they are painful and can make eating and drinking difficult and unpleasant. These symptoms are more common for children with juvenile-onset lupus (jSLE). Oral ulcers can be an obstacle to getting the right nutrition and staying hydrated.

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Why do Mouth Ulcers Happen?

The most common way of getting a mouth ulcer is through an injury to the mouth. This can be accidentally biting the inside of their mouth, burning the mouth on food or drink that is too hot, or eating rough-textured or sharp foods that cut the mouth. Over-enthusiastic toothbrushing and irritating mouthwashes can also cause these injuries, which then become sores as they heal. Most oral ulcers caused by injury heal in 2-3 days.

Hormone changes can also cause sores. Some hormone medications, as well as the normal menstrual cycles of women, can cause sores to appear in the mouth. Because women with lupus are more sensitive to hormone changes, they have more of these sores.

While these are the most common reasons for the development of mouth sores, they are not the only reasons that they may develop. Genetics, diets low in vitamin B12 or iron, and some medications (especially steroid medications) can lead to the appearance of oral ulcers.

Autoimmune diseases including lupus, allergies, and stress have also been linked to mouth sores. With lupus, the sores are often painful and easily irritated, and may resemble the discoid lesions of cutaneous lupus. Most doctors believe that oral ulcers are the mouth equivalent to these skin symptoms of lupus.

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What to Watch for with Oral Ulcers

20% of people – not just Lupus Warriors – have sores that come and go without injury, hormone changes, or inflammation. These recurring or aphitious ulcers can be harmless as well. However, if they don’t clear up after 10 days, then they may be related to other underlying health issues.

A few symptoms to watch out for include:

  • Shiny red tongue
  • Red, white, or distorted spots
  • Dry mouth and enlarged salivary glands

These symptoms can hint at deeper problems, including infections. This is especially likely in people with compromised immune systems, either because they have an autoimmune disease (such as lupus) or are being treated with immune system suppressing medications. There is also a risk of cancer in the mouth, tongue, or soft palate.

If you have any of these symptoms, you should talk to your lupus treatment team and see if you can get a dentist on board to make sure that all is well.

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Getting Rid of Mouth Sores

Keeping your mouth clean of bacteria that can cause infections, and treating your mouth gently, can go a long way towards helping mouth sores go away.

  • Brush gently but thoroughly
  • Floss regularly
  • Use non-irritating mouthwashes

Ice can help reduce the swelling surrounding the oral ulcer and make the pain less intense. Wet tea bags are also great home remedies, as they draw out moisture from the ulcer and act as an antibacterial, helping the wound heal faster.

Changing your diet can also help – make sure that you are eating a healthy balanced diet with enough vitamin B12 and iron, and try not to hurt your mouth while you eat. Avoiding foods that are high in acid can also help.

Otherwise, anything that prevents a lupus flare will also prevent oral ulcers, as they can be a part of a flare. Take medications as prescribed and avoid triggers. If your medications (such as antimalarials) are causing a lot of mouth sores to appear as a side effect, talk to your lupus treatment team about adjusting medications.

In particular, it may be useful to ask about Dapsone or topical creams —  these medications can be used to treat particularly stubborn sores.

The mouth is the beginning of the gastrointestinal tract and keeping it healthy is key. Here are a few diet tips to help keep your gut healthy and happy.


Things to try:

Dental hygiene
  • Use a high-quality toothbrush
  • Regularly visit the dentist
Diet changes
  • Eat a diet rich in vitamins A, C, and E
  • Include fresh fruit and vegetables
Comments (11)

11 thoughts on “Oral Ulcers, Mouth Sores: Battling Lupus Symptoms

    1. I’ve been having a lupus flare that’s got a few mouth sores. I can’t wear my dentures due to the pain. But I have these even when I am not having a flare up

  1. I have had several flares and my Dr prescribed Nystatin. Oral rinse 3 times a day. I also use Biotine,mild mint,it helps sooth a dry sore mouth. Sojrens . I also see a hygenist every 4 months to help keep gums and teeth healthy.

  2. I have had an ulcer for over 2 weeks. I have always been able to cure it in 2 to 3 days. Since it is taking so much longer I went to the Dentist to see if it was infected and told it wasn’t. I also use a compound prescription mouth rinse called Magic Mouthrinse. In addition I have a dental steroid paste as a second line of defense but that is also not helping. The dentist I saw yesterday stated the longer you have them they become resistant to the meds. He also stated if they last over 3 weeks they sometimes rewound the spot to create a fresh wound to help it heal. I’m a senior and have been dealing with this for years. I swear by my water pic . Beside putting bottled water in it I add peroxide as well as the latest listerine product for gum therapy. The Dentist was impressed with the state of my teeth & gums even though I have broke every tooth in my mouth, some 3 or 4 times. Anyone who doesn’t have Lupus or Sjögren’s has absolutely no idea of everything that comes with these progressive diseases. My depression is getting steadily worse.

    1. Did you have any trouble getting insurance to pay for your Magic Mouthwash? My Rheumy prescribed it for me earlier this year when I was having an especially hard time with mouth sores, and my insurance refused to cover it and it was going to cost over $200! So, to say the least I suffered through without it and used sore throat spray. 😕

  3. I am slowly loosing all my teeth do to the mouth sores, and dry mouth issues, the Mary’s Magic Mouthwash Helps although not totally, once healed, make sure to keep some GUM, with you at all times, it works for me…keeps you mouth wet,(not dry) hopefully it will help someone else, just a thought. best of luck to all of us, it is a lifetime battle to the ones living with this disease. I personally have had it 20 years. love ta all

  4. I highly recommend KANKA-Softbrush. It’s compact design makes it really easy to use. Effective at providing instant relief and has even promoted the healing process for me.

  5. I’m not getting ulcers, but my tongue and the roof of my mouth burn. It’s like eating something extremely hot, but it happens no matter what I eat, even with cool or cold food. When I’m not eating, my gums and the outer edge of my tongue burn and tingle. Anyone else ever have this?

  6. I have found using Kanka after brushing my teeth before bed, works great. Then during the day when then start hurting I use Kanka soft brush. The slim design can easily go in purse or pocket. This seems to heal them quickly.

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