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Ex-smoker suffers from mouth ulcerDear Dr. Reitz: In a recent article you discussed the cause and treatment for cold sores. My problem is the occasional painful mouth ulcer that first occurred a few months after I gave up cigarette smoking. Is there any reason my past smoking made me more susceptible to mouth ulcers, or does my mouth just miss that daily cigarette? - Robert Dear Robert: There are various causes of oral ulcerations. I will just discuss the most common and least harmful. Ulcers that form on the cheek, floor of the mouth and bottom of the tongue are generally minor aphthous ulcers also known as canker sores. They occur in about 20 percent of the population generally between 10 and 40 years of age, and usually only in nonsmokers. The exact cause of aphthous ulcers is unknown; however it does appear to run in families, which may suggest an inherited abnormal immune response. In other words, the lining of your mouth overreacts to the normal bacteria in your mouth. It has been suggested that the nicotine in tobacco inhibits the immune response, thereby preventing your body from causing an ulcer. Unfortunately, smoking is not a good method of preventing aphthous ulcers. Some studies associated anxiety and emotional stress to aphthous ulcers, while others linked eating tomatoes and strawberries, indicating a food sensitivity as the cause. Regardless of what initiated the ulcerative lesions, they all contained many different species of bacteria. A strong relationship has been found between sodium lauryl sulfate, an ingredient in most toothpaste, and aphthous ulcers. SLS is the ingredient that gives toothpaste its foaming action, and since most toothpaste manufacturers want their product to make suds, it's hard to find a toothpaste that doesn't contain SLS. I would first suggest you change to a toothpaste that is free of SLS. There are various over-the-counter medications that may limit the duration and pain of the lesions. One product in the form of a rinse, aptly named Rincinol, sooths the pain by forming a coating over aphthous ulcer. A different approach by Colgate (Soothe-N-Seal) applies a film barrier to the ulcer to accelerate healing. While the ulcer is present, avoid spicy foods, acidic drinks such as orange juice, and don't rinse with salt water or mouthwash containing alcohol, because they all irritate the lesions. Healing should occur within two weeks. If not, it's time to make an appointment with your dentist. The column is written by John Reitz, DDS, and does not represent the opinion of the Pennsylvania State Dental Board. Dr Reitz answers questions from readers. E-mail them via his Web site at reitzdds.com or mail to John Reitz, DDS, 30 Commerce Drive, Wyomissing PA 19610 John
V. Reitz, D.D.S., F.A.G.D. Copyright
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