1. You're stressed OUT.
If you find your ulcers pop up whenever you're feeling particularly drained or run-down, there could be a connection between the crazy pace of your life and your oral health. There's no proven scientific reason why stress causes ulcers to appear, but it's a common complaint - "scientists are unclear on what exactly causes mouth ulcers, but many people do report that they develop ulcers during stressful times, so there could be a link," says Henry Clover, Denplan's Chief Dental Officer at Denplan. "During stressful times, people often clench or grind their teeth in their sleep – known as bruxism – which this may lead to trauma of the cheek tissues, from which a mouth ulcer might form."
2. You're eating "trigger" foods.
Love fruit, or a total chilli addict? Brace yourselves for some bad news. "Some patients report things like spicy foods and acidic fruits such as tomatoes, oranges, pineapple, apples and strawberries as their mouth ulcer triggers," Henry says. "People with allergies, such as coeliacs, may find that allergens such as wheat flour cause a mouth ulcer too." If you suffer from recurrent mouth ulcers, it may be worth keeping a food diary for a few weeks to see if there are any particular triggers for you – not only will it help your dentist figure out what's going on, it'll help you to avoid future flare-ups.
3. You're vitamin deficient.
Equally, mouth ulcers can be caused by the things you're not eating, as well as the ones you are. Being deficient in vitamin B12 or iron in particular can make you more prone to developing them - a common problem amongst vegetarians and vegans, as these nutrients are generally found in meat, fish and dairy products. However, it's not impossible if you're on a restricted diet. Try eating more eggs, fortified breakfast cereals, and iron-rich veggies like beans and spinach, or take a targeted multivitamin, and if this is the cause of your ulcers, you should see an improvement.
4. You're choosing the wrong toothpaste.
"A small proportion of people may find they're sensitive to an ingredient found in toothpaste and other toiletries called sodium lauryl sulphate (SLS), which provides the foaming action when you brush your teeth," explains Henry. "This ingredient may cause sensitivity in the lining of your cheeks, causing the skin to peel or other irritation such as mouth ulcers." If you think you might be sensitive to SLS, speak to your dentist about finding a suitable alternative toothpaste, but make sure whatever you choose still contains the recommended level of fluoride to protect your pearly whites against tooth decay.
5. You've given up smoking.
If you've recently kicked the cigs to the kerbs, you might notice you're developing way more ulcers than usual. It sucks (like you weren't having a hard enough time with the withdrawal symptoms already!) but it's a totally normal symptom that affects 2 in 5 would-be non-smokers in the early months, along with coughing, sneezing, and more frequent sore throats. Thankfully, you should find that all of these issues are temporary, usually passing within about six weeks, so don't let the initial irritation put you off your ultimate goal of giving up.
6. You need to see your dentist.
The majority of mouth ulcers appear for no apparent reason and, although annoying, usually resolve themselves within a week or two. "However, you should always see your dentist if you have a mouth ulcer that doesn't heal within three weeks as it could be a sign of mouth cancer," Henry says. "Early diagnosis of mouth cancer is very important and significantly improves the chances of successful treatment." Don't panic – mouth cancer is rare in young people, and it could be something as simple as your diet or your brushing technique that's causing your problem. However, cases of mouth cancer have risen by a third in the last ten years, so get checked out anyway – it's far better to be safe than sorry.