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Diagnosing Mouth Ulcers

If you have a mild mouth ulcer, there is no need for you to have a formal diagnosis from your GP.
You only need to visit your GP if you have a mouth ulcer that is very painful, has lasted for more than three weeks, or if you are getting mouth ulcers regularly.

What the GP will do
In these instances, your GP will probably look inside your mouth to examine your mouth ulcer. They will also look at your medical history to help them work out what is causing your ulcer.
If you have mouth ulcers that keep coming back, your GP may ask you a series of questions to help work out whether your mouth ulcers have an underlying cause. For example, you may be asked:
•how often you get mouth ulcers
•how long your ulcers last for
•how severe the pain is
•what treatments you have used – either prescribed or over the counter
If your GP is unsure about the diagnosis, they might want to rule out any conditions that could be causing your ulcers to keep coming back. You may be referred you for a series of blood tests such as:
•Full blood count (FBC). This is a common type of blood test that indicates the state of your general health. It shows whether there is an infection in your body, and will also indicate whether you have been exposed to any toxic substances.
•Erythrocyte sedimentation rate (ESR). This test shows whether there is inflammation in your body. If there is, your GP can conduct further tests to help find out what condition may be causing it.
•Ferritin. This test measures how much iron is being stored in your body. A lack of iron in your body can cause mouth ulcers.
•Vitamin B12. This test checks whether you have enough vitamin B12 in your body. A lack of vitamin B12 can also cause mouth ulcers.

Seeing a specialist
If you have had a severe mouth ulcer for more than three weeks, your GP may refer you to a hospital specialist.
You may also be referred if your mouth ulcer looks abnormal, for example if you have large red and white patches in your mouth, which often bleed and are painful.
You may require a biopsy, which is a procedure in which a small tissue sample is taken from your mouth for further examination.

Is it mouth cancer?
Sometimes, a severe, long-lasting mouth ulcer can be a sign of mouth cancer. About 80% of people with mouth cancer have a long-lasting mouth ulcer that does not heal.
Ulcers caused by mouth cancer usually appear on or under the tongue, although they can appear elsewhere in the mouth.
You are more at risk of developing mouth cancer if you are:
over 45 years old
a heavy smoker
a heavy alcohol drinker
If mouth cancer is detected early, the chances of a complete recovery are good. This is why it is always important to have regular check-ups with your dentist. They can carry out a thorough assessment of your teeth and mouth, and will be able to spot any possible signs of mouth cancer.

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