Oral ulcers can be an unwelcome and painful symptom of autoimmune conditions, often impacting everyday activities like eating, speaking, and even smiling. For those managing autoimmune diseases, understanding the connection between these conditions and oral health is vital. In this blog, we’ll explore how dentists diagnose and treat oral ulcers in patients with autoimmune conditions, ensuring better oral care and improved quality of life.

What Are Oral Ulcers?
Oral ulcers are open sores that develop in the soft tissues of the mouth, such as the inner cheeks, tongue, gums, or lips. While occasional ulcers might result from injury or irritation, recurrent or persistent ulcers often indicate an underlying condition—especially autoimmune diseases.

Autoimmune Conditions Linked to Oral Ulcers
Autoimmune diseases occur when the immune system mistakenly attacks healthy tissue. In many cases, the mouth is one of the first areas to show symptoms. Some autoimmune diseases commonly associated with oral ulcers include:

Systemic Lupus Erythematosus (SLE): Ulcers in lupus patients are often painless and located on the roof of the mouth.
Behçet’s Disease: This condition frequently causes recurrent, painful oral ulcers.
Pemphigus Vulgaris: A rare condition where blisters in the mouth burst to form ulcers.
Lichen Planus: Characterised by white, lace-like patterns and painful sores on the inner cheeks or tongue.
Crohn’s Disease: Though primarily affecting the digestive system, Crohn’s disease can lead to swollen gums and painful ulcers in the mouth.
Symptoms of Oral Ulcers in Autoimmune Diseases
Oral ulcers linked to autoimmune conditions often share common symptoms, such as:

Persistent pain or discomfort.
Red, inflamed areas surrounding the ulcer.
Difficulty eating or speaking.
Recurring ulcers that heal and reappear.
However, the exact presentation can vary depending on the underlying disease.

Diagnosing Oral Ulcers
Dentists play a crucial role in identifying oral ulcers and determining their cause. Here’s how the diagnostic process works:

1. Patient History
Your dentist will start by reviewing your medical history to identify autoimmune diseases or other conditions that might contribute to oral ulcers.

2. Physical Examination
A thorough examination of the mouth helps the dentist assess the size, shape, location, and frequency of the ulcers.

3. Biopsy
In cases where the cause is unclear, a small sample of tissue may be taken for lab analysis. This can rule out infections, cancer, or other conditions.

4. Collaboration with Specialists
If an autoimmune disease is suspected but undiagnosed, the dentist might refer you to a rheumatologist, dermatologist, or gastroenterologist for further evaluation.

How Dentists Treat Oral Ulcers
The treatment of oral ulcers in autoimmune diseases focuses on managing pain, promoting healing, and addressing the underlying condition. Here are common approaches:

1. Topical Treatments
Corticosteroids: Gels or creams like hydrocortisone can reduce inflammation and speed healing.
Anaesthetic Gels: Benzocaine or lidocaine helps numb the area, providing temporary pain relief.
2. Mouth Rinses
Antimicrobial or anti-inflammatory rinses can reduce discomfort and prevent infection in ulcerated areas.

3. Systemic Medications
For severe or persistent ulcers, systemic treatments may be required:

Immunosuppressants: Drugs like methotrexate or azathioprine help control autoimmune activity.
Biologic Therapies: Medications like infliximab or adalimumab target specific immune pathways.
4. Laser Therapy
Low-level laser therapy can reduce pain and accelerate healing in some cases.

5. Nutritional Support
Nutritional deficiencies, such as low iron, folate, or vitamin B12, can worsen ulcers. Dentists may recommend supplements if deficiencies are identified.

Preventing Oral Ulcers in Autoimmune Conditions
While it’s not always possible to prevent oral ulcers entirely, these tips can reduce their frequency and severity:

1. Maintain Good Oral Hygiene
Brush gently with a soft-bristled toothbrush and use fluoride toothpaste to minimise irritation.

2. Avoid Trigger Foods
Spicy, acidic, or rough-textured foods can exacerbate ulcers. Stick to soft, bland foods during flare-ups.

3. Stay Hydrated
Dry mouth can worsen ulcers. Drink plenty of water and consider saliva substitutes if needed.

4. Manage Stress
Stress can trigger autoimmune flare-ups and ulcers. Practices like mindfulness, yoga, or therapy can help.

5. Regular Dental Check-Ups
Frequent visits to the dentist can help catch ulcers early and monitor changes in oral health.

The Role of Dentists in Comprehensive Care
Dentists are an essential part of the care team for patients with autoimmune diseases. By working closely with medical specialists, they ensure oral health is prioritised as part of the broader treatment plan. This collaboration is particularly important for patients experiencing recurrent or severe oral ulcers.

Oral ulcers caused by autoimmune diseases require careful diagnosis and tailored treatment. With the right interventions, dentists can help alleviate discomfort, support healing, and improve overall quality of life. If you’re managing an autoimmune condition and struggling with oral ulcers, don’t hesitate to consult your dentist. A proactive approach to oral care can make a world of difference.