Chronic Oral Ulcerations
A 35-year-old woman residing in New Jersey is currently taking an SSRI along with various multivitamins and supplements, but is not prescribed any additional medications. For the past month, she has been experiencing a burning sensation in her mouth accompanied by recurring clusters of painful sores resembling ulcers or canker sores on the edges and tip of her tongue. Initially, this discomfort also included an exceedingly sore, inflamed throat, but that symptom has diminished over time. However, the soreness within her mouth persists, fluctuating in intensity and location; different areas of her tongue hurt at various intervals, making it difficult for her to find relief. For instance, upon waking this morning, she noticed a solitary ulcer on the side of her tongue, and by the evening, the number of smaller sores had increased to three or four. In an attempt to alleviate her symptoms, she has tried treatments for oral thrush and is currently using a magic mouthwash, which has offered little to no relief. Even with the lidocaine in the mouthwash, the pain continues unabated, and instead of providing comfort, it accentuates the awareness of the bumps on her tongue. Occasionally, she experiences mild burning sensations in her lips and cheeks as well. Feeling frustrated and at her breaking point, she consulted her primary care physician, an ENT specialist, and a dentist; however, their responses were underwhelming as they mostly recommended returning if the condition does not improve. She is left wondering what might be causing these persistent oral issues.
Answers (1)
8/17/2025, 1:02:06 AM
OpenHealth AI
Experiencing persistent oral ulcerations and a burning sensation in your mouth can be frustrating and painful. While you've already sought help from your primary care physician, an ENT specialist, and a dentist, it’s essential to continue looking for answers and managing your symptoms.
Possible Causes:
The symptoms you're describing may stem from several potential causes, including:
- Aphthous Stomatitis (Canker Sores): These are common and can be triggered by stress, certain foods, or nutritional deficiencies (like vitamin B12, folate, or iron).
- Oral Lichen Planus: A chronic inflammatory condition that can cause sores or white patches in the mouth.
- Medication Side Effects: SSRIs or certain supplements can sometimes cause oral issues.
- Mouth Irritants: Certain toothpastes or mouthwashes may exacerbate sensitivity or cause irritation.
- Digestive or Systemic Issues: Conditions like reflux can also contribute to oral symptoms.
Next Steps:
Here’s a prioritized action plan to help manage your symptoms and potentially identify the underlying cause:
-
Nutritional Evaluation: Consider a diet that is rich in vitamins, especially focusing on vitamin B12, folate, and iron. If it's difficult to track your intake, a multivitamin specifically aimed at these nutrients could be beneficial.
-
Avoid Known Irritants: Identify and eliminate potential triggers from your diet—these might include spicy foods, citrus, and certain toothpaste brands (especially those with sodium lauryl sulfate).
-
Topical Treatments: Since the magic mouthwash hasn’t provided relief, consider applying coconut oil or aloe vera gel to the sores. These can provide a soothing effect and promote healing.
-
Stress Management: Since stress can exacerbate oral ulceration, incorporating stress-reducing activities such as yoga, meditation, or gentle exercises may help.
-
Oral Hygiene: Maintain gentle oral hygiene practices—use a soft toothbrush and consider rinsing with saline (salt water) for gentle cleansing, which can also aid in healing.
Monitoring Symptoms:
Keep a journal to track the appearance of sores, potential triggers (foods, stress levels), and any other symptoms. This can provide valuable information for your future consultations.
When to Seek Further Help:
If your symptoms do not improve within the next few weeks or if new symptoms arise (such as fever, significant weight loss, or difficulty swallowing), reconsider following up with your healthcare providers or possibly seeking a second opinion from a specialist in oral medicine or a dermatologist who focuses on oral conditions.
Please remember that seeking effective relief is important, and the persistence of these symptoms warrants thorough exploration and management strategies tailored to your needs. You're not alone in this; finding the right approach may take some time, but you're taking proactive steps towards improvement.
Related Questions
Understanding Tuberculosis Exposure Risk
A 26-year-old male, who neither drinks alcohol nor smokes, seeks to understand the implications of exposure to tuberculosis (TB). As an anesthesia technician, I became concerned after I encountered a TB-positive patient about a month ago. I had to enter the patient’s room several times to perform blood gas tests. On my first entry, I mistakenly wore my N95 mask incorrectly due to the hectic nature of attending to multiple rooms. From my research, it appears that TB is quite transmissible; direct exposure can pose a serious risk of infection. Transmission usually requires prolonged contact with an infected individual, particularly in a close or face-to-face setting. In this case, the patient was lying face down and appeared to be sleeping when I entered. I have already undergone testing for TB, but I am eager to deepen my understanding of the risks involved in these situations.
24M | Unexplained Fainting Incident
**Note:** I previously shared this story, but it was inexplicably removed. I’m a 24-year-old male without any medical diagnosis or prescription medications. While I do consume alcohol occasionally, I hadn’t been drinking before this happened. Around 3 a.m., I got up from bed to use the restroom. As soon as I began to urinate, I suddenly felt a wave of dizziness. The next moment I was aware of was regaining consciousness in the bathtub, startled awake by the sensation of something dripping on me—only to discover it was my own blood. This was my first experience with fainting. When I came to, confusion set in. I was disoriented and couldn’t comprehend why I was being dripped on while in what I thought was my “bed.” Strangely, I also imagined that I was lying on a collection of marbles (which I actually don’t own)—this turned out to be the shattered glass of my shower door lying around me. I’m uncertain whether I lost consciousness first and then fell, or if the fall caused my brief blackout. It took me a few moments to understand why I was in the bathroom at all. I’m not sure how long I was out; I only remember it was around 3 in the morning when I initially got up, and about the same time when I regained consciousness. I dialed 911, and the ambulance arrived promptly. They checked my vitals, performed an EKG and measured my blood sugar, finding nothing unusual. At the emergency room, they repeated the vital checks, conducted a CT scan, drew blood, and took x-rays—yet still no abnormalities were detected. I had several cuts on my face and left arm (curiously, this is the arm that would have been turned away from the door), along with bruising around my ribs. Since the incident, I’ve been suffering from headaches and pain in my ribs. I received stitches on both my face and arm. The nurse suggested I could have stronger pain relief, but I opted for just Toradol. They eventually discharged me, stating, "We’re unsure what caused this, but return if it happens again." What might have triggered such an incident? How can I safeguard against it reoccurring if they remain uncertain about the cause?
Swelling Beneath My Chin Near the Jawline
18-Year-Old Male: I'm reaching out to any medical professionals who might provide insights into my situation. I've been using marijuana since I was 14, but now, at 17, I'm making an effort to stop and have been clean for 18 days. Recently, I've discovered an unusual swelling located just beneath my chin, behind my jaw. It causes some discomfort when I move, yet it doesn’t feel painful continuously. I'm somewhat anxious that this could be indicative of a more serious issue, especially considering it's positioned near my chin's lymph nodes. Any advice or information would be greatly appreciated as it might help alleviate my worry.
Challenges with Appetite and Discomfort While Eating — Difficulty in Gaining Weight
As an 18-year-old male, I find that I become satisfied after consuming rather minimal amounts of food. This situation presents a considerable challenge, particularly since I only need to have a standard breakfast, lunch, or dinner to feel completely satiated for the remainder of the day. My goal of increasing my weight has made this issue even more complicated. When I limit myself to one meal per day, I often face weight loss or an uncomfortable sensation of fullness that leaves me feeling sluggish. Opting for two meals makes me feel excessively bloated, distracting me from my daily responsibilities. Moreover, I suffer from an unusual issue with my throat, where almost any food I consume causes discomfort, as detailed in the list below. I have contemplated focusing on having just lunch while continuing my weightlifting regimen to maintain my current weight and gradually build muscle. What advice could you offer? Could there be an underlying cause for these symptoms? Lastly, would it be wise for me to consult a healthcare professional? Foods That Cause Discomfort: Bread, flour, pizza, fruits, sugary or starchy items, seed oils, chips, and essentially everything else. Foods That Are Tolerable: Rice, salads, chicken, fish, and vegetables. Overall Symptoms Include: * Quick satiety after normal meals * Challenges in gaining weight * Bloated and lethargic sensations when consuming more than one meal * Persistent throat sensitivity to a wide variety of foods
Seeking Insights: My Journey with Undiagnosed Neurological Symptoms
Hello everyone, I'm a 34-year-old female grappling with neurological symptoms that first appeared in October, and I’m eager to hear from anyone who might have faced similar challenges. My journey began with unexpected migraines, blurred vision, and an ongoing sensation of being off-balance or intoxicated. Gradually, I began experiencing mainly sensory-related symptoms, such as tingling and burning sensations, feelings of extreme heat and cold, sharp pains radiating in my arms and back, as well as discomfort in my hands and toes, alongside intermittent numbness. I also endure varying degrees of weakness and heaviness in my right side, specifically my arm and leg, although I haven’t suffered complete functional loss. The nature of my symptoms is erratic; they fluctuate rather than consistently deteriorate. An MRI revealed mild, scattered lesions in the white matter, which were deemed nonspecific. Further tests from a lumbar puncture returned normal results, showing no markers of inflammation, and the oligoclonal bands were not present. A thorough range of lab tests yielded no significant findings. After evaluating my case, the neurology team suggested a possible diagnosis of MS and administered a three-day course of intravenous steroids. While I noticed a slight improvement in some sensory pain, my symptoms persist and continue to vary day by day. I still experience headaches and pressure in my head along with episodes of blurred vision, but there have been no new deficits since treatment. I am reaching out to connect with others who have had similar experiences. I would like to learn about the insights or diagnoses you encountered and what treatments proved beneficial (such as those related to migraine disorders, dysautonomia, or sensory neuropathy, for example). If you have navigated a similar path, I would greatly appreciate your sharing your story. Thank you!