Mouth ulcers and halitosis: causes and management

Mouth ulcers and halitosis are distressing conditions that often prompt patients to seek advice from the dental team. There are a number of causes and treatment options for them.

Ulceration of the oral mucosa is known by many names—aphthous ulceration, recurrent aphthae, canker sores, dyspeptic ulcers and Mikulicz's ulcers.

Aphthae can be categorised into three types: minor aphthae; major aphthae (or periadenitis mucosa necrotica recurrens or Sutton's disease); and herpetiform aphthous ulcers. Herpetiform ulcers are not related to the herpes virus.

The most common ulcers are minor aphthae, which account for 80% of all mouth ulcers. 10–15% are major aphthae and 5–10% are herpetiform (British Society for Oral Medicine, 2011). Aphthous ulceration is not contagious.