A mouth ulcer that won’t heal: when to see a doctor

Almost everyone gets mouth ulcers from time to time. A bite on the cheek, a sharp tooth, spicy food or stress can all cause one. These ulcers are painful but usually heal on their own within one to two weeks.

An ulcer that does not heal is different. In India, mouth cancer is one of the most common cancers, and it often starts as a small sore that people ignore for months.

Signs that need a doctor’s attention

See a doctor, a dentist or a cancer surgeon if you notice any of these for more than two to three weeks:

• An ulcer or sore that is not healing
• A white patch (leukoplakia) or red patch (erythroplakia) on the tongue, cheek or gums
• A lump or thickening in the mouth or neck
• Bleeding from the mouth without an obvious cause
• Difficulty opening the mouth, chewing or swallowing
• Teeth becoming loose for no reason

Pain is not a reliable guide. Early mouth cancers are often painless, which is one reason they are missed.

Who is at higher risk?

The biggest risk is tobacco in any form: gutka, khaini, betel quid with tobacco, cigarettes and beedis. Areca nut (supari) and alcohol add to the risk. Sharp, broken teeth that rub on the same spot for years can also play a part.

What happens at the clinic

The doctor examines your mouth and neck. If an area looks suspicious, a small piece of tissue is taken under local anaesthetic (a biopsy). This is a quick procedure, and it is the only way to know for certain whether a sore is cancer.

Why early matters

Mouth cancer found at an early stage is often treated successfully with surgery alone, with smaller operations and better function afterwards. Found late, it usually needs more extensive surgery along with radiotherapy.

If a sore in your mouth has lasted more than two to three weeks, don’t wait for it to hurt. Get it checked.