Mouth ulcers or aphthous ulcers are found under the tongue, on the inner side of the lower lip, or on the inner side of the cheeks. At least that is where they are most commonly found; they can be found anywhere in the mouth. Although they are extremely small and may indeed be hardly visible, they cause a great deal of pain. They are white, rarely more than a couple of millimetres across and last on average for a week or ten days. They often occur in groups of three or four.

No one really knows what causes them but the unfortunate folk who suffer tend to keep on suffering. The only optimistic note is that as the years go by they usually occur less frequently.

Physical trauma (slipping with the toothbrush or chewing something particularly hard) can cause aphthous ulcers but the most important cause seems to be stress. Some people get indigestion when under stress, some get headaches and others get aphthous ulcers. There are a number of treatments around which are designed to provide symptomatic relief: there is no cure as yet.

Among the leading products are Rinstead Pastilles and Rinstead Gel. The pastilles are said to sell approximately 30 million packs a year and consist of a mixture of antiseptics and ingredients intended to relieve pain. They do seem to provide an acceptable amount of relief. Rinstead Gel contains benzocainc (an anaesthetic) which is also an ingredient of Cox’s Mouth Ulcer Lozenges, Cupal Month Ulcer Tablets and Ora-jel. Anbesol, Medijel, Medijel Pastilles and Mulcets Gel all contain another anaesthetic – lignocaine. Oralcer contains clioquinol and I do not recommend it. Mulcets Mouth Ulcer Tablets contain ascorbic acid (vitamin C) and cetylpyridinium chloride which is an antiseptic. I think that products containing benxocainc or lignocainc should provide useful relief.

Mouthwashes and gargles are advertised as being suitable for a wide range of conditions including mouth ulcers, sore throats, gum infections and soreness. The following products all contain at least one antiseptic or disinfectant: Bansor Mouth and Throat Antiseptic, Betadine Gargle and Mouthwash, Boots Antiseptic Mouthwash and Gargle, Dentosine and Listerine Antiseptic. There are also a number of gels, lotions and pastilles designed to help relieve soreness of the gums. These include Gum-e^e, Smith’s Red Gum and Menthol Pastilles, Tellora D3, Three Flasks Sore Gum Lotion and Tyordac Gum Pastilles. Most minor mouth infections will clear up by themselves and more serious infections need the attention of a dentist or doctor. Corsodyl (available as a gel or mouthwash) which is recommended in the treatment of gingivitis (gum infection and inflammation) has been reported to stain the teeth.

Cold sores, like mouth ulcers, are small, painful and common.

Menthol and camphor are both said to have a soothing effect. One or both of these substances are available in the following products: Ajrtons Cold Sore Lotion, Boots Cold Sore Lotion, Cold Sore Lotion, Candol Cold Sore Salve, Cnpal Cold Sore Cream and Three Flasks Cold Sore Lotion. Dryness and soreness of the lips caused by an allergy to a cosmetic, or by sun or wind, can be eased by using zinc and castor oil cream or calamine cream or any suitable plain cream. Zinc and Castor Oil Ointment BP and Calamine Ointment BPC are non-branded substances which are useful. These are probably as helpful and effective as commercial, branded products.