Dr. Gott: Mouth ulcers plague teen

Dear Dr. Gott: My 18-year-old daughter has suffered with mouth ulcers for years. She has seen two ear-nose-and-throat specialists and a dermatologist, with no results. One of the specialists diagnosed her with acid reflux despite her lack of symptoms. She has had a biopsy, but it was normal. Her primary-care physician suggested taking lysine and B vitamins and changing her brand of toothpaste, but nothing has made a difference. After reading some old home remedies in the library, we found that swishing sauerkraut juice helped but only for a short time. We are both at our wits’ ends looking for a treatment or preventive therapy. She usually has an outbreak every month that consists of four to 10 ulcers at a time. Please help.

Dear Reader: Let’s start with the acid reflux. If your daughter truly has acid reflux, she should be under the care of a gastroenterologist to determine whether it caused by a hiatal hernia or other factor. If she is asymptomatic, she shouldn’t need medication, but that is best determined by the specialist.

Now, to the mouth ulcers. These can be very painful, especially when they occur in clusters. You say that a biopsy was taken, but you did not share the results. The most common cause is the herpes virus. If this is the case, your daughter may benefit from an antiviral medication such as Valtrex.

Regardless of the cause, your daughter should also find ways to reduce stress, which can worsen an outbreak or bring one on. She can also try brushing her teeth with baking soda and water rather than manufactured toothpaste. Many contain sodium laurel sulfate, which can cause mouth ulcers in people sensitive to it. Natural toothpastes, such as Tom’s of Maine, contain very small amounts (or none at all) and may not have the detrimental effect that standard brands do.

I recommend your daughter see a dentist as a next step. This type of specialist has a vast knowledge of the mouth and teeth and may have alternative therapies or suggestions that a general physician does not. In the meantime, your daughter can try oral numbing agents, such as Orajel, to dull or eliminate the pain caused by the ulcers. While this is not a long-lasting solution, it can provide relief for several hours.