Mouth ulcers are a classic feature of lupus and are one of the defining criteria of the disease. They typically occur due to a reduction in salivary flow. Mouth ulcers may indicate a flare-up or be the first sign of the condition.

Lupus is a chronic autoimmune condition. This term describes when a person’s immune system mistakenly attacks healthy tissue. Systemic lupus erythematosus (SLE) is the most common type of lupus, but other types include cutaneous lupus, which affects the skin, and drug-induced lupus.

Lupus causes inflammation and can affect different areas of the body, which may result in a variety of symptoms. Some common symptoms of lupus include fever, rash, fatigue, and mouth sores.

In this article, we will discuss why some people with lupus may get mouth ulcers.

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Mouth ulcers are a classic feature of lupus and are on the list of criteria for SLE set by the American College of Rheumatology. Mouth ulcers typically occur during a lupus flare and may be associated with other lupus symptoms, such as joint pain, rash, and hair loss.

A 2022 review indicates that oral ulcers may be more prevalent in people who develop SLE in childhood compared with those who develop the disease in adulthood. Additionally, the review notes that 75% of people with SLE have reduced salivary flow, which may be a risk factor for oral health issues, such as mouth ulcers.

In addition to a lupus flare, other factors that can trigger mouth sores include:

  • periods of stress
  • certain medications
  • injury or irritation in the mouth
  • underlying vitamin or iron deficiencies

According to Lupus UK, oral lesions, such as mouth ulcers, typically improve when managing the condition, and their recurrence is often a sign of a new flare-up. Research also suggests that oral symptoms of lupus are among the first to appear and can help a doctor diagnose the condition.

Lupus UK also advises that oral dryness in lupus may be related to Sjögren’s disease. This is another autoimmune condition that is often associated with lupus.

The Centers for Disease Control and Prevention (CDC) explain that mouth ulcers in lupus usually appear on the roof of the mouth. However, the sores may also occur on the gums, inside the cheeks, or on the lips. Mouth ulcers may be painless or cause a sore, dry mouth.

Oral ulcers typically heal on their own without any treatment. However, a person with lupus may require medications to help decrease the severity of their mouth sores.

Health experts, such as a doctor or dentist, may suggest the following medications:

  • steroid tablets, such as prednisolone
  • antimalarials, such as hydroxychloroquine
  • anesthetic, such as benzocaine

Additionally, a healthcare professional may also recommend over-the-counter treatments to help speed up healing, prevent infection, or reduce pain. These can include:

  • antimicrobial mouthwash
  • a painkilling mouthwash, gel, or spray
  • corticosteroid lozenges

As dry mouth is linked to oral ulcers in lupus, people may help prevent them from occurring by avoiding the contributing factors to dry mouth, such as:

  • smoking
  • drinking alcohol
  • using mouth rinses containing alcohol
  • drinking caffeinated beverages

A person may also consider chewing gum or using salivary stimulants to help encourage salivary flow and address dry mouth.

Other prevention tips may include:

  • avoiding foods that may trigger or worsen symptoms
  • talking with a doctor about changing medications that are known to cause ulcers
  • maintaining dental hygiene and regular dental appointments
  • avoiding triggers known to cause outbreaks in the past

Mouth ulcers may be one of the first signs of lupus. Diagnosing lupus can be difficult due to the variety of nonspecific symptoms. As such, it may be advisable to consult a doctor if a person notices mouth ulcers in addition to other symptoms such as fatigue, rashes, and fever.

For individuals with a diagnosis of lupus, mouth ulcers may be a sign of a flare-up, which could require medical treatment. A person may wish to contact their doctor if their mouth sore lasts longer than 3 weeks or becomes very painful.

Mouth ulcers are a common symptom of lupus. They can indicate a flare-up or be the first sign of lupus in an individual without a diagnosis.

When the condition is active, the widespread inflammation may manifest as mouth sores. It can also cause dry mouth, which can contribute to oral ulcers. Other factors, such as certain medications, can also cause mouth sores.

If a person notices mouth sores, in addition to other symptoms of lupus, it is advisable that they seek medical help. If the sores do not heal or cause severe pain, medical assistance may be necessary. While many mouth sores naturally resolve, a doctor may suggest over-the-counter creams or gels or prescribe medication.