Can Gum Disease Cause Ulcers?

If you’ve noticed a painful ulcer around your gums while also dealing with swollen or bleeding gums, it’s easy to assume the two must be connected.

You might be wondering whether gum disease caused the ulcer, whether it means your gum problem is getting worse, or whether the sore has another explanation.

Gum disease doesn’t usually directly cause mouth ulcers. Gingivitis and periodontitis primarily affect the gums and other tissues supporting your teeth, while mouth ulcers are localised sores that can develop for several different reasons.

It is possible to have gum disease and a mouth ulcer at the same time without one necessarily causing the other.

Can Gum Disease Cause Mouth Ulcers?

The short answer is usually no.

Gum disease commonly causes symptoms such as:

• Red or swollen gums
• Bleeding when brushing
• Sore or tender gums
• Persistent bad breath or an unpleasant taste
• Gum recession
• Sensitive teeth
• Loose teeth in more advanced disease

A typical mouth ulcer is different.

Healthdirect describes mouth ulcers as shallow sores that often have a white or grey surface with redness around the outside. They can develop in several areas of the mouth, including on the gums.

This means an ulcer can appear directly on gum tissue without necessarily being caused by gum disease.

The location alone doesn’t establish what caused it.

Can Gingivitis Cause Mouth Ulcers?

Gingivitis is a common form of gum disease caused by plaque building up along the gumline.

It can make your gums:

• Red
• Swollen
• Sore
• Prone to bleeding

However, mouth ulcers aren’t considered a typical symptom of gingivitis.

If you have gingivitis and develop a painful ulcer, another explanation may therefore be responsible.

For example, mouth ulcers may be associated with injury or irritation inside the mouth, stress, certain foods, some medicines or medical conditions.

Braces and dentures can also sometimes irritate the tissues and contribute to mouth ulcers.

Can Periodontitis Cause Ulcers?

Periodontitis is a more advanced form of gum disease that affects the tissues and bone supporting the teeth.

It can cause symptoms such as:

• Gum recession
• Bleeding gums
• Persistent bad breath or an unpleasant taste
• Sensitive teeth
• Loose teeth

A typical mouth ulcer isn’t considered a characteristic symptom of periodontitis.

If you have periodontitis and notice a new ulcer, don’t automatically assume that the gum disease caused it.

An unusual or persistent sore in the mouth should also not simply be dismissed as part of existing gum disease.

If it doesn’t heal or you are concerned about its appearance, arrange an assessment.

What Causes Mouth Ulcers?

The exact cause of many mouth ulcers isn’t known.

Healthdirect identifies several factors that may make mouth ulcers more likely.

Minor Injury

Injury or irritation inside the mouth can contribute to an ulcer.

Possible sources include:

• Accidentally biting the inside of your mouth
• Dentures rubbing against the tissue
• Braces or other appliances irritating the mouth
• Other minor trauma

Stress and Tiredness

Stress and anxiety are recognised factors associated with mouth ulcers.

Some people notice that ulcers appear during stressful periods.

However, ulcers have several possible causes, so stress shouldn’t automatically be assumed to be responsible.

Certain Foods

Some people find that particular foods are associated with their mouth ulcers.

Foods may also make an existing ulcer more uncomfortable.

If a particular food repeatedly seems to trigger or irritate your ulcers, avoiding it while the area heals may help reduce discomfort.

Nutritional Deficiencies

Some nutritional deficiencies can be associated with mouth ulcers.

Healthdirect identifies iron deficiency and vitamin B deficiency among factors that may increase the likelihood of mouth ulcers.

Folate deficiency can also cause mouth ulcers.

This doesn’t mean recurrent ulcers automatically indicate a nutritional deficiency, and supplements shouldn’t be started solely because an ulcer has appeared.

If ulcers keep recurring or there are other symptoms suggesting a deficiency, a GP can determine whether further assessment or blood testing is appropriate.

Certain Medicines or Medical Conditions

Some medicines and medical treatments can be associated with mouth ulcers.

Certain medical conditions, including coeliac disease, can also be associated with persistent or recurrent ulcers.

If ulcers repeatedly return or occur alongside other unexplained symptoms, discuss them with a dental professional or GP.

Can Gum Disease Make an Existing Ulcer Worse?

Gum disease and a mouth ulcer can occur in the same area, which may make the mouth feel more uncomfortable.

However, there isn’t good reason to assume that gum disease directly makes a typical mouth ulcer larger or prevents it from healing.

If the surrounding gums are already swollen, sore or prone to bleeding, brushing and eating around the area may feel more uncomfortable.

Continue appropriate oral hygiene, but clean gently and avoid deliberately touching, picking or rubbing the ulcer.

How Can You Tell the Difference Between a Mouth Ulcer and Gum Disease?

Look at the overall pattern rather than relying on one symptom.

Gum disease is more likely to cause:

• Bleeding during brushing
• Red or swollen gums
• Persistent bad breath or an unpleasant taste
• Gum tenderness
• Gum recession
• Sensitive teeth
• Loose teeth in more advanced disease

A typical mouth ulcer is more likely to appear as:

• A localised shallow sore
• A white or grey surface
• A red border
• Pain or discomfort when eating, drinking or brushing
• A sore that gradually heals

You can have both conditions at the same time.

If you’re unsure what a lesion is, a dental professional or GP can examine it.

Can a Gum Infection Look Like an Ulcer?

This is an important distinction.

A dental abscess is different from a typical mouth ulcer.

A tooth abscess is a collection of pus caused by an infection involving a tooth or the tissues around its root.

Possible symptoms include:

• Toothache
• Gum or facial swelling
• Pain when biting or chewing
• A bad taste
• Fever
• Redness around the affected tooth
• A loose tooth

Because swelling or an abnormal area can appear on the gum near an infected tooth, it may sometimes be difficult to determine what you’re looking at without an examination.

If you’re experiencing significant tooth pain, swelling, fever or a bad taste associated with swelling, arrange prompt assessment with a dental professional.

A suspected dental abscess shouldn’t simply be treated as an ordinary mouth ulcer.

Why Won’t My Mouth Ulcer Heal?

Most ordinary mouth ulcers heal without treatment within 1 to 2 weeks.

If an ulcer isn’t healing, however, it should be assessed.

Healthdirect recommends seeing a doctor if a mouth ulcer lasts longer than 2 weeks or keeps coming back.

Arrange an assessment if the ulcer:

• Lasts longer than 2 weeks
• Keeps returning
• Is very painful
• Looks unusual
• Is associated with changes elsewhere in the mouth
• Occurs alongside other unexplained symptoms

A persistent ulcer doesn’t automatically mean something serious is wrong.

There are many possible causes.

The important point is that a mouth ulcer that isn’t healing shouldn’t simply be ignored.

What Can You Do for a Mouth Ulcer?

Most mouth ulcers heal without treatment.

While an ulcer is healing, Healthdirect recommends measures that can help reduce irritation, including:

• Using a soft toothbrush
• Eating softer foods if needed
• Avoiding foods that irritate the sore
• Avoiding very hot or spicy foods
• Avoiding touching or picking at the ulcer
• Maintaining appropriate oral hygiene

A pharmacist can also advise about over-the-counter products that may help manage discomfort.

If you also have gum disease, continue appropriate brushing with fluoride toothpaste and cleaning between your teeth.

Managing your gum health remains important even if the ulcer has a separate cause.

When Should You See a Dental Professional?

Arrange an assessment if you have persistent:

• Bleeding gums
• Gum swelling
• Gum pain
• Bad breath or an unpleasant taste
• Gum recession
• Loose teeth
• Tooth pain

You should also have a mouth ulcer assessed if it:

• Lasts longer than 2 weeks
• Keeps returning
• Is very painful
• Looks unusual
• Is associated with other changes in your mouth that concern you

A dental professional or GP can examine a mouth ulcer and determine whether further investigation is appropriate.

The Bottom Line

Gum disease doesn’t normally cause typical mouth ulcers directly.

Gingivitis and periodontitis primarily affect the gums and supporting tissues around the teeth, while mouth ulcers are localised sores that can develop for several different reasons.

So, having swollen or bleeding gums and an ulcer at the same time doesn’t necessarily mean that one caused the other.

Most ordinary mouth ulcers heal within 1 to 2 weeks.

If an ulcer lasts longer than 2 weeks, keeps returning or looks unusual, arrange an assessment.

Persistent gum bleeding or swelling should also be assessed by a dental professional so the underlying cause can be identified.