Doctor’s answer
👉 A mouth ulcer that does not heal after 2 weeks should never be ignored.
While many ulcers are harmless, persistent ulcers may indicate infection, nutritional deficiency, immune disorders, or early oral cancer and need professional evaluation.
What Is a Non-Healing Mouth Ulcer?
A mouth ulcer normally heals within 7–14 days.
If it persists beyond 2 weeks, increases in size, bleeds easily, or becomes hard, it is termed a chronic or non-healing oral ulcer.
Common Causes of Mouth Ulcer Not Healing After 2 Weeks
- Repeated Trauma (Most Common)
- Sharp tooth edge
- Broken filling or denture
- Habitual cheek or tongue biting
➡️ Ulcer keeps reopening → delayed healing
- Nutritional Deficiencies
Deficiency of:
- Vitamin B12
- Iron
- Folic acid
➡️ Healing capacity of oral mucosa reduces
- Chronic Infections
- Tuberculosis
- Fungal infection (especially in diabetics)
- Viral ulcers (rarely persistent)
- Immune-Related Conditions
- Aphthous ulcers (major type)
- Lichen planus (ulcerative type)
- Autoimmune disorders
- Tobacco or Areca Nut Use ⚠️
- Smoking
- Gutkha / pan / chewing tobacco
➡️ Delays healing and increases cancer risk
- Early Oral Cancer (Important to Rule Out 🚨)
A painless ulcer that:
- Does not heal
- Has raised or hard edges
- Bleeds on touch
➡️ May be an early sign of oral cancer
Red Flag Signs – When to Worry 🚨
Seek immediate evaluation if ulcer is associated with:
- ❌ Non-healing beyond 2 weeks
- ❌ Hard base or raised margins
- ❌ Bleeding on touch
- ❌ White or red patch around ulcer
- ❌ Difficulty in swallowing or speech
- ❌ Unexplained weight loss
- ❌ History of tobacco use
Difference Between Benign and Dangerous Ulcers
| Feature | Benign Ulcer | Suspicious Ulcer |
| Healing | 7–14 days | > 2 weeks |
| Pain | Usually painful | Often painless |
| Margins | Soft | Hard / raised |
| Bleeding | Rare | Common |
| Cause | Trauma / stress | Needs evaluation |
What Tests Are Needed?
An Oral Medicine specialist may advise:
- Detailed clinical examination
- Blood tests (B12, iron, Hb)
- Elimination of trauma source
- Biopsy (if ulcer persists or looks suspicious)
➡️ Biopsy is simple and lifesaving when done early.
Can Mouth Ulcer Cancer Be Painless?
✅ Yes.
Early oral cancer ulcers are often painless, which is why many patients ignore them.
What Should You Do Immediately?
✔ Avoid tobacco and spicy food
✔ Maintain oral hygiene
✔ Do not self-medicate repeatedly
✔ Consult an Oral Medicine specialist if ulcer persists beyond 2 weeks
Doctor’s Advice (Expert Tip)
“Any oral ulcer lasting more than 14 days without clear healing should be clinically examined. Early diagnosis saves lives.”
Key Takeaway
👉 A mouth ulcer not healing after 2 weeks is not normal.
Early evaluation by an Oral Medicine specialist ensures peace of mind or early lifesaving treatment.
FAQs
- Can stress cause non-healing mouth ulcers?
Yes, stress can delay healing, but ulcers still should heal within 2 weeks. - Are painless ulcers dangerous?
Painless ulcers persisting beyond 2 weeks require evaluation. - Can vitamin deficiency cause chronic ulcers?
Yes, especially B12, iron, and folate deficiency. - Is biopsy painful?
No. It is a minor procedure done under local anesthesia. - Can mouth ulcers heal on their own after 2 weeks?
Some do, but waiting longer without evaluation is risky. - Can a sharp tooth cause a mouth ulcer that doesn’t heal?
Yes. Continuous trauma from a sharp tooth or denture can prevent healing until the cause is removed. - Do antibiotics help in non-healing mouth ulcers?
Not always. Antibiotics work only if there is a bacterial infection; most ulcers do not need them. - Can diabetes delay healing of mouth ulcers?
Yes. Poorly controlled diabetes can significantly slow oral wound healing. - Is a biopsy mandatory for every non-healing ulcer?
No. It is advised only when the ulcer looks suspicious or does not heal despite treatment. - Which specialist should I consult for a non-healing mouth ulcer?
An Oral Medicine specialist or Oral & Maxillofacial Surgeon is the most appropriate.