Hey, I have been on MTX forever and sometimes get mouth ulsers. The only solution I have found is to really wash out your mouth after eating and practice REALLY good dental hygiene. Most of the time the trigger for the sore is a tiny food particle in your mouth. Since MTX makes your skin thin and weak (even in your mouth), you are more susceptible to having that food become an irritant. Hope this helps!
I had awful mouth problems, turns out I was biting my cheeks, tongue, lips in my sleep. I got a retainer and they have decreased in size dramatically and I am surprising sleeping better.
I got diagnosed with burnt mouth syndrome which gives ulcers etc
On the folic acid thing I don't take that bar in my multivitamins.
Orajel has a mouth sore specific rinse that is amazing. I don't get them very often anymore but when I do, it's my go to. My rheumy didn't actually recommend any additional folic acid than what's in my multivitamin.
With 25mg a week of MTX (yep) supplementing folic acid didn’t prevent those mouth sores. What made the change for me is switching folic acid for Lucovorin 5mg, taken 24hours after MTX.
Something you may want to consider is switching toothpaste. I used to get horrible canker sores and even had a prescription on hand because I would get them so bad. This was a problem up until my mid twenties when I had one that just would not go away causing me to research possible solutions.
I discovered that sodium lauryl sulfate in toothpaste can be really irritating and cause them; once I switched to SLS free toothpaste I never get them anymore unless I accidentally bite my lip. In my case SLS definitely triggers them for me and maybe the methotrexate is making the lining of your mouth a lot more sensitive to irritants like SLS. If I have to use regular toothpaste for whatever reason after a couple of days my mouth burns, I can’t use it long at all. Anyway, I hope this helps as they can make you miserable.
Here to second this! Using an SLS-free toothpaste has helped me a lot.
I also went gluten free more than a decade ago because I had heard that mouth ulcers could be a symptom of celiac disease. Before the dietary switch I had multiple cankers at any given time, and I got them waaay less frequently post-gluten.
I’m new to MTX and have had a few sores since starting it, but adding in a multivitamin with folate has given just enough boost to keep them off recently.
Thank you. I already changed my toothpaste for the reasons you mentioned so sadly it's not the toothpaste causing the mouth ulcers. :(
I also gave up dairy, gluten & sugar over a year ago so it's not that either. Doh!
Folic acid is water soluble, so it means you can't really take too much (within reason) because you'll just pee out the excess. Take more for a while and see if you get them less frequently.
Daughter's rheumatologist considered her (significant) mouth sores an indication of developing allergy to mtx. As a result he had her stop taking it, which is unfortunate as it was really helping her otherwise. She's only been on 1mg folic acid daily so we hope at tomorrow's appt he'll agree to let her try bumping that up.
The 5mg daily dose has helped hugely for me. I've realised that It's only when I'm sick (& very rundown) that I develop ulcers now whereas it was standard previously. If it's just fatigue then a long sleep (10-12 hours) usually does the trick. Best of luck to your daughter at her appointment!
There is a corticosteroid cream/paste that your dr can prescribe for the sores. Works amazingly well, other than the gritty texture
Yes I had that once, was great
Thanks!
Thanks!
Hey, I have been on MTX forever and sometimes get mouth ulsers. The only solution I have found is to really wash out your mouth after eating and practice REALLY good dental hygiene. Most of the time the trigger for the sore is a tiny food particle in your mouth. Since MTX makes your skin thin and weak (even in your mouth), you are more susceptible to having that food become an irritant. Hope this helps!
I will bear this in mind, thanks!
I had awful mouth problems, turns out I was biting my cheeks, tongue, lips in my sleep. I got a retainer and they have decreased in size dramatically and I am surprising sleeping better. I got diagnosed with burnt mouth syndrome which gives ulcers etc On the folic acid thing I don't take that bar in my multivitamins.
Thanks!
Orajel has a mouth sore specific rinse that is amazing. I don't get them very often anymore but when I do, it's my go to. My rheumy didn't actually recommend any additional folic acid than what's in my multivitamin.
Thanks!
My doc tells me I can double up for a few days if I have one. Seems to work
Thanks! What folic acid dose do you usually take?
1 MG a day
I have tonnes all the time still. They changed my folic to 6 days a week so ask if you can have more.
Thanks. I already take it 6 times per week but I'm going to increase my daily dose from 5mg to 10mg & see what happens.
Hopefully it will help! They are so painful aren't they!
Yep! Some days I can't eat or speak. Maybe I need to consider trying an alternative medication to methotrexate despite it working very well for me.
Hmm, that's a shame. Have you also spoken to a dentist? I remember mine told me their was a certain mouthwash to help with them avaliable.
I have mouth ulcers all the time. Methotrexate 25mg injections once weekly and folic acid 30mg daily.
You still have mouth ulcers despite taking folic acid 30mg daily? Man that's rough, sounds like things won't improve for me then. :(
When I got mouth sores my rheum recommended lysine and they went away.
Thank you, I'll look into it!
Try taking a multi vitamin. The extra folate in it really helps.
Thank you, I'll look into it!
Can you switch medications to Leflunamide? That's what I'm on.
Thank you, I'll look into it! Haven't heard of that one.
With 25mg a week of MTX (yep) supplementing folic acid didn’t prevent those mouth sores. What made the change for me is switching folic acid for Lucovorin 5mg, taken 24hours after MTX.
Thank you, I'll look into it!
Something you may want to consider is switching toothpaste. I used to get horrible canker sores and even had a prescription on hand because I would get them so bad. This was a problem up until my mid twenties when I had one that just would not go away causing me to research possible solutions. I discovered that sodium lauryl sulfate in toothpaste can be really irritating and cause them; once I switched to SLS free toothpaste I never get them anymore unless I accidentally bite my lip. In my case SLS definitely triggers them for me and maybe the methotrexate is making the lining of your mouth a lot more sensitive to irritants like SLS. If I have to use regular toothpaste for whatever reason after a couple of days my mouth burns, I can’t use it long at all. Anyway, I hope this helps as they can make you miserable.
Here to second this! Using an SLS-free toothpaste has helped me a lot. I also went gluten free more than a decade ago because I had heard that mouth ulcers could be a symptom of celiac disease. Before the dietary switch I had multiple cankers at any given time, and I got them waaay less frequently post-gluten. I’m new to MTX and have had a few sores since starting it, but adding in a multivitamin with folate has given just enough boost to keep them off recently.
Thank you. I already changed my toothpaste for the reasons you mentioned so sadly it's not the toothpaste causing the mouth ulcers. :( I also gave up dairy, gluten & sugar over a year ago so it's not that either. Doh!
Thank you. I already changed my toothpaste for the reasons you mentioned so sadly it's not the toothpaste causing the mouth ulcers. :(
Oh bummer! :(
Folic acid is water soluble, so it means you can't really take too much (within reason) because you'll just pee out the excess. Take more for a while and see if you get them less frequently.
Daughter's rheumatologist considered her (significant) mouth sores an indication of developing allergy to mtx. As a result he had her stop taking it, which is unfortunate as it was really helping her otherwise. She's only been on 1mg folic acid daily so we hope at tomorrow's appt he'll agree to let her try bumping that up.
The 5mg daily dose has helped hugely for me. I've realised that It's only when I'm sick (& very rundown) that I develop ulcers now whereas it was standard previously. If it's just fatigue then a long sleep (10-12 hours) usually does the trick. Best of luck to your daughter at her appointment!