(Mouth Ulcers, Aphthous Ulcers)
The Facts on Canker Sores
Canker sores are small sores that appear on the inside of the mouth, especially the cheeks, lips, and tongue, and occasionally on the gums or on the roof of the mouth. They are also called aphthous ulcers. Small canker sores disappear within 14 days and do not scar. Large ones are less common. They may take weeks to heal, and can leave scars. Canker sores aren’t contagious like cold sores.
At any given time, 20% of Americans will have a canker sore. They are most common in women and in people ages 10-40 years. Many people get them regularly, at least once a year. In the most severe cases, people develop one after another.
Causes of Canker Sores
Doctors don’t know exactly what causes canker sores. They may be hereditary, but there is no conclusive evidence as to how this develops in the DNA. Researchers think they may be an overreaction to the Streptococcus bacteria, because this bacteria is found in the canker sore. People with canker sores often have small injuries from dental injections and toothbrushes in the lining of the mouth. Allergies also may be associated with an increased risk of canker sores.
Canker sores often occur near the time of a menstrual period. They may also be brought on by stress – for example, many students get them during exams. Other possible causes include a lack of cyanocobalamin (vitamin B12), folic acid, or iron. Some canker sores may be precipitated by trauma to the mouth, including biting the side of one’s cheek or eating crunchy foods like chips or French bread that might cause a small cut in the mouth. The well-known sourdough bread of San Francisco often sends tourists to the doctor for mouth sores. These small cuts may not develop into canker sores, but patients with sores can often recall some trauma to the mouth prior
to the development of a sore.
Some canker sores have been linked to toothpastes and mouthwashes that contain sodiumlauryl sulfate. This ingredient is included in many brands and is thought to make the mouth drier, predisposing the unlubricated mouth to form canker sores. Switching to toothpaste that does not contain sodium lauryl sulfate can reduce sores.
Symptoms and Complications of Canker Sores
A canker sore appears as a round white spot with a red border. It forms on the soft tissues in the mouth, such as inside the lip or cheek or on the roof of the mouth. Small sores are about 1 to 2 millimetres across and often come in groups. Large sores have an irregular shape. Some people may feel burning or tingling up to 24 hours before a canker sore appears. Canker sores cause a lot of pain that lasts between 4 and 10 days. The pain is worsened by hot or spicy foods that touch the sore. Complications of canker sores can include fever, swollen glands, and feeling run-down. Recurring sores may indicate a vitamin deficiency or an underlying health
Fortunately, canker sores disappear over time and there is no further health risks associated with
Diagnosing Canker Sores
Herpes simplex sores (cold sores) look like canker sores, but usually a dentist or doctor can diagnose canker sores by their shape, size, and location. Canker sores are always found inside the mouth, whereas cold sores are usually found on the lips. Canker sores cause a lot of pain for a sore that is quite small. A doctor may test for other health problems if sores keep returning.
Treatments and Prevention Canker Sores
Canker sores usually heal by themselves in 14 days without any treatment. Various treatments are only useful in relieving the pain of the sores. People with canker sores can rinse their mouth with saltwater. Avoiding hot and spicy foods also helps to minimize pain. You can help prevent canker sores by making sure you’re not deficient in folic acid or vitamin B12. If injury or irritation to the mouth causes canker sores, it is important to remove any sources of irritation, such as ill-fitting dentures.
There are many pain relievers for canker sores. Viscous lidocaine* is an anesthetic that can be applied to the sore or used to rinse the mouth to numb the pain. Although it relieves pain, it may interfere with a person’s sense of taste. Carboxymethylcellulose is a protective coating that can also be put on the sore to relieve pain. Benzydamine mouthwash can provide temporary relief from the pain of canker sores, but it does not speed up healing. Silver nitrate can also be applied to the sore to relieve pain, but it may cause discoloration where it is applied and may delay healing.
If you tend to have a lot of canker sores, or they keep coming back, it is a good idea to see a dentist or doctor. The dentist or doctor can prescribe a tetracycline mouthwash to treat a developing sore. This mouthwash should not be given to children less than 9 years old, as it discolors developing teeth.
Severe canker sores may be rubbed with a corticosteroid ointment, available by prescription only. They may also be treated with a medication called dexamethasone in a mouth rinse, or prednisone taken as tablets.