Canker Sores or Aphthous Ulcers

Canker sores are tiny, shallow ulcers that form on the soft tissue or the gums in the mouth. They are also known as aphthous ulcers. Unlike cold sores, these are not contagious, however can be painful and make talking and eating uncomfortable.

Most of the canker sores require no treatment as they disappear on their own. Seek your dentist’s help if you have abnormal large and painful sores that don’t heal soon.

Causes of Canker Sores

The actual cause is not know, however research shows that canker sores can be caused due to a combination of factors.

The possible factors/triggers for canker sores are:

  • An insignificant small injury to the mouth that may occur from vigorous brushing, dental work, acidic or spicy foods, an accidental cheek bite and sports injury
  • Mouth washes and toothpastes containing sodium lauryl sulfate
  • A diet deficient in iron, folic acid, zinc and B12
  • Sensitivity to foods like coffee, chocolates, eggs, strawberries, cheese, nuts and high acidic foods
  • Emotional stress
  • Changing hormone levels during menstrual cycle
  • Helicobacter pyroli, bacteria which causes peptic ulcers
  • Allergic response to some bacteria in the mouth

Canker sores also appear due to some disease conditions like:

  • Celiac disease, intestinal disorder associated with gluten sensitivity
  • Inflammatory bowel disorders like ulcerative colitis and Crohn’s disease
  • Behcet’s disorder that is associated with inflammation of the mouth and entire body
  • Defective immune system which affects healthy cells of the mouth
  • AIDS causing HIV virus

Symptoms of Canker Sores

Canker sores are generally oval or round with a red border and a yellow or white center. They appear inside the mouth – especially under the tongue, lips, inside the cheeks, on soft palate and base of the gums. You will experience a burning or tingling sensation before the sores start appearing.

Canker sores are of following types, each one with different symptoms. They are:

Minor canker sores – These sores are tiny, oval shaped and do not leave any scars on healing. Heal within one to two weeks.

Major canker sores – These sores are large, deeper, have irregular edges and leave scars. Take more than six weeks o heal.

Herpetiform canker sores – These sores develop during later stages in life. They are pinpoint sized with irregular borders and leave no scars on healing. They occur in masses of 10 – 100 sores and take up to 1 – 2 weeks to heal.

Treatment for Canker Sores

Treatment is not needed for minor sores, as they heal on their own. Major and herpetiform sores require treatment and treatment options range from mouthwashes to cautery of sores.

Mouthwashes – If you have severe canker sores, your physician may prescribe steroid dexamethasone containing mouthwash to relieve the pain and inflammation. Oral suspensions with antibiotic tetracycline also help reduce the pain and healing time, however tetracycline has some cons. It makes you susceptible to thrush, and also discolors the teeth in children.

Topical pastes – Over the counter pastes containing active components like fluocinonide, amlexenox and benzocaine helps in relieving the pain and healing time. It is suggested to apply the paste 2 – 4 times a day until it gets healed.

Oral medications – Certain medications which are not intended for canker sores such as colchicines and cimetidine, usually used in treating gout, are helpful in treating canker sores. These steroid containing oral medications are prescribed only when the sores will not respond to other treatments. They are usually considered a last resort because of their serious side effects.

 Cautery of sores – In this procedure, a chemical substance or an instrument is used to destroy, dry or burn the tissue. Debacterol is one such chemical solution while on application speeds the healing time by cauterizing the sore. Another option is silver nitrate, which relieves the sore pain and not the speeding time.

Nutritional supplements – These are suggested when you consume low amounts of important nutrients like zinc, folic acid, iron and vitamin B12.

Care / Prevention of Canker Sores

Canker sores have the ability to recur frequently. However, their frequency can be reduced by following these preventive measures.

Beware of what you eat – Avoid foods that cause irritation in the mouth. They may include chips, certain spices, pretzels, salty foods, nuts and acidic foods like oranges, grapefruits and pineapple. Avoid those foods to which you are allergic or sensitive.

Select healthy foods – Eat plenty of fresh whole grains, fruits and vegetables to prevent any type of nutritional deficiencies.

Maintain proper oral hygiene – Keep your mouth clean and free from foods that can trigger sores by regular brushing and flossing the teeth. Use a soft bristled brush to prevent any form of irritation to the mouth tissues. avoid mouthwashes and toothpastes which contain sodium lauryl sulfate.

Avoid talking and chewing at the same time – This type of action can cause trauma to the mouth which can result in sores.

Reduce stress – If canker sores are likely to happen from stress, learn and practice stress reduction programs like meditation.

Protect the mouth – If you have dentures, braces or any other appliances, go for orthodontic waxes to cover the sharp ends.