Canker Sores

A canker sore is a small ulcer in the lining of the mouth that is often painful and sensitive. Also known medically as aphthous ulcers or aphthous stomatitis, canker sores are very common, occurring in about 20% of the population at any one time.

Canker sores can occur at any age, but they are more commonly seen in teenagers. Females are slightly more likely than males to have recurrent canker sores. Genetic studies show that susceptibility to recurrent outbreaks of the sores is inherited in some patients. This partially explains why family members often share the condition.

Canker sores typically occur on the movable parts of the mouth, such as the tongue, the inside lining of the lips and cheeks and at the base of the gums. They have a thin white or yellow surface and a red edge. Generally, the sores heal within two weeks without scarring.

The cause of canker sores is not well understood. Although they do not appear to be caused by viruses or bacteria, an allergy to a particular bacterium commonly found in the mouth may trigger them in some people. The sores may be an allergic reaction to certain foods and there is some research that suggests they may be caused by an irregularity in the immune system that causes the body's defenses against disease to attack and destroy the normal cells of the mouth or tongue. Canker sores may also be caused by nutritional deficiencies, especially the lack of vitamin B12, folic acid and iron, according to some studies.

Trauma or injury to the mouth, such as an orthodontic wire poking a cheek or lip, brushing with hard toothbrushes and hot foods can lead to canker sores. Other possible causes of canker sores include emotional stress and illnesses in which the immune system causes swelling or inflammation of the body tissues.

If you have a canker sore:

• Avoid abrasive foods such as potato chips that can stick in the cheek or gum and aggravate the sores.
• Avoid acidic and spicy foods.
• Avoid toothpastes that contain sodium lauryl sulfate, which can irritate mouth tissue.

Over-the-counter treatment options:

• Create a mouthwash solution by mixing two tablespoons of Maalox and one half tablespoon of Benadryl Allergy liquid. Swish one teaspoon over the sore four times per day. This solution should provide temporary relief from pain. You should NOT swallow the solution.
• Topical medications containing benzocaine (Oragel, Anbesol, Orabase, Zilactin-B) are available in drug stores without a prescription. Follow the directions on the medication’s package. These medications only relieve discomfort and do not shorten the duration of the sore.
• Pain relievers, such as ibuprofen and acetaminophen, may be taken for pain relief if the sores are intolerable. Some patients may get relief from sucking on zinc lozenges or taking vitamin B and C complex.

Prescription treatment options:

• Anti-inflammatory (steroid) gels may also be applied to reduce the inflammation. The main ingredient in these medications is usually fluocinonide or triamcinolone. Your doctor or dentist can provide you with a prescription.
• Amiexanox (Aphthasol) reduces the size and duration of the lesions.
• A 5% lactic acid mouthwash can significantly reduce symptoms. You should swish one teaspoon three times a day before meals.
• Topical antibiotics, such as tetracycline, may also be recommended by your doctor.