Canker Sores
Canker sores (aphthous ulcers) are a common oral irritation, especially among young adults. As much as 60 percent of the population has had a canker sore at some time in their lives. Canker sores occur most frequently between the ages of 10 and 40, often reappearing again and again.
The main problem caused by canker sores is pain, which ranges from slight to severe. The most painful phase lasts three to four days, with complete healing in 10 to 14 days.
Appearance of sores
Canker sores are small, oval-shaped sores that usually have a shallow, yellow-white center surrounded by a narrow red ring. They most often occur on the softer surfaces of the mouth, such as the inner cheeks, the inside of the lips, soft areas of the mouth’s top and bottom, the tongue, gums, and throat. One or more sores may be present at a time.
Causes
No specific cause of canker sores has been identified. Possible contributing factors include:
- injuring the soft parts of the mouth, such brushing too hard or biting the tongue or cheek
- certain foods or drinks
- food allergies or sensitivities
- toothpastes or rinses containing sodium lauryl sulfate
- nutritional deficiencies
- hormonal changes, especially around menstruation
- a weakened immune system
- stress or fatigue
Canker sores are not the same as cold sores, which are caused by the herpes virus. Canker sores are not contagious, but can be a sign of underlying health problems, especially if the sores are large, many in number, or don't heal within three weeks.
Treatment
Since no specific cause for canker sores has been found, there is no cure. Treatment is aimed at controlling pain, healing the tissue, and preventing further injury or secondary infection. Try the following treatment measures:
- Apply or suck on ice to lessen the pain.
- Eat soft foods. This will prevent further injury to the mouth and irritate the sore less as it heals.
- Avoid salty and acidic foods, coffee, and citrus.
- Do not talk while chewing or chew food quickly to avoid injuring the mouth.
- Use a toothbrush with soft bristles and avoid toothpastes with sodium lauryl sulfate, a chemical that produces foam and irritates the tissues.
- Use topical over-the-counter painkillers such as Orabase, Orajel, Anbesol, or Zilactin-B which numb and coat the sores to provide protection.
- Apply milk of magnesia to the sore three times daily for pain relief.
- Use a thin paste of water and baking soda on the sore to help seal and dry it out.
- Drink plenty of fluids. Acidic drinks such as coffee or citrus juices (e.g., orange juice, lemonade, limeade) may irritate the sore and cause pain.
- Minimize stress as much as possible.
Occasionally, prescription medications may be necessary to help the sore heal or relieve pain. This is generally only necessary if the sore is particularly large or painful.
When to contact a clinician
Contact a clinician if any of the following occur:
- sores that last for more than ten days
- unusually large sores
- sores with a fever or lymph node swelling
- extreme difficulty eating or drinking
- self-care measures listed above are not enough to control the pain
