Canker Sore – Causes and Remedies

What is Canker Sore?

Canker sore or aphthous stomatitis is a painful recurrent disease of oral mucous membrane. They are usually seen on the inner lining of the cheeks, tongue, lips and the base of the gums.

What Causes Canker Sores?

The true cause of canker sores is not clear. Genetic studies show that it is inherited in about one third of the patients. About 10-20% of the cases are due to underlying hematological abnormality such as low serum iron or ferritin, or deficiency of folate or vitamin B12. About 3% of the cases are due to gastrointestinal malabsorption and coeliac disease.

Other triggering factors include trauma (toothbrush injury, self biting, and dental procedures), sodium lauryl sulfate containing toothpaste, stress, spicy foods, citrus, medications allergy, hormonal changes in women, and sometimes cessation of smoking.

Canker sores may also be the oral manifestation of a number of systemic diseases including acute HIV infection, Behçet disease, sweet’s syndrome, cyclic neutropenia, Systemic lupus erythematosus and other immunodeficiencies.

Unlike cold sores which are caused due to herpes simplex virus, canker sores are not associated with herpes simplex virus infection.

Three clinical presentations are usually observed which are as listed below:

Minor sores: They accounts for almost 90-95% of the total canker sores and cause minimal symptoms. They present as few (1-6), small (2-4 mm in diameter) sallow ulcers. They resolve within 7-10 days without scarring and recur at variable interval

Major sores: They accounts for 5-10 % of all the sores and are painful. They present as few, large (1-3 cm) deep ulcers. They usually resolve within 2-6 weeks and may result in scarring.

Herpetiform ulcers: They accounts for 1-5% of all the canker sores and are extremely painful and recur very frequently. They present as cluster of multiple (1-100) small (1-3 mm diameter) shallow ulcers. They usually resolve within 7-10 days.

Are Canker Sores Contagious?
Unlike cold sores which are highly contagious, canker sores are not contagious, but they tend to run in families.

Canker Sore Treatment

Treatment is usually not required as ulcer heals by themselves. For recurrent ulcers there is no permanent cure. The initial step in canker sores treatment is to correct the triggering factors. If it is due to spicy food or food allergy it should be excluded from the diet. If it is due to zinc, folate or vitamin B12 deficiency it should be corrected. Good oral hygiene should be maintained. Mouth wash containing chlorhexidine or triclosan can be bought at any stores, this will help maintain oral hygiene and reduce the duration of ulcer.

Canker Sore Remedies

• Rinse your mouth with normal salt water or baking soda.
• Mix equal parts of Milk of Magnesia and Benadryl and hold the mixture in your mouth for 5 minutes and split it out, it will soothe your pain.
• Mix equal part of hydrogen peroxide and water. Apply the mixture directly to the canker sore using cotton swap.
• Apply small amount of Milk of Magnesia on the canker sore for 3 to 4 times a day. This will help soothe the pain and quicker healing.
• Applying ice to your canker sores may also help soothing the pain.
• If pain is severe one teaspoonful of Lidocaine 2% solution can be kept in the mouth for several minutes. Other topical anesthetics like dyclonine hydrochloride 0.5% can also be applied to the lesion.
• If your condition is severe, you may consult your doctor. He may prescribe you some anti-inflammatory medicines like mild to moderate topical corticosteroid accordingly.