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An Uncomfortable Ulcer on the Inside of the Mouth: Canker Sores

What is a Canker Sore-

Some people easily confuse the difference between a canker sore and a cold sore. A canker sore is a small, shallow ulcer that appears inside of the mouth, and can make talking or eating very difficult. There are two different types of canker sores:

  • 1. Simple canker sores: may appear three to four times a year, and can last around 8 days. The most common age group to suffer is in between 9-21 years of age.
  • 2. Complex canker sores: These are less common, and will show up in people more frequently who have already struggled with them.

causes of canker sores
Like many dental issues, the exact cause has not been pinpointed or determined. Injury to tissue and stress are thought to be common causes, as well as certain foods. Just as it is in the issue of teeth enamel, citrus and very acidic foods such as lemons and oranges can trigger the formation of a canker sore, or irritate an existing one.

Toothpastes and mouthwashes that contain sodium lauryl sulfate can be possible triggers, especially if one is already under a high amount of stress in their daily life. Some foods such as coffee and chocolate are known triggers for canker sores, as well as eggs, strawberries, and cheese. A lack of iron, vitamin B12, zinc, folic acid, or iron can be factors as well, especially when combined with other factors.

If there is preexisting bacteria in your mouth from an issue such as periodontal disease, canker sores may form as an allergic response. Hormonal stress linked to menopausal issues and menstruation are also thought to be factors when it comes to canker sores.

If a patient has issues such as Crohn’s disease of ulcerative colitis, bowel diseases, and Celiac disease all can flare up enough with their own specific symptoms. But these are also conditions that can affect a canker sore prevalence in both men and women. Unlike cold sores, canker sores are not linked to HPV and other herpes virus infections.

symptoms of canker sores
canker sore
Most canker sores are round or ovular, with yellow center and a border of distinguishable red around them. They can be found on the inside of your mouth, even under the tongue, at the base of your gums, or the soft palate. Before they appear, you may notice a burning sensation or tingling, even 24-48 hours prior.

canker sore doctor
canker sore doctors
If your canker sores are unusually large, and if you experience new sores before previous ones are gone are some of the main reasons to seek medical help. If you have sores that are lasting for two weeks or longer, this is also a serious situation. If you are starting to realize extreme difficulty while eating or drinking, or developing a high fever, this is also a dire warning to seek help.

If you see sores that are beginning to extend into the lips themselves, or are encountering much higher than average levels of pain, you should see a doctor right away. Canker sores are one of those issues that some see as merely a rite of passage, and when they really rear up and get out of hand, you need to take action.

questions about canker sores

Before you go in for treatment, there are some important questions to ask yourself and document. This way, when you go in, you can show the specialist details about what you have been experiencing.

    • What are the exact symptoms?
    • When where they noticed?
    • How severe do you feel the pain is on a scale of 1 to 10?
    • Have you ever had these sores in the past?
    • Which treatment was most effective, if this was the case?
    • Has there been any dental work in your mouth lately?
    • Has any major life change as of late overwhelmed you with stress?
    • What is your daily diet like?
    • What other medications do you take besides over the counter, like vitamins, herbs, and other supplements?

treatments canker sores

If you have more than one canker sore, the specialist may prescribe a mouth rinse that contains a steroid: dexamethasone is known to reduce pain, and inflammation that canker sores are known for. There are some over-the-counter products such as creams and gels that may help relieve pain, and will speed healing if they are applied to sores as soon as they appear. Some of the ingredients in these that will really help are Benzocaine, Fluocinonide, and Hydrogen peroxide.

“Canker sores are very painful and can keep you from talking, eating, receiving good nutrition, and proper rest. In addition the sores may be slightly raised, causing you to bite the soft tissue. Talk about your one-two punch. There are some products available that claim to shorten the duration of canker sores. But the usual treatment involves using a numbing product that contains benzocaine and letting them run their course.”

Dr. David Hudnall

Sometimes when canker sores are severe enough that they don’t respond well to topical treatments, medications such as sucralfate and other oral steroids are used. Some of these can provide some fairly noticeable side effects, and for these reasons are used as a bit of a last resort.

The processes known as cautery of sores is when an instrument in conjunction with a chemical substance is used to burn, destroy, or otherwise sear the target tissue. Debacterol is a topical solution that is designed to treat extreme gum problems and canker sores. With this chemical, the patient can sometimes minimize the healing time to just around a week. Another chemical that is sometimes used is Silver Nitrate, another component in helping to relieve the pain.

Nutritional supplements may be recommended as well: folate, vitamin B-6, and zinc are all some that can make for a healthier mouth rid of canker sores. We all know how hard it can be to alleviate stress from our lives, but yoga, breathing exercises, and sleeping in a room without extra light and televisions on all night can benefit you greatly as well.

Medically Fact-Checked & Written by Our Dental Editorial Team

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