Canker sores, also known as aphthous ulcers, are small, white or reddish inflamed spots that develop on the soft inner lining of the mouth. The word aphthous comes from the Greek word aphthi, which means “set on fire.” And, generally, sores can be quite painful, appearing simultaneously in groups of two or four. They can even affect your routine activities like eating or talking.
Typically, a day or two before sores develop, you can feel a burning or tingling sensation in your mouth. When the sores emerge at the site of irritation, they’re oval or round in shape, and they have a yellow or white center with a red border. Canker sores can pop up anywhere inside your mouth, but they typically appear on the inner cheek walls or inner side of lips. Less often, they can be found on the tongue or even on your soft palate.
There are three types of canker sores, namely:
- Minor canker sores: Small, oval, or round-shaped, shallow lesions that heal within a week or two.
- Major canker sores: More painful and deeper sores with a size between 1 and 3 centimeters. They take about six weeks to heal and often leave a scar behind.
- Herpetiform canker sores: Pinpoint sores that develop in clusters of tens or hundreds that merge to form one large ulcer. Their edges are irregular, and they heal within two weeks.
What Causes Canker Sores?
Despite the ailment’s commonality, the exact cause of canker sores remains unknown. Experts surmise that canker sores are most likely hereditary, meaning, they are passed down as a generational trait, from parent to child.
Scientists have noted that aphthous ulcers can be triggered by a combination of possible factors, such as:
- Overzealous brushing of teeth
- Accidental cheek biting
- Overhanging or sharp-edged dental fillings
- Food allergies like chocolate, eggs, coffee, nuts, etc.
- Deficiency of Vitamin B12, zinc, iron, or folic acid
- Hormonal shifts during menstruation
- Underlying conditions such as celiac disease, Crohn’s disease, ulcerative colitis, Behcet’s disease, or immunosuppressive diseases like HIV/AIDS
How Long Do They Last?
Generally, canker sores are self-resolving and may heal within one to two weeks. Major canker sores, however, may stick around a little longer, taking around six weeks to heal, with potential scarring afterwards.
How to Help Get Rid of Them
A definitive cure for canker sores does not exist. However, there are options to help reduce pain, limit how long they stick around, and lower their frequency of occurrence.
To help reduce pain and inflammation, mouth rinses can help offer topical relief to canker sores. Ingredients like zinc can promote overall oral health and boost your immunity, empowering your mouth to fend off sores from popping up in the first place. As per a 2022 study, canker sores are generally “less common in individuals with good oral hygiene practices.”
If you’ve already tried over-the-counter options, consider asking your doctor to prescribe you a mouth rinse with dexamethasone or lidocaine as its chief ingredient. While dexamethasone is a steroid that can help reduce inflammation, lidocaine, a topical anesthetic agent, often soothes the canker sores by lowering pain.
Pain-relieving pastes or gels
Products like gels, pastes, or liquids can also help minimize pain and maximize potential healing of aphthous ulcers. Application of these products should preferably be done as soon as the ulcers appear.
The most common active ingredients inside these products are:
- Fluocinonide: a topical corticosteroid used to reduce itching or inflammation
- Benzocaine: a topical anesthetic agent that reduces pain
- Hydrogen peroxide: a mild antiseptic that reduces irritation inside the mouth
When in doubt, consult your dentist about the pain-relieving product that best suits you.
In some cases, canker sores can become severe and may not respond to over-the-counter options or topical prescriptions. You may need to turn to stronger medications such as:
- Prednisone: a systemic steroid that acts as an anti-inflammatory, providing relief to the site of irritation
- Sucralfate: an aluminum salt of sucrose octasulfate, typically used to treat intestinal ulcers, that relieves pain and speeds the healing process
Please consult with your doctor and only use these strong medications as a last resort.
In this potential treatment, a doctor chemically or physically cauterizes the affected tissue, meaning they burn and destroy it at the surface level.
Debacterol is one of the most common solutions for chemical cautery, with the possible healing time for canker sores being reduced to just a week. Silver nitrate is another chemical that has shown potential to heal canker sores. While it does not limit healing time, silver nitrate has been known to help reduce the pain of canker sores considerably.
Nutrients like folate, Vitamin B6, and zinc are necessary building blocks of our body and are known to help aid in wound healing. Vitamin B12 has shown to be one of the safest nutritional supplements that can treat aphthous ulcers.
Are Canker Sores Contagious?
As many will be relieved to hear, canker sores are not contagious. If you’re prone to them, rest easy knowing that you will never be able to pass them on to another person through your saliva via activities like kissing or sharing food.
How to Help Prevent Them
Wondering how to help prevent canker sores? Try to figure out why you get them in the first place. The key to keeping canker sores at bay lies in identifying your specific triggering factors. Here are a few tips that might help:
- Avoid specific food products: Try not to consume foods that are spicy, too salty, or acidic that can irritate your mouth. If you are aware of foods that you are allergic to, avoid them completely.
- Have a balanced diet: Plan your meals in such a way that your food becomes your medicine. By having a balanced diet, you tend to reduce the scope of any nutritional deficiency, and possibly limit the frequency of canker sores. As always, be sure to include fresh fruits, vegetables, and whole grains in your diet.
- Avoid oral irritation: People who wear braces tend to bruise their lips, gums, or tongue with their orthodontia’s sharp edges, causing oral irritation. Conversely, if you have a sharp tooth or other natural oral protrusion, canker sores may also emerge at those points of aggravation. Consult your orthodontist or dentist to try and limit these factors.
- Maintain oral hygiene: Keeping your mouth clean with regular tooth-brushing and flossing can help reduce oral ailments en masse. Just be sure to always use a soft toothbrush and follow the proper brushing technique. Note: Not only can vigorous tooth-brushing be a possible trigger for a canker sore formation, but it can also harm your gums and ware down your tooth enamel.
- Lower your stress levels: If stress triggers your canker sores, try some stress-relieving activities like mindful breathing or meditation
Canker sores are quite painful and can be a serious cause of discomfort. Further research needs to be done to find their exact cause and their proper cure, but by embracing the strategies above, you can help prevent sores at the source. Your mouth will thank you soon enough!