Painful Canker Sores in the Mouth

Canker Sore

What are Canker Sores?

Ouch!  Ever get that annoying and painful sensation inside your mouth?  Often times it can suddenly occur without warning, and it can be very painful to touch, making it difficult to eat.

Also known as aphthous ulcers, or aphthous stomatitis, these are benign and non-contagious lesions that form anywhere inside the mouth.  It can occur on the tongue, inside the cheek, on the gums, the roof of the mouth, on the floor of the mouth, or inside the lips.  Some people may notice a discoloration or an unusual feeling prior to its onset.  When the canker sores are fully formed, it is usually a small white circular lesion in the middle, while the outside border is bright red.  In severe cases the interior of the lesion may even bleed, while also causing a slight fever.  Such cases would suggest the body is fighting an infection.

However, be careful if one notices sores on the outside of the lips.  These are not canker sores, but rather herpetic lesions that are very contagious.  Such lesions should be treated accordingly by your dentist and physician.

What causes Aphthous Ulcers?

Unfortunately we don't really know what causes aphthous ulcers (canker sores).  Some studies suggest it may be due to environmental factors like stress, physical trauma and injury to the affected area, or even smoking.  Highly acidic foods may also play a role (ie. lemon, lime, figs, and tomatoes).

A Journal of American Board of Family Medicine  suggests that low levels of Vitamin B12 may also be a possible cause of canker sores.  Other studies also suggests that folic acid and iron may play a similar role, but its unclear if such supplements may improve healing or reduce occurrence.

Despite common misconceptions, there is no established association between canker sores and autoimmune diseases.  Recent studies show that such occurrences have no common antibodies, and are believed to be independent of each other.

How to treat and manage Canker Sores?

Treatment for aphthous ulcers is palliative at best (ie. controlling and managing pain and its symptoms).  Prevention is difficult because the exact cause is not clearly demonstrated and not understood.

• Most sores (minor aphthous ulcers) will heal on its own within 7-10 days.  Over the counter ointments such as Zilactin-B may help with pain relief).
• For sores that are larger in size and severity (termed major aphthous ulcers) medications such as a corticosteroid rinse may help (ie. hydrocortisone sodium succinate aka Solu Cortef and beclomethasone dipropionate aerosol).

Other methods that may decrease the occurrence of canker sores include:

• Wearing a sportsguard to prevent injury to the gums and gingiva during athletic events
• A diet high in Vitamin B12, folic acid, and iron (ie. dark and leafy green vegetables like spinach and kale, red meats like beef, and fortified dairy products like milk and yogurt)
• Good oral hygiene  and regular dental cleanings and checkup
• Avoiding foods that may irritate the gums and mucosal lining (ie. spicy foods, acidic vegetables and fruits like lemon, lime, escarol, pimento, tomatoes, and any vegetables processed with vinegar, such as canned artichokes, pickles, sauerkraut). 

If you have any questions or concerns regarding canker sores, or if you notice your sore has not healed within 14 days, please consult your doctor or dentist.

Warm Regards from your gentle family dentist in Bellevue,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600