Canker sores or aphthous ulcers are common red and shallow ulcers seen in the oral mucosa. To know its causes, symptoms, triggers, diagnosis, and treatment, read the article.
Canker sores, otherwise called aphthous ulcers, are red, small, painful, and shallow lesions that appear on the mucous lining of the mouth and gums. Multiple such lesions in the mouth make eating and talking difficult and painful. Most of these lesions get better on their own in a couple of weeks. But, if you get these ulcers frequently and if they do not heal in time, then consult a dentist immediately.
It predominantly affects women, teenagers, and runs in families, and are not contagious. You should not confuse this with cold sores, which are blister-like lesions seen on the lips, the roof of the mouth, and sometimes on the gums and is caused by the herpes simplex virus.
The condition that causes multiple and recurrent episodes of oral ulcers in otherwise healthy individuals is called recurrent aphthous stomatitis (RAS). Such frequent episodes of oral ulcers can also be seen in systemic conditions like fever with adenitis or pharyngitis, Crohn’s disease, celiac disease, HIV or AIDS, and cyclic neutropenia.
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The common characteristics of a canker sore are that it is round or oval, red in color with a white or yellow center. They commonly develop under the tongue, inside of your cheeks or lips, gums, and the roof of the mouth. Most of the time, the place feels tingly a day before the sore appears.
Depending on their shape and other features, there are many types of canker sores. The common ones include:
Minor canker sores - These are the most common type. They are -
Oval in shape.
Have a red edge.
Heal in a couple of weeks without a scar.
Major canker sores - These are less common. They are -
Larger in size and deeper.
Round with well-defined borders.
And take about 6 weeks to heal and leave a scar behind.
Herpetiform canker sores - These are uncommon, and should not be confused with herpetic lesions or cold sores, as these mouth ulcers are not caused by herpes virus infection. They are -
Pinpoint in size.
Occur in clusters of 10 to 100, which can merge and form a larger ulcer.
The edges are irregular.
Heal in 1 to 2 weeks without scarring.
Canker sores usually heal on its own in about one to two weeks. But in the following conditions, consult a doctor immediately:
If the sore is unusually large.
If new sores keep developing before the previous ones heal.
If you have excruciating pain.
If you have a high fever.
If the sores last for more than a couple of weeks.
If the sore extends to the corner of the mouth or lips.
Canker sores are believed to be caused by a combination of factors and triggers, but the exact cause is not known. Some of the common triggers include:
Mouth injury from brushing, sports, accident, and dental procedures.
Helicobacter pylori infection.
Lack of sleep.
Sodium lauryl sulfate present in mouthwashes and toothpaste.
The acidic content in food like oranges, strawberries, and pineapples.
Hormonal changes or imbalance.
Food items like chocolate and coffee.
Vitamin and mineral deficiencies like vitamin B12 deficiency or deficiency of zinc and iron.
Irritation caused by braces.
Or sometimes, mouth ulcers are a sign of some severe medical conditions like:
Celiac disease (gluten intolerance).
Inflammatory bowel disease.
Behcet’s disease (results in inflammation in the entire body).
There is no specific test to diagnose canker sores. Your dentist will be able to identify them with the help of a visual examination. In case the sore is not healing or you get such sores frequently, then the dentist might ask you to perform some tests to rule out the conditions that can cause similar symptoms.
Minor cancer sores do not need any treatment, as they usually clear out on their own in a week or so. Treatment might be needed for larger and more painful sores. The treatment options include:
1) Mouthwashes - To reduce severe pain and inflammation, mouthwashes containing Dexamethasone or lidocaine are prescribed.
2) Topical creams or gels - To relieve pain and speed the healing process, your dentist might give topical gel or cream to apply on the sore. These ointments usually contain Benzocaine, Fluocinonide, or Hydrogen peroxide.
3) Oral medicines - If the sore does not respond to topical creams, then oral medicines are prescribed. Oral steroids are very rarely prescribed and used only when all other treatment options have failed.
4) Cautery - Here, an electrical instrument or a chemical is used to burn the ulcer. The chemicals used are Debacterol and Silver nitrate.
5) Nutritional supplements - To treat deficiency of folic acid, vitamin B12, iron, or zinc.
If the ulcers are due to an underlying health condition, then the underlying condition has to be treated.
Rinsing the mouth with saltwater or 1 teaspoon of baking soda in half a cup of lukewarm water.
Avoid acidic or spicy foods.
Eat ice chips.
Brush your teeth gently.
Drink warm chamomile tea.
Avoid overly spicy or food that can tear or irritate your oral mucosa.
Brush using a soft bristle brush.
Cover the sharp edges of braces with orthodontic waxes.
For more information on oral lesions, consult a dentist online now!
Last reviewed at:
27 Nov 2019 - 4 min read
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