A canker sore, also called an aphthous ulcer, aphthous stomatitis, or Sutton’s disease is a burning open sore or a surface wound in the mucous membrane. Sutton’s disease is characterized by a canker sore that is recurring.
A canker sore is a very common oral condition that normally develops inside the lining of the mouth or the upper throat. A canker sore is not contagious and its exact causes are unknown. It is not associated with smoking or drinking alcohol. Many studies cite a combination of the following factors as potential causes of a canker sore: physical and emotional stress, vitamin deficiencies, chemical irritants on the mouth, and hormonal influences (such as menstrual periods in women). The appearance of canker sores is usually reddish. A membranous white coating sometimes covers the canker sore. A canker sore is painful, but it is considered a minor oral ulceration that will heal on its own. Canker sores are frequently mistaken for fever blisters or cold sores which develop on the outer lips and the corners of the mouth. Fever blisters are caused by the herpes virus.
How to heal a canker sore depends on the severity and the size of the lesion. Even without the aid of canker sore treatments and canker sores cures, the painful lesions normally go away on their own in seven to ten days.
Canker sores are seen more frequently in females than in males. Teenagers and people in their 20s are also prone to getting canker sores. Moreover, the recurrence of canker sores is said to be inherited.
Canker sores are classified according to the ulcerated lesion’s diameter. The bigger the sore, the more painful and severe it can become. The most common forms of canker sores are the minor ulcerations, which are 3 to 10 mm in diameter. Major ulcerations are bigger than 10 mm in size and are quite painful. Herpetiform ulcerations are the most severe forms of canker sores. Although they are small in size, around 1 to 3 mm, herpetiform ulcerations tend to grow in clusters and are very painful.
An important thing to note about canker sores is that, they normally give a stinging and burning sensation. When a particular canker sore is painless, then that is worrisome. Any ulcer in the mouth that is painless may be an early indication of oral cancer. The typical healing period of a canker sore is seven to ten days. If a particular mouth sore does not disappear after that period, consult with a dentist. Most importantly, you must consult a dentist or a doctor for any canker sore that does not hurt at all. Cancer is best treated successfully during its early stages. When it spreads to other parts of the body, then the cancer becomes much more difficult or impossible to beat.
Factors that may contribute to the development of a canker sore
- Citrus fruits. Oranges, lemons, and other citrus fruits have acidic juices that are strong and can burn the sensitive lining of the mouth. They can irritate the mouth lining and may contribute to the development of a canker sore.
- Spicy foods. Like acidic juices, spicy foods can burn and irritate the lining of the mouth and may lead to a canker sore.
- Physical trauma. Abrasions from the toothbrush and certain hard foods (like toasts and potato crisps), unintentional biting, losing teeth, and the presence of dental braces are factors that may present physical trauma to the lining of the mouth and may cause the appearance of canker sores.
- Stress. Physical or emotional stresses weaken the immune system. People with weak immune systems are seen to be more prone to getting canker sores.
- Lack of sleep. Even a single instance of being sleep deprived can weaken the immune system and make an individual prone to developing a canker sore.
- Sudden weight loss.
- Genetic predispositions. If a parent often develops canker sores, then it is believed that he or she can pass this on to an offspring.
- Age. People in their twenties or in their teenage years have the highest incidence of canker sores.
- Gender. Women, on average, have twice the probability of getting canker sores than men. This is believed to be caused by the menstrual cycle. Women usually develop canker sores during the start of their menstrual cycles.
- Food allergies. A 2009 study published in the journal Oral Diseases, cow’s milk allergies is strongly related to the appearance of canker sores in certain people.
- Immune system reactions. Celiac disease (refer to number 17) is a prime example of an immune system reaction which leads to canker sores.
- Deficiencies in vitamin B12, folic acid, and iron.
- Nicorandil and certain chemotherapy. These are potential chemical irritants.
- Toothpaste which contains sodium lauryl sulfate (SLS). Sodium lauryl sulfate promotes a drying effect on the tissues and lining of the mouth, thus breaking down the mouth’s surface protection. When the mouth lining is weak, it easily gets irritated or inflamed to produce the beginning of a canker sore.
- Hormonal changes. Most women who suffer from bouts of canker sores get them before the start of their monthly periods.
- Thermal injury.
- Celiac disease. For people who suffer from this autoimmune genetic disorder, eating foods containing gluten will damage their small intestines. This also makes them especially prone to developing canker sores.
- Crohn’s disease. Canker sores are common in individuals who have this disease.
- Behcet disease. Canker sores are usually a manifestation of Behcet disease.
Drugstore remedies generally include analgesics, anesthetics agents, anti-inflammatory medications, antiseptics, steroids, benzocaine, benzydamine (choline salicylate), and phenol. Home remedies for a canker sore include supplements of vitamin B12, application of vitamin E oil, baking soda, salt, saltwater, aloe vera, sage, onions, and chamomile. The following section is an extensive discussion dealing with how to get rid of a canker sore. Additional details regarding canker sore pain relief methods are also included.
How to get rid of a canker sore
There are so many canker sore treatments and aids to be used for canker sore relief. They are normally in the form of over the counter medications, simple home remedies, or combinations of both. Here are some of the most common canker sore remedies and relief.
- Aloe. Press a little juice from the inner part of an aloe leaf over the canker sore. Do this many times daily to speed up the healing process. Aloe vera juice is also commercially sold in gallons; you may use this packaged form instead if you do not have any other source of aloe in your home. Aloe leaf has salicylates which have a naturally inflammatory effect and best for pain relief. Furthermore, aloe has some antibacterial properties.
- Baking soda. This is a cheap and very effective home remedy for treating canker sores. You can make a paste of baking soda or you can apply baking soda directly on the canker sore. Baking soda neutralizes the acids which cause the ulceration. Baking soda also has antibacterial qualities, and it can enhance the healing of the sore.
- Vinegar and salt. Mix vinegar and salt and rinse your mouth with this solution three times a day to clear the canker sore.
- Fresh onion. Dice a small onion bit and put a little of that diced mixture onto the canker sore. Hold for about a minute to let the onion juices seep into the sore. Do this three or four times a day. Onion has been known to heal a canker sore fast.
- Sage. Boil some water and place a few teaspoons of sage leaves. Cover and let it steep for fifteen minutes. Rinse your mouth with this sage mixture many times a day. You may also pound the sage leaves into powder form, then apply this directly onto the canker sore. Sage is a widely accepted herbal remedy used to get rid of canker sores.
- Salt. If you can tolerate the pain, then put a little salt directly onto the canker sore. This has a drying effect on the lesion and speeds up its healing time.
- Saltwater. Gargle with saltwater three times a day to help heal the canker sore and other minor mouth and throat problems. Saltwater has an antibacterial effect and it is particularly beneficial as a cheap and inexpensive gargling solution to combat minor throat infections.
- Copper sulfate. Apply copper sulfate directly on the canker sore once or twice every day until the painful lesion goes away. Copper sulfate is effective and fast when it comes to treating a canker sore. This particular canker sore treatment compound has been used by many people for a long time.
- Clover oil. When applied directly on the canker sore, clover oil numbs the area and can provide pain relief.
- Tea tree oil. Tea tree oil is a proven antibacterial and antiseptic. Mix 1 part of tea tree oil with 9 parts of water and gargle the solution. You may do this three times a day until the canker sore goes away.
- Papaya leaves. Chewing papaya leaves to release its juices is a folk remedy for canker sore. Some people swear by its efficacy for treating canker sores.
- Plum juice. This is another folk remedy that can speed up the healing process of a canker sore.
- Salt and hydrogen peroxide. Mix a teaspoon of salt and a teaspoon of baking soda with two ounces of hydrogen peroxide solution. Use this mixture to rinse your mouth four times a day. You may dilute it with a little water if you find the taste too strong or the tingling sensation is uncomfortable. The use of hydrogen peroxide solution is popular in canker sore treatment.
- Cayenne. Cayenne may be a skin irritant for some people, but it is proven to be very effective when it comes to relieving the pain brought about by canker sores. Capsaicin is a compound found in cayenne pepper. Capsaicin temporarily numbs the nerves. As a matter of fact, candies made from cayenne pepper are widely used for pain relief from mouth sores resulting from radiation and chemotherapy.
- Styptic pencil. This is another pain relief method. Barbers use styptic pencils for a long time to stop the bleeding from minor cuts and nicks. When a styptic pen is used on a canker sore, it will desensitize the nerves and lessen the pain.
- Ice. This is also another effective pain relief. Just apply an ice cube onto the canker sore. You can also swish ice water inside your mouth to numb the mouth lining and reduce the pain from the canker sore.
- German chamomile. This is a potent homemade pain remedy. Take caution if you have allergies to chrysanthemum, ragweed, aster, and feverfew because you cannot use chamomile. Moreover, chamomile interacts with alcohol, sedative medications, anti-clotting drugs, and anti-platelet or blood-thinning medications (like warfarin).
- Lady’s mantle. Alchemilla vulgaris is an herb used as a homemade remedy for mouth infections, throat infections, dysmenorrhea, and skin rashes. There are studies that prove the herb’s efficacy in treating canker sores. A glycerine gel which contains 3% extract of lady’s mantle applied three times a day relieved the pain and cured the canker sores in 75% of the 48 people who were tested. The healing period of the canker sore was reduced to three days.
- DGL or Deglycyrrhizinated licorice. This type of herb licorice speeds up the healing process for people with canker sores.
- Chlorophyll tablets. Used as blood detoxifier, chlorophyll tablets are occasionally chewed to counteract canker sores.
- Goldenseal powder. You can make a homemade antiseptic mouth rinse from half a teaspoon of goldenseal powder, ¼ teaspoon of salt, and a cup of warm water. Use this to rinse your mouth four times a day. Goldenseal has anti-inflammatory and antibacterial properties that can help to hasten the healing of a canker sore.
- Vitamin E. Break off a vitamin E capsule and apply the oil directly on the lesion. This has been proven to quickly heal the canker sore. It can also even hasten the healing process of most types of external wounds.
- Good oral hygiene. This does not only prevent the appearance of canker sores. Good oral hygiene contributes to speedy healing of a canker sore. An important thing to note about good oral hygiene is to avoid extensive use of mouthwashes and oral antiseptics. These chemical products will disrupt the normal bacterial flora in the mouth.
- Supplements. The appearance of canker sores may be linked to deficiencies in vitamin B12, folic acid, zinc, iron, and the amino acid lysine. A weak immune system is also a major factor for the eruption of a canker sore. The following list may be helpful supplementation for prevention and treatment of canker sores:
- Vitamin B12. Preferably 1,000 micrograms a day.
- A vitamin-B complex containing 100 milligrams of most of the major B vitamins three times daily, with meals.
- Vitamin C and bioflavonoids. Preferably 1,000 milligrams three times per day, with meals.
- Zinc. Preferably 50 to 100 milligrams every day.
- Iron. Preferably 15 milligrams every day.
- Folic acid. Preferably 400 milligrams two times a day.
- L-Lysine. Preferably 4 grams every day for the first 4 days then reduce the dosage to 500 milligrams three times per day. This supplement must be taken in an empty stomach.
- Acidophilus powder or capsules. Probiotics such as acidophilus supplements will restore the healthy balance of bacteria that resides in the mucous membranes of the mouth.
- Use over the counter medications. They come in so many forms such as lozenges, antiseptic creams, and mouth rinses. Benzocaine is usually the common active ingredient among these drugstore remedies. The following products are some of the most popular canker sore remedies you can find in the drugstore: Colgate’s Orabase with benzocaine, Oragel ointment, and pain relief from aspirin, ibuprofen (Advil, Motrin, etc.), topical lidocaine, or acetaminophen (Tylenol, etc.). Here are the four types of over the counter medications used to get rid of a canker sore:
- Numbing agents are intended to reduce the pain and discomfort of a canker sore while it is in the process of healing. They are not designed to treat the canker sore. Numbing agents simply provide relief from the symptoms of pain brought by the ulcerated oral lesion.
- Protective films are medications that provide a membranous coating for canker sores. Coating the canker sore will prevent further damage on the lesion and the subsequent irritation that will aggravate it. These types of medications promote and enhance the natural healing process of the canker sore.
- Products that are formulated for cleaning ulcers will help to effectively treat canker sores. A canker sore is generally considered a form of ulcer or ulceration, and cleaning away the debris which accumulates on its inflamed surface can drastically shorten the time it takes for a canker sore to heal.
- Antibacterial products have no ability to cure the existing canker sore; they simply protect the canker sore from further infection which will worsen its condition and prevent it from healing naturally.
- Prescription medication that your physician may prescribe to treat a canker sore or to provide pain relief. Some examples are steroid gels for pain relief, fluocinonide (Lidex), aphthasol topical paste (or Amlexanox), triamcinolone, and topical antibiotics with tetracycline (Achromycin). Prescription remedies for treating canker sores are classified under the following categories:
- Anti-inflammatory medications reduce the size of canker sores so that their healing time is less.
- Collagenase inhibiting medications prevents the formation of collagenase. Collagenase is an enzyme which breaks down collagen. This enzyme is present in very high levels in sites of canker sores.
- Corticosteroids lessen the degree of inflammation and keep a canker sore small so it will heal more quickly. These corticosteroidal preparations normally contain triamcinolone acetonide or hydrocortisone hemisuccinate which are found to be effective in controlling painful symptoms and treating the ulcerated lesion.
Although canker sores generally heal on their own, without treatment; controversial treatment methods for dealing with canker sores still abound and are being diligently developed. Invasive treatment procedures like laser therapy, surgical removal, and low intensity ultrasound are some of them. Another controversial method to get rid of a canker sore is the application of silver nitrate. Silver nitrate will cauterize the ulcerated lesion and will reduce pain significantly, but this compound has no effect whatsoever on the actual healing time of a canker sore. It mainly deals with the symptoms of pain produced by the canker sore. Moreover, the use of silver nitrate in children leads to tooth discoloration if the teeth are in the stage where they are still developing. Tetracycline is another controversial treatment method for canker sore. The use of the following chemicals to treat canker sore is also dubious and controversial: colchicine, gamma-globulin, evamisole, dapsone, monoamine oxidase inhibitors, and estrogen replacement.
A canker sore is neither caused by a bacteria nor a virus. Smoking and alcohol are not even listed as its possible causes. It is a minor oral inflammation that results from many factors. Although the actual mechanism for its development is not fully understood, a canker sore eventually goes away, with or without treatment. Some treatment methods, most especially the invasive ones, may be too harsh and can be considered as overkill. The ultimate judge of which treatment method (whether via a drugstore medication or a popular homemade remedy) to use is really up to the person who is suffering from the symptoms of a canker sore. Sometimes, a particular home remedy works perfectly well for one person but not on the other. When it comes to home remedies for canker sore treatments, they are very safe and very inexpensive. Baking soda, aloe vera, salt, cayenne pepper, onion, etc. are pantry staples and are found in most kitchens. It is strongly recommended to try most of them to see which one works the best.