Overview
Canker sores, also called aphthous ulcers, are small, shallow lesions that develop on the soft tissues in your mouth or at the base of your gums. Unlike cold sores, canker sores don't occur on the surface of your lips and they aren't contagious. They can be painful, and can make eating and talking difficult. Canker sores come in different types, including minor, major, and herpetiform sores. Minor canker sores are the most common, usually small, oval-shaped with a red edge, and heal without scarring in one to two weeks. Major canker sores are less common, larger and deeper, round with defined borders, and can take up to six weeks to heal, leaving extensive scarring. Herpetiform canker sores are pinpoint-sized, often occur in clusters, have irregular edges, and heal without scarring in one to two weeks. If you experience unusually large canker sores or canker sores that don't seem to heal, it's best to consult your doctor or dentist.
Understanding the disease
Symptoms
The symptoms of canker sores, also known as aphthous ulcers, are small, shallow lesions that develop on the soft tissues in the mouth or at the base of the gums. They are usually round or oval with a white or yellow center and a red border. Canker sores can be painful and may make eating and talking difficult. They may also cause a tingling or burning sensation before they appear. There are three types of canker sores: minor, major, and herpetiform. Minor canker sores are the most common and are usually small, oval-shaped, and heal without scarring in one to two weeks. Major canker sores are less common, larger and deeper, and can be extremely painful. They may take up to six weeks to heal and can leave extensive scarring. Herpetiform canker sores are pinpoint size, often occur in clusters, and have irregular edges. They heal without scarring in one to two weeks. It is recommended to consult a doctor if you experience unusually large canker sores.
Risk Factors
Risk factors for developing canker sores include:
- Age: Canker sores tend to occur more often in teens and young adults, and they are more common in females.
- Family history: People with a family history of recurrent canker sores may have a hereditary predisposition or be exposed to a shared environmental factor, such as certain foods or allergens.
- Stress: Emotional stress can be a trigger for canker sores in some individuals.
- Certain foods and allergens: Specific foods or allergens may contribute to the development of canker sores in some people. Common food sensitivities include chocolate, coffee, strawberries, eggs, nuts, cheese, and spicy or acidic foods. Please note that these risk factors may not apply to everyone and that canker sores can occur in individuals without any of these risk factors present.
Development
Canker sores, also known as aphthous ulcers, develop as small, shallow lesions on the soft tissues in the mouth or at the base of the gums. They can be round or oval with a white or yellow center and a red border. There are three types of canker sores: minor, major, and herpetiform. Minor canker sores are the most common and typically heal without scarring in one to two weeks. Major canker sores are less common, larger, and deeper, and can take up to six weeks to heal, sometimes leaving extensive scarring. Herpetiform canker sores are pinpoint-sized, often occur in clusters, and heal without scarring in one to two weeks. The exact cause of canker sores is unknown, but factors like stress, diet, hormonal shifts, and certain health conditions can contribute to their development.
Assessment and Diagnosis
Triage
You should see a doctor if you have unusually large or painful canker sores, or canker sores that don't seem to heal. This could indicate a major canker sore or a more severe condition. Additionally, consult your doctor if you experience recurring sores, persistent sores lasting two weeks or more, sores that extend into the lips, severe pain that doesn't improve with self-care measures, extreme difficulty eating or drinking, or a high fever accompanied by canker sores. Remember, while most canker sores heal on their own within a week or two, it's best to seek professional advice if your symptoms are concerning or unusual.
Diagnosis
To diagnose a canker sore, your doctor or dentist can conduct a visual examination of your mouth. Usually, no tests are needed to diagnose canker sores, as they can be identified by their characteristic appearance. However, your doctor may recommend tests to rule out other health problems, especially if your canker sores are severe, persistent, or recurrent. If you have multiple canker sores or unusual symptoms, your doctor may order blood tests or other diagnostic tests to check for underlying health conditions, such as vitamin deficiencies, autoimmune disorders, or hormonal imbalances. In some cases, a biopsy may be performed to examine the tissue of the canker sore.
Management and Treatment
Home Remedies
Home remedies for canker sores include:
- Over-the-counter pain relievers: Use nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen to help alleviate pain and reduce inflammation.
- Salt water rinse: Dissolve a teaspoon of salt in a cup of warm water and rinse your mouth with it. This can help debride the area and provide some relief.
- Hydrogen peroxide: Dilute hydrogen peroxide with water and apply it to the canker sore using a cotton swab. This may help with healing and disinfection.
- Milk of magnesia: Apply a small amount of milk of magnesia to the canker sore with a cotton swab. The alkaline nature of milk of magnesia may help with pain relief.
- Baking soda: Mix a small amount of baking soda with water to create a paste, then apply it to the canker sore. The natural antiseptic and pain-relieving properties may help with healing and discomfort.
- Zinc lozenges: Sucking on zinc lozenges may help speed up the healing process of canker sores. Remember that home remedies may not work for everyone, and it's essential to consult your doctor or dentist if your canker sore is unusually large, painful, or persistent.
Treatment
Treatment for canker sores usually isn't necessary for minor sores that tend to clear on their own in a week or two. However, if you have large, persistent, or unusually painful sores, medical care may be needed. Treatment options include mouth rinses, topical products, and oral medications. Over-the-counter and prescription products, such as pastes, creams, gels, or liquids, may help relieve pain and speed healing if applied to individual sores as soon as they appear. Some products have active ingredients, such as benzocaine, fluocinonide, and hydrogen peroxide. For severe cases or non-responding sores, your doctor may recommend oral steroid medications or cautery of sores using medications like Debacterol or Silver nitrate. It's important to consult with a doctor or dentist for proper diagnosis and treatment recommendations, as they can tailor the treatment to your specific needs and medical history. To prepare for your appointment, make a list of your symptoms, medications, and medical conditions, and gather information about other topical products that may be effective in treating canker sores. Additionally, following lifestyle and home remedies like rinsing your mouth with salt water or baking soda, avoiding abrasive, acidic, or spicy foods, and using ice can help relieve pain and speed healing.