Canker Sore

The Secret of Great Health Care

Your Subtitle text

Canker Sores

It is unclear what causes canker sores (aphthous ulcers). Factors that may contribute to canker sores include: hormonal fluctuations, viral infection, emotional stress, and local trauma. These ulcers – which are often confused with cold sores - are not infectious.

What does it look like

Canker sores can occur at different places on the inside of the mouth and their reoccurrence is in variable spots. This is opposed to cold sores, which often reoccur at similar spots.

Canker sores are painful reoccurring ulcers that occur inside the mouth on the lips, checks or throat.

Canker sores usually start between the ages of 10 and 40 and are characterized by:

Painful shallow ulcers in the mouth
Tingling, numbness or burring may be noticed one to 2 days before the lesion erupts
No systemic symptoms (no fever, chills or feeling sick)
Small sores that are 0.5 to 1 cm
One sore to as many as 6
Sores that heal in 7-10 days

When to worry

Most self-limiting mouth lesions are painful and last 7-10 days. Certain factors increase the likelihood of a more serious condition:

Painless sores
Sores that do not heal in 10 days

Treatments

Treatment involves reducing pain and providing comfort while you wait for resolution. Multiple comfort measures are available to help.

Apply ice to the sore – it will reduce pain and swelling
Popsicles are comforting
Avoid irritation from foods such as spicy, acidic or rough foods
Use a soft toothbrush

Over-the-counter medicationsSome over-the-counter products are available to reduce pain. These include topical agents and general pain medications. Oral pain relievers – such as ibuprofen or acetaminophen may reduce pain.

Topical agents are also available to provide comfort. Most over-the-counter products are some sort of numbing medicine. They do not speed healing, but can provide comfort. No research suggests one is any better than another. See chart.

An antiseptic called thymol – which is found in Listerine mouthwash – may be helpful in treating canker sores, but the research is limited.

To purchase products discussed in this chapter visit The Drug Store.

Prescription drugs

Chlorhexidine mouthwashes have the most proof to speed healing and reduce pain. It is an antiseptic mouthwash or gel that reduces germs. Everyday use can stain the teeth and tongue but it is reversible when it is stopped.

Steroid mouthwashes, creams, gel or pastes are often used to reduce pain and decrease inflammation. Triamcinolone dental paste is one example and is used in those over 12-years-old can be applied four times a day.

Numbing mouth rinses can be used to help provide comfort. The most popular agent is viscous lidocaine. It is sometimes mixed with liquid Benadryl and Maalox.

Amlexanox (Aphthasol oral paste) for those over the age of 18-years-old is able to reduce inflammation.

Summary

Canker sores take time to heal. Applying some of the comfort measures is helpful. In addition treating the sores with topical medications may be helpful. No OTC agent has proven more effective than any other.

The best strategy is to avoid irritating the sore, use ibuprofen and try some of the topical agents available over-the-counter. One product is not necessarily better than any of the others – try a few of them and see what works best for you. Using Listerine mouthwash one to two times a day may help speed healing.

If you do not get adequate relief going to the doctor for a prescription medication is the next step. These products may be no more effective than over-the-counter medications.