Canker sores are small lesions on the inside of the mouth and are white or yellow bordered with red. They occur inside the cheeks, at the base of the gums, on the inside of the lips and on or under the tongue. Unlike cold sores, canker sores are not contagious and they do not form on or around the outside of the lips. Most canker sores, although painful, are small and will clear up on their own in a week or two.
Major canker sores are large, irregular lesions. These can last month or even years to go away. Herpetiform canker sores are clusters of many tiny lesions all together in one spot. Sometimes they merge together to form one huge, very painful, lesion. This type of canker sore usually occurs in older people and can last a week or a month or longer. Occasionally a canker sore may cause fever, listlessness or swollen lymph nodes.
Experts do not know what the precise cause of canker sores is but there are many factors that can lead to canker sores. An irregular immune system can attack healthy cells instead of bacteria and viruses. A minor injury to the mouth caused by biting the lip or mouth, dental work, a sport’s accident, etc. An allergic reaction to bacteria present in the mouth. Helicobacter pylori is a bacteria that causes ulcers which if present in the mouth can lead to canker sores. B-12, zinc, folate or iron deficiency can be a factor. Celiac disease, inflammatory bowel diseases such as Chron’s, Behcet’s disease and HIV or AIDS can all make you more likely to suffer from canker sores. Some foods, in particular chocolate, eggs, cheese, nuts, berries, coffee and highly acidic foods such as oranges and also toothpaste or mouth rinse containing sodium lauryl sulfate are also factors that can irritate your mouth and lead to canker sores. Also, emotional stress and hormonal shifts during menstruation can also play a factor.
Normally, there is no need to see a doctor or dentist to receive an official diagnosis. The only time a dentist would need to be consulted is if the cause is believed to be sharp tooth surfaces or dental work such as braces. Medical advice from a doctor should be sought if the canker sores are abnormally large, frequently recurring (the canker sore doesn’t have time to heal before another one appears), the canker sores take longer then 3 weeks to heal, canker sores that spread onto the lips themselves, pain that is unmanageable with over the counter methods, difficulty eating or drinking or a high fever. No tests are needed to diagnosis canker sores. A simple visual exam will suffice. If an underlying disorder is suspected to be the cause of the canker sores then tests may be done to diagnose the underlying disorder.
More often then not canker sores will clear up on their own and need no treatment. Sometimes however, with persistent or large canker sores other measures must be taken. If numerous canker sores are present a mouth rinse will likely be the recommended treatment. Mouth rinses for canker sores usually contain the steroid dexamethasone which helps with pain and inflammation. Topical pastes can be applied to the canker sore to relieve pain and may be acquired over the counter or from a prescription. Debactorol is a topical solution that cauterizes the canker sores and reduces healing time to a week in most cases. If the cause is nutritional deficiencies the doctor will often subscribe vitamin supplements. Oral steroid medication is the last resort for canker sores and only used if nothing else works. If the canker sores are caused by an underlying condition the doctor will try to treat that condition.
Canker sores occur more often in women and are more likely at ages 10 through 40. As a person ages the frequency of canker sores lessens. Canker sores also tend to run in families. There are things that can be done to make canker sores less likely to occur. If canker sores are caused by dental work then orthodontic waxes can be obtained to cover any sharp edges. Avoid food that may irrigate the mouth, especially spicy or highly acidic foods. Eat healthy to avoid vitamin deficiencies. Brush your teeth regularly and develop good oral hygiene.