What is a canker sore? Causes, symptoms and treatment of aphthous ulcers

18 June 2019   |    27 June 2019   |   Category: Dermatology
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Canker sore is ulcer of the mouth that can be caused by a variety of reasons; this condition, also called aphthous ulcer or aphthae, is a very common health problem. It generally develops with the irritation caused by the damaged mucosa inside the mouth and appears like colored, oval wounds. There can be many reasons for the problems of lips and mouth; however, the most important factors are poor immune system, vitamin and mineral deficiency, hormonal factors during puberty and celiac disease. Canker sores generally occurs as a result of a wound inside the mouth caused by biting the cheeks or a blow to the mouth but it is not a contagious disease. Aphthae are especially frequent in puberty and more common in women. Today aphthae can be effectively treated and prescribed ointments and other effective drugs are used.

What causes canker sores?

Canker sores are surrounded by white, yellow or red-colored inflammatory soft tissue and generally heal on their own within 7 to 10 days. However, serious canker sore may require up to 6 weeks to heal. The most common causes of aphthous ulcers are:

  • Viral infections
  • Food allergies
  • Hormonal fluctuations and menstrual cycle problems
  • Immune system problems
  • Oral trauma
  • Vitamin and mineral deficiency
  • Behçet’s or Celiac disease
  • Sodium lauryl sulphate containing toothpaste and mouthwash
  • Unfitting oral implants and dental problems
  • ‘Helicobacter’, which also causes stomach ulcer, and ulcerative colitis

The cause for mouth sores and aphthae worsening due to vitamin and mineral deficiencies are generally B3, B9 and B12 vitamin deficiencies. People with canker sore history in their families can be more vulnerable against it. In some cases, physicians may not be able to pinpoint the cause of canker sores.

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Some fruits and vegetables, such as citrus fruits, tomato, strawberry, apple, fig, lemon and orange, may exacerbate aphthae wound and pain. Having sharp edges inside the mouth due to implants such as dental plate and dental braces are among the factors that can worsen aphthous ulcers and pain.

Symptoms of canker sores

  • Pain and wounds in the cheeks, tongue, at the back of the mouth and palate,
  • Tingling and pain sensation before wound formation,
  • White, gray and yellow-colored circular wounds with red edges,
  • Increasing pain inside the mouth that is felt upon speaking,
  • Wounds that spread to the outside of the mouth,

Symptoms of serious and progressing canker sores and oral wounds

  • Swollen lymph nodes,
  • Fever amd tiredness,
  • Physical exhaustion can be seen.

Types of canker sores

  • Minor canker sores are more common and they generally have small sizes. These are have red boundaries. Minor canker sores tend to go away on their own within one or two weeks
  • The less common major canker sores are larger and deeper that smaller ones.Their edges are generally circular, or sometimes can be irregular. Highly painful major aphthous ulcers may take up to six weeks to heal.
  • Third type is herpetiform and they generally not common. These rare wounds are not caused by “herpes virus”.

When to treat canker sore?

Bacterial infections causing aphthae may lead to complications in case of serious progression. In such cases or for recurrent and difficult-to-heal canker sores, a doctor must be consulted. You must see a doctor before the disease persists over a few weeks and must follow the treatment prescribed by your doctor.

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Are canker sores contagious?

Although patients can confuse throat sores and canker sores, these two diseases are completely different. While throat sores caused by cold weather is highly contagious, canker sores are completely non-contagious. Throat sores are caused by a virus called “herpes simplex” and the virus is carried inside the body during the course of the disease. Patients may be exposed to the risk of sores in the lips, nose and eyes.

Which diseases do canker sores and mouth ulcers may indicate?

As HIV can be a reason for canker sore, doctors must also consider this possibility. Especially if there is major aphthae, doctors should refer to HIV test. If there is bleeding in your or gingival, your teeth are loose, if you are having problems with swallowing and suffering from ear pain, there is a possibility of mouth cancer. Therefore, we highly recommend you to seek medical advice immediately in case you encounter these problems.

Diagnosis of canker sores

Your doctor may perform biopsy for the relevant region inside the mouth for definitive diagnosis. Blood tests can also be used for this since biopsy could be necessary in case of suspected vitamin and mineral deficiency, hormonal disorder, virus, poor immune system.

Canker sore treatment

Canker sore generally heal on their own without requiring treatment. However, your doctor may use different methods and drugs to let you get rid off these wounds quickly. For this you must brush your teeth regularly and make dental floss a habit. You should avoid spicy food, eat plenty of yoghurt and drink milk. You can alleviate the wounds inside your mouth.

In case of severe aphthous ulcer, you may have some pain relief by gargling with salt water. You can also relieve the pain by using the drugs and topical products recommended by your doctor.

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Canker sore medicines

Today, there are many effective drugs for the treatment of canker sores and other mouth ulcers. Some drugs prescribed by the doctor for aphthae treatment are as follows:

  • Benzocain-containing drugs like Orabase, Zilactin B, Kank A,
  • Hydrogen peroxide rinsing drugs like Peroxyl, Orajel,
  • Fluocinonide-containing drugs,
  • Mouth rinsing drugs like Peridex, Periograd,
  • Mouth washes and tablets like Monodox, Adoxa, Vibramycin etc.,
  • Corticostreoid-containing oinments,
  • Dexamethasone-containing drugs that are effective against inflammation and pain
  • You can gargle with salt water in case of mild oral wounds.

Other methods used for canker sore treatment

Your doctor may prefer one of many methods for aphtha treatment. The method of choice depends on the progression level of the disease. Most common methods used for canker sores treatment are listed below:

  • Canker sore treatment with antibiotics: Your doctor may consider antibiotic treatment necessary for some aphthae cases.
  • Local anti-inflammatory agents: Triamcinolone containing drugs and local treatment methods are among the most common medications prescribed by doctors to accelerate the healing process of aphthae ulcers.
  • Immune modulators: This method, especially used for patients with HIV, aims to enhance the immune system. Aphthasol 5% paste, an immune modulator, is directly adhered onto the wound.
  • Silver nitrate application: The aim of this application is reducing the local and systematic symptoms. This procedure is highly painful; therefore, silver nitrate rods are applied to the wounds under a short term of anesthesia.
  • Zinc gluconate pastils: These pastils prescribed to the patients contain high amounts of vitamin C and B, and its oral use can accelerate the healing.

Prevention of canker sores

You must cease the consumption of spicy food you may have been eating in order to prevent and stop the formation of aphtha ulcers. In addition to spicy food, you should also avoid salty and acidic food and beverages. If the reason of aphtha is stress, or your doctor diagnosed a stress-related cause, you may enroll to a course to learn calming methods like meditation, deep-breathing etc.

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You can use a soft toothbrush to prevent your gingival and inflamed tissues from further irritation. You must consult your doctor to diagnose whether you have any vitamin and mineral deficiency. If vitamin and mineral deficiency is detected, you should do your best to follow nutrition plan given by your doctor.

Ask for medical advice if you encounter one of the following symptoms:

  • Punctured or large wounds inside the mouth,
  • Unbearable pain inside the mouth,
  • High fever, Rash
  • Diarrhea, Headache

If you have severe pain that prevents you from eating and if the wounds inside your mouth are not healed within a few weeks, you must see a doctor. As aphthae ulcers may repeat, you need to apply some protective methods regularly in order to avoid having these wounds over and over again.

Herbal remedies for canker sores

You can prepare helpful cures by using below medicinal plants at your home to accelerate the healing process of apthae. The best methods and medicinal plants, fruits and vegetables to fight off aphtae are listed below.

Kiwi

Your canker sores can heal quickly thanks to kiwi for its ability to enhance immune system. All you have to do is nothing but to eat plenty of kiwis during the day! Kiwi, fighting against aphthous ulcers, has been very helpful for many people suffering from aphthae. So have some kiwis and join the club!

Baking soda

Baking soda, that lets you make fluffy meals in the kitchen, is another helpful nutrient that fights against mouth ulcers Apply baking soda directly onto the wounds inside your mouth to make use of its miraculous effect. Or brush your teeth using baking soda. Last but no least, mix the baking soda with a little amount of water to make a paste and apply it directly on your wounds.

Yoghurt

Yoghurt is one of the most popular methods for canker sore treatment for its ability to fight off bacteria and alleviate wounds. However, you should never add sugar to the yoghurt and only consume pure, flavorless and natural yoghurt. The wounds inside your mouth can heal faster.

Aloe vera

Extract the juice of Aloe Vera, one of the most miraculous fruits mother nature has to offer, and wash your mouth with this juice.

Salt water

You accelerate the healing process of aphthous ulcers by gargling with salt water. Add half teaspoon of salt to a glass of water. Wash your mouth several times a day with this mixture!


References: 1- Canker Sores, 2- What is a canker sore?, 3- Mouth sores and ulcers

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