Canker sores 101: Everything you need to know

Canker sores, also known as aphthous ulcers, are small, reddish-white spots of inflammation on soft tissues like inside the mouth, tongue and gums. They are not contagious i.e., they don’t spread from one person to another. The best part, they usually heal by themselves and rarely lead to further complications, even in people sporting braces.

Based on their form, canker sores are of three different types.

• Minor Aphthous Stomatitis: Ulcers are less than 1 cm in size. This type affects about 80% of the population and is the most common form of oral ulcers. These canker ulcers usually take less than a week to heal.
• Major Aphthous Stomatitis: These sores are slightly bigger than 1 cm and affect ~15% of the patients. While these types of cankers also take less than a week to heal, they are quite painful.[2]
• Herpetiform Aphthous Stomatitis: Only a small group of people, roughly 5%, suffer from this serious form of sores. When small clusters of cankers eventually merge to form larger ulcer spots, they are termed herpetiform aphthous stomatitis. They usually take more than a week to heal.

Canker sores are often confused with cold sores, which are caused by the highly contagious herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). These clusters of fluid-filled blisters that can be spread through personal contact like kissing.

What causes canker sores?

Although the exact cause of canker sores is not known, the widely accepted reasons by medical professionals are as follows:

• Stress
• Injury to the mouth, sometimes due to braces or dentures that aren’t set well
• Eating acidic foods e.g., citrus fruits
• Nonsteroidal anti-inflammatory drugs like ibuprofen
• Deficiencies like iron, vitamin B-12, folic acid or zinc.

For patients with a complex case of canker sores, the reason may be a defective immune system caused by Celiac disease, AIDS, Behcet’s disease, Crohn’s disease or even Lupus. Some medical experts believe they could be hereditary.

Signs and symptoms

The most common symptom of canker sores/mouth ulcers is the red, white or yellow ulcer spots inside the mouth. They are accompanied by burning/ stinging pain when one talks or eats.[1] In extreme cases, patients may even have a fever or experience swollen lymph nodes and fatigue.

Diagnosis, prevention and treatment

Canker ulcers are usually diagnosed on a close physical examination. However, medical professionals might suggest blood work to look for any vitamin deficiencies that can be easily corrected.

In terms of treatments, cankers usually heal by themselves over a few days. However, to ease the symptoms, dental experts like those from Toothsi, may prescribe corticosteroid ointments containing medicines such as fluocinonide, beclomethasone or hydrocortisone. They may also prescribe mouthwashes that contain hydrogen peroxide, chlorhexidine or dexamethasone. In rare severe cases, cauterization or burning the ulcer might be necessary to sterilize the affected area and speed up the healing process.

When it comes to the prevention of a canker sore inside the mouth, it is important to follow these habits:

• Avoid extremely acidic/spicy/salty foods
• Maintain good oral health by brushing twice a day
• Have regular check-ups for any correctable deficiencies

Conclusion Oral canker sores are one of the most common types of mouth ulcers that can affect anybody. The best way to take care of them is by timely diagnosis and regular check-ups with doctors. It is also important to maintain proper oral health and a balanced diet.

Persons using invisible braces should take extra care to prevent cankers. Canker sore mouth ulcers usually heal by themselves, but if you see the symptoms persist, immediately pay a visit to your doctor.