Canker sores
Definition
Canker sores are small sores or ulcers that appear inside the mouth. They are painful, self-healing, and can recur.
Description
Canker sores occur on the inside of the mouth, usually on the inside of the lips, cheeks, and/or soft palate. They can also occur on the tongue and in the throat. Often, several canker sores will appear at the same time and may be grouped in clusters. Canker sores appear as a whitish, round area with a red border. The sores are painful and sensitive to touch. The average canker sore is about one-quarter inch in size, although they can occasionally be larger. Canker sores are not infectious.
Approximately 20% of the
women than men get them. Women are more likely to have canker sores during their premenstrual period.
Canker sores are sometimes confused with cold sores. Cold sores are caused by herpes simplex virus. This disease, also known as oral herpes or fever blisters, can occur anywhere on the body. Most commonly, herpes infection occurs on the outside of the lips and the gums, and much less frequently on the inside the mouth. Cold sores are infectious
Causes and symptoms
The exact cause of canker sores is uncertain, however, they seem to be related to a localized immune reaction. Other proposed causes for this disease are trauma to the affected areas from toothbrush scrapes, stress, hormones, and food allergies. Canker sores tend to appear in response to stress. The initial symptom is a tingling or mildly painful itching sensation in the area where the sore will appear. After one to several days, a small red swelling appears. The sore is round, and is a whitish color with a grayish colored center. Usually, there is a red ring of inflammation surrounding the sore. The main symptom is pain. Canker sores can be very painful, especially if they are touched repeatedly, e.g., by the tongue. They last for one to two weeks.
Diagnosis
Canker sores are diagnosed by observation of the blister. A distinction between canker sores and cold sores must be made because cold sores are infectious and the herpes infection can be transmitted to other people. The two sores can usually be distinguished visually and there are specific diagnostic tests for herpes infection.
Treatment
Since canker sores heal by themselves, treatment is not usually necessary. Pain relief remedies, such as topical anesthetics, may be used to reduce the pain of the sores. The use of orticosteroid ointments sometimes speeds healing. Avoidance of spicy or acidic foods can help reduce the pain associated with canker sores.
Alternative treatment
Alternative therapies for canker sores are aimed at healing existing sores and preventing their recurrence. Several herbal remedies, including calendula (Calendula officinalis), myrrh (Commiphora molmol ), and goldenseal (Hydrastis canadensis), may be helpful in the treatment
of existing sores. Compresses soaked in teas made from these herbs are applied directly to the sores. The tannic acid in a tea bag can also help dry up the sores when the wet tea bag is used as a compress. Taking dandelion (Taraxacum officinale) tea or capsules may help heal sores and also prevent future outbreaks. Since canker sores are often brought on by stress, such stressrelieving techniques as meditation, guided imagery, and certain acupressure exercises may help prevent canker sores or lessen their severity.
Prognosis
Canker Sore Treatment
Self-Care at Home
* Try rinsing your mouth with a solution of ½ teaspoon salt dissolved in 8 ounces of water.
* Another mixture that may be helpful consists of 1-2 tablespoons of Maalox mixed with ½ tablespoon of liquid diphenhydramine (Benadryl). Swish a teaspoonful in your mouth and spit it out. This can be done four times a day.
* A number of medications are available over the counter, for example, calamine (Calamox) lotion.
* Liquids or ointments with a numbing ingredient such as benzocaine (Anbesol, Oragel, Orabase, Zilactin-B, Tanac) help relieve the discomfort of canker sores.
* Applying certain steroid salves directly to the sore is effective if you use the salve early in an attack. If over-the-counter medications do not help, a common prescription consists of triamcinolone acetonide, a corticosteroid, in a sticking dental paste (Kenalog in Orabase). Typically, you apply the paste to the lesions three times daily. More recently, doctors have prescribed amlexanox (Aphthasol). Although no one knows why amlexanox works, it may be related to its anti-inflammatory and anti-allergic effects.
* Tetracycline suspensions (Achromycin, Nor-tet, Panmycin, Sumycin, Tetracap) used as a mouthwash can relieve pain and accelerate healing.
Resources
BOOKS
Larsen, D. E., editor. Mayo Clinic Family Health Book.
John T. Lohr, PhD
The eMedicineHealth
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