Canker sores: what they are, symptoms, causes and treatment

By Cristiano Antonino On Jan 24, 2023

Canker sores are small lesions of the skin, which, if they form inside the mouth (palate, cheeks, tongue) or at the base of the gums, are called oral canker sores (or aphthous stomatitis or aphthous ulcer)

The manifestation of canker sores can occur singly or in groups and generally look like small, round or oval abrasions a few millimeters in size, whitish in color or with a red halo around them.

They are not contagious nuisances, are very painful, and in some individuals suffering, for example, from recurrent aphthous stomatitis, they may recur more frequently.

They generally last one to two weeks.

What are canker sores?

Aphthae, also called aphthous stomatitis or aphthous ulcers in medical jargon, are nothing more than very common types of ulceration, among the most common of oral mucosal infections.

They generally affect women, but are also usual in pediatric age.

But what exactly do they consist of?

They involve a rupture of the oral mucosa, which may be preceded a few days earlier by a feeling of discomfort or burning.

They not only involve the oral mucosa, but can also affect other areas of the body, such as the male and female genital mucous membranes and semi-mucous membranes, i.e., the foreskin – glans, labia minora and labia majora.

Importantly, canker sores on the labia are not contagious, unlike blisters caused by Herpes Simplex.

What are the symptoms of canker sores?

Generally, the symptoms that herald the appearance of canker sores are:

pain often accentuated especially when eating;
burning;
redness;
fever if large, extensive canker sores are present;
swelling of the lymph nodes under the jaw.

What are the most common causes?

Several causes may underlie the infection; in fact, today the origins and mechanisms of canker sores development are still not well understood.

In medicine, the prevailing theory is that associates the appearance of canker sores with psychophysical stress exactly as is the case with Herpes Simplex or lip fever.

These infections can be the result of:

contact with dirty objects and pets.
minor trauma of the mouth, such as accidentally biting the cheek, acidic or spicy foods, vigorous use of the toothbrush;
menstruation;
hormonal imbalances;
Helicobacterpylory infection;
diet low in vitamin B12, zinc, folic acid (folate) and iron;
immunodeficiency syndrome and immunosuppressive drugs.

They can also be caused by the use of dentures, chipped or injured teeth, or still can be caused by hard foods, smoking, or rubbing too vigorously with a toothbrush.

Food intolerance, taking antibiotics or other substances and medications, hormonal changes during a woman’s menstrual cycle, or even a folic acid deficiency (typical of pregnant women), can also result in the appearance of these lesions.

In these cases, mouth ulcers represent a signal that gives the body as a wake-up call and for which it is useful to undergo specific tests

Other factors related to health and genetic predisposition such as diabetes, or diseases of viral or bacterial origin may also contribute.

Finally, the repeated presence of mouth ulcers, present mainly on the mucosa of the tongue, lips and cheeks, may be a symptom of aphthous stomatitis, a very painful but not contagious condition.

How to prevent the occurrence of canker sores?

Certainly it is very important to adhere to a routine of oral cavity hygiene, using a soft-bristled toothbrush and toothpaste after every meal.

It also helps to prevent the occurrence of mouth ulcers to avoid eating acidic or spicy foods often, such as chips, spices, pineapple, grapefruit, oranges, nuts, etc.

Instead, it is advisable to eat plenty of fruits, vegetables and whole grains and to drink a lot.

As we anticipated above, stress can be a trigger for infection, so it would be wise to slow down any accumulated psychological or physical tension.

Reducing states of anxiety and stress, definitely helps prevent canker sores.

If you have dentures or braces, you should take care of their hygiene and inform your dentist of any discomfort or injury.

Diagnosis

Treating canker sores and assessing inflammation generally only requires a visit to your primary care physician, especially when you experience a lot of pain.

No other diagnostic tests are, in fact, necessary.

Treatment and Care of Canker sores

Canker sores, particularly oral canker sores, heal on their own within a maximum of a couple of weeks.

When this does not happen and you experience a lot of pain, it is advisable to use:

mouthwashes that form a protective film over canker sores that prevents contact with food;
touchings with retinoic acid that facilitates healing in fewer days;
touchings with aluminum chloride astringent gel that stimulates the mucosa to re-epithelialize.

If left untreated, these inflammations can surely worsen, so it is best to take care of them before they become even more painful. The fastest way to do this is to apply a protective layer over the ulcer.

This will block the external stimulus that can cause further irritation and infection.

Another remedy for mouth ulcers is as mentioned above the use and application of mouthwashes with Chlorhexidine, which are antiseptic and alcohol-free, acting as a barrier to protect the wound as well as offering pain relief.

By using them even in small doses when a canker sore or mouth injury is present, it heals quickly and tends not to reappear.

To accelerate healing and relieve pain from the injury, it is advisable to avoid for a time the intake of overly spicy and acidic foods, such as citrus fruits, spices, drinks that are too hot, coffee and alcohol.

Instead, foods rich in fiber and vitamins, such as eggs, meat, fish and cheese, should be preferred in all cases.

Certainly, the remedies to be taken depend greatly on the type of mouth ulcer and the degree of intensity and pain.

Usually, in fact, stomatitis resolves spontaneously within a couple of weeks, but it is possible to speed up the healing process through a therapy based on the medications listed above.

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