An overview of Canker Sores

Canker sores — or aphthous ulcers — are small, shallow ulcers that occur in the lining of your mouth. A canker sore starts as a white or yellowish mouth sore with a red border. They’re usually very small (less than 1 millimeter) but may grow to 1/2 inch to 1 inch in diameter.

You can get canker sores on your tongue, gums, roof of your mouth, inside of your lip or under your tongue. They can be painful and often make eating and talking uncomfortable.

There are two types of canker sores:

Simple canker sores: These may appear three or four times a year and last up to a week.

Complex canker sores: These are less common and occur more often in the people who have previously had them.

Experts aren’t exactly sure why some people are more likely to get canker sores. But they’ve discovered many factors that can trigger the development of these ulcers, including:

1. Stress.

2. Injury to the inside of your mouth.

3. Acidic foods, such as citrus fruits.

4. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

5. Dental appliances, such as braces or ill-fitting dentures.

Complex canker sores may develop in people with immune system conditions, including:

1. Lupus.

2. Behcet’s disease.

3. Celiac disease.

4. Ulcerative colitis.

5. Crohn’s disease.

6. AIDS.

Canker sores may also be linked to nutritional deficiencies in vitamin B-12, zinc, folic acid or iron.

Common canker sore symptoms include:

1. One or more painful sores inside of your mouth. These ulcers may form on your tongue, the inside of your lips, your inner cheeks or the roof of your mouth.

2. Burning or tingling sensations.

3. Small, round ulcers that are white, gray or yellow with a red border.

In severe cases, you may also experience:

1. Fever.

2. Physical sluggishness.

3. Swollen lymph nodes.

There’s no surefire way to prevent canker sores. But there are several things you can do to reduce your risk:

1. Steer clear of acidic, salty or spicy foods.

2. Practice good oral hygiene. Brush twice a day with a soft-bristled toothbrush and floss once daily.

3. Talk to your healthcare provider about potential nutritional deficiencies.

Try stress reduction techniques, such as mindfulness and meditation.

Your healthcare provider can diagnose canker sores during a physical exam. They might also recommend a blood test to see if you have a vitamin deficiency or another condition that’s causing the ulcers.

Canker sore treatment may include over-the-counter or prescription products to ease your symptoms. Your healthcare provider may recommend one or more of these canker sore remedies:

1. Topical anesthetics, such as benzocaine.

2. Mouth rinses containing hydrogen peroxide, chlorhexidine or dexamethasone.

3. Corticosteroid ointments, such as fluocinonide, beclomethasone or hydrocortisone hemosuccinate.

4. Antibiotics, such as doxycycline (usually recommended for recurrent, or returning, canker sores).

If you have canker sores caused by nutritional deficiencies, your healthcare provider may recommend certain vitamins or supplements.

For severe canker sores, your healthcare provider may recommend cauterization (burning the affected tissue). This can sterilize the area, reduce pain and speed up healing.

Complications of canker sores can include fever, swollen glands, and feeling run-down. Sores that keep coming back can indicate that important vitamins may be low or that there is an underlying health problem.

Fortunately, canker sores do disappear over time and no further health risks are associated with them.