Mouth ulcers or mouth sores, also called canker sores, are a common condition affecting almost every individual over the course of their lifetime. Mouth ulcers, also known as aphthous ulcers, can be a painful condition and can make routine activities such as eating and talking difficult. It can be a result of common incidences such as cheek bite, pizza burn, harsh brushing.
It can also occur due to underlying systemic conditions such as ulcerative colitis, Celiac disease, and Behcet’s disease. Immunocompromised people have a high incidence rate of aphthous ulcers.
If you have a recent dental procedure done such as dental braces, chances are you may get a few mouth sores due to irritation of the soft tissue against the braces components. Allergic reaction to specific components in toothpaste and food sensitivities are also a leading cause of mouth sores.
Applying local anesthetic cream and avoiding spicy and hot food can help soothe the pain and burning sensation associated with canker sores. Let us understand in detail what are the possible causes of mouth sores and how to get rid of canker sores naturally.
What are canker sores?
Mouth sores also called canker sores, or aphthous ulcers are painful ulcers found on the cheeks, lips, gums, tongue, the floor of the mouth, and the soft palate.
These sores can be a result of a variety of factors, ranging from stress to gastrointestinal diseases. Mouth sore symptoms is mostly a burning or tingling sensation inside the mouth followed by painful, sensitive ulcers (1).
In more severe cases, mouth sores can be accompanied by swollen lymph nodes, physical fatigue, and fever. The sores are small, shallow lesions that develop on the soft tissues in your mouth, unlike cold sores, they are not contagious.
They can be painful, however, and can make eating and talk difficult.
Symptoms of canker sores
Most canker sores have a round or oval, white or yellow center and an inflamed red border. They can occur in any soft tissue inside your mouth. A tingling or burning sensation can occur a day or two before the sores appear.
What are the causes of canker sores?
There is no known cause or factor for canker sores. They are thought to be brought on by a variety of triggers, including –
- Weakened immune system
- Hormonal changes
- Sensitivity to acidic foods
- A poor diet lacking in certain vitamins and minerals, such as vitamin B12
- Sodium lauryl sulfate found in certain toothpaste and mouthwashes
Research has also associated canker sores with several inflammatory diseases like Crohn’s disease, ulcerative colitis, Celiac disease, and Behcet’s disease, plus diseases related to a suppressed immune system, such as HIV/AIDS.
Many different risk factors can play a role alone or in combination with triggering canker sore outbreaks. They include –
Some tissue damage often precedes a canker sore formation. This might be an accidental self-inflicted bite, irritation caused by the sharp edge of a tooth that needs repair, trauma from sharp food or even harsh tooth brushing.
Pizza burn is the leading cause of palate sores (2). Tongue bite and cheek bite can cause local tissue damage leading to an ulcer. Abnormalities in the composition of saliva can also cause local tissue trauma.
Conditions such as xerostomia or dry mouth strip away the moisture and make the mucosa more prone to trauma.
Researchers have found that patients who have chronic stress tend to have a higher incidence rate of aphthous ulcers (3).
Canker sore outbreaks can also be associated with nutritional deficiencies. Nutrient deficiencies related to zinc, folic acid, iron, selenium, and calcium.
Vitamin deficiencies related to B1 (thiamine deficiency), B2 (riboflavin deficiency), B6 (pyridoxine deficiency), B12(pernicious anemia), and C (scurvy).
Certain food sensitivity or allergies can trigger an outbreak (4). These can include –
- Cereal grains: buckwheat, wheat, oats, rye, barley, the gluten protein found in grains
- Fruits and vegetables: lemons, oranges, pineapples, apples, figs, tomatoes, strawberries, eggplant
- Additives: cinnamonaldehyde / cinnamon oil, benzoic acid
- Dairy: milk, cheeses
- Other foods: nuts (walnuts), peanuts, almonds, chocolate, shellfish, soy, vinegar, French mustard, tea, coffee
Sodium lauryl sulfate (SLS)
Some studies have suggested that products which contain sodium lauryl sulfate, a foaming agent used in most toothpaste and mouthwash formulations, may place a person at increased risk for canker sore breakouts (5).
SLS can have some damaging effect on the outer protective layer of oral tissues. As the outer layer degrades, the tissues that lie underneath it becomes more exposed to the effects of irritants, with this trauma resulting in the formation of a lesion.
For women, the ulcer formation can coincide with the particular phase of their menstrual cycle. Some women notice a remission of their sores during pregnancy.
Some people can have a genetic predisposition for canker sores. People who have a positive family history typically get their first ulcers at an earlier age and experience more intense symptoms.
Several medical conditions correlate with canker sore formation (6). Some of the medical conditions are Behcet’s disease, neutrophil dysfunction diseases, inflammatory bowel diseases such as celiac, Crohn’s, ulcerative colitis, HIV-AIDS, MAGIC syndrome, Reiter’s syndrome, systemic lupus erythematosus, cyclic neutropenia, Marshal’s syndrome, and Sweet’s syndrome.
Medications such as nonsteroidal anti-inflammatory medications (NSAIDs), beta-blockers, and nicorandil, on regular consumption, can increase the risk factor for more frequent breakouts.
Mouth sores from braces
If you have recently got dental braces installed or altered, mouth sores can occur from irritation of the mucosa and even daily activities can become very painful. Applying wax on your braces can help prevent irritation of tissue thus preventing mouth ulcers.
Mouth sores from dentures
Similar to braces, new dentures or old ill-fitting dentures can rub against your gums and buccal mucosa causing painful mouth sores.
Talk to your dentist about possible adjustments which can be made in the denture and other treatments for preventing denture based ulcers. Also, avoid wearing dentures once you have irritated sore till the sore heals on its own (7).
Types of canker or mouth sores
There are three main types of canker sores and they are –
Minor canker sores
These are the most common and are usually small and oval shaped. They have an inflamed yellowish center with a red edge. Minor canker sores heal without scarring in around one to two weeks’ time.
Major canker sores
They are less frequent and are more extensive and deeper than minor canker sores. They usually have defined borders, but can have irregular edges when very large in dimensions.
Major canker sores can be painful and can take up to six weeks to heal. In some cases, it can leave extensive scarring.
Herpetiform canker sores
These are uncommon and rare. Herpetiform canker sores are usually pinpoint the size and occur in clusters of 10 to 100 sores. They tend to merge into one large ulcer. They have irregular edges and usually heal without scarring in one to two weeks.
How to get rid of canker sores?
Most mouth sores heal without treatment in 10-14 days, but there are a variety of over-the-counter topical anesthetics, such as benzocaine, hydrogen peroxide rinses, fluocinonide, etc., can lessen the pain (8).
Your dentist might prescribe you a prescription mouthwash, which contains lidocaine or dexamethasone for the reduction of inflammation and pain.
But if you are looking for home remedies for treating canker sores then there are some –
- Gargle with salt water, this helps keep the surface of the ulcer clean and avoids any food retention
- Create a paste of baking soda and water and apply to the ulcer. let it rest for some time
- Avoid triggers like hot, spicy, salty, or acidic foods and beverages
- Eating yogurt, drinking milk or having ice cream can help in reducing the pain
- Regular brushing and flossing your teeth can prevent a bacterial infection
Cold sores vs. canker sores
Canker sores and cold sores are not same conditions. They are quite different in many ways such as –
- Canker sores happen inside mouth whereas cold sores appear outside mouth such as around lips, under nose and chin.
- Cold sores are contagious as they are caused by herpes simplex virus HSV and HSV-2. On the other hand, canker sores are not contagious.
Final words on how to get rid of canker sores
A healthy diet, rich in vitamins and essential minerals will help maintain adequate oral health. It will also help avoid the incidence of mouth sores.
Avoid eating spicy and hot food items during the period and stay hydrated. A common canker sore remiss in around a week or two weeks’ time.
If the mouth sore is due to a dental procedure, visit the dentist and get the necessary corrections made.