What are canker sores?
Canker sores are a common condition that affects the
lining of the soft tissue of the mouth. The medical term for canker sores is
"recurrent aphthous ulcerations" or simply "aphthae." Canker sores start as
white to yellowish ulcers that are surrounded by redness. They are usually very
small (less than 1 mm) but may enlarge to ½ to 1 inch in diameter. They tend to
be painful and can interfere with eating and speaking. Healing usually takes
place in seven to 10 days.
Who gets canker sores?
Anyone can get canker sores. They seem to be more common in Caucasians, young adults, and women.
What is the cause of canker sores?
Canker sores are not due to an infection and are therefore not contagious. The actual cause is unknown, but many doctors believe
that canker sores are due to a localized self-immunity that leads to destruction of lining tissues.
What can I do to prevent canker sores?
Some patients relate the onset of lesions to minor injuries to the inside of the mouth, acidic foods, stress, and menstruation. Use
a soft bristle toothbrush, avoid very hot (temperature) foods, like pizza, and don't talk while eating. Patients should also avoid oral hygiene products
containing sodium lauryl sulfate.
How are canker sores diagnosed?
The typical appearance of canker sores, their history
of recurrence, and location are usually sufficient to make a clinical diagnosis.
The main confusion for patients and physicians alike is separating canker sores
from cold sores, which are caused by herpes simplex infection (HSV-1). While
both conditions commonly occur in the mouth, their causes and treatments are
completely different. Therefore it is important to distinguish the two.
How are canker sores treated?
Patients who are infrequently bothered by canker sores
may choose not to treat or may use simple over-the-counter products such as
Cankaid®, Zilactin®, or Orabase®. If you get many painful ulcers that don't heal
before new ones appear, or you get very large ulcers, your doctor may prescribe
corticosteroid gels--solutions or pills that temporarily suppress the overactive
immune system. A paste called Aphthasol® is also effective.
Are any other diseases associated with canker sores?
Some diseases of the immune system may be associated
with canker sores. They include systemic lupus erythematosus, Behcet's disease,
inflammatory bowel diseases, and AIDS. It is important to remember that most
canker sores occur without an associated disease.
References
Coleman GC. Diseases of the mouth. In: Bope ET, et al. Conn's Current Therapy 2011. 1st ed. Philadelphia, Pa.: Saunders Elsevier; 2011:section 13.
Scully C, Porter S. Oral mucosal disease: Recurrent aphthous stomatitis. British Journal of Oral and Maxillofacial Surgery. 2008; 46(3):198-206.
American Academy of Oral & Maxillofacial Pathology. Aphthous ulcerations.
www.aaomp.org. Accessed January 11, 2011.
American Academy of Otolaryngology – Head and Neck Surgery. Mouth sores.
www.entnet.org. Updated December 2010. Accessed January 11, 2011.
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