CANKER SORES

anker sores are painful ulcerations in the mouth affecting about 25 percent of the population. The medical term for this baffling condition is aphthous stomatitis – but these sores by any other name are just as painful.

Many people confuse canker sores with cold sores. A virus causes cold sores. But we know little about what causes canker sores and even less about what cures them. Nor do we know what prevents them. We do know that they are not contagious, they are more common in women, they are not hereditary, and they do not cause cancer.

Canker sores develop as small blisters in the mouth, singly or in groups, which usually go unnoticed. These blisters break, and small, round, shallow ulcers develop. The ulcers gradually enlarge and become yellow and shiny with bright red borders. They can be exquisitely tender and painful – so painful sometimes that it can severely disrupt a person’s eating.

Canker sores can be found anywhere in the mouth: the inside of the cheeks, the lips, the sides of the tongue, the floor of the mouth, the gums, and the palate. They heal by themselves in about two weeks without leaving scars. Unfortunately, however, they tend to recur. Some people develop them every few weeks, others every few months, and some unlucky few are never without them. Although no one knows what causes these painful mouth sores, many of the following triggering factors have been suspected:

Poor dental hygiene. Inadequate and improper brushing and flossing may give rise to these painful ulcerations.
Injury caused by stiff toothbrushes, poorly fitting dentures, as well as certain denture materials have been known to provoke canker sores.
Foods such as chocolate, citrus fruits, spices, milk, cola drinks, and nuts, especially English walnuts, can activate canker sores in susceptible people.
Allergies to drugs. Some common offenders are aspirin, antibiotics, sulfa drugs, and chemotherapeutic agents to treat cancer.
Illness accompanied by fever.
Menstruation
Fatigue, emotional stress and tension.
Viruses (similar to the viral infection responsible for cold sores).
Bacteria
Many patients have told me – and other dermatologists – that shortly after they had given up smoking, they began to develop canker sores. And when they started to smoke again, the sores disappeared never to return. (However, I do not recommend smoking to alleviate or prevent canker sores!)

If you have recurrent canker sores the following general measures may prevent attacks:

Keep your mouth clean.
Avoid all kinds of nuts and any foods you suspect might be triggering factors.
Stop chewing gum, and discontinue mouthwashes.
If you are using fluoridated toothpaste, and one with Tartar Control (and who isn’t?), switch to a nonfluoridated brand (if you can find one! – Tom’s Toothpaste is one, but make sure you get the one without fluoride), or use salt or baking soda as a substitute.
If they appear before your menstrual period, take an antihistamine daily, beginning a week or ten days before.

If none of these measures help, consult a dermatologist or dentist. Either one may be able to pinpoint the cause of your sores and suggest additional measures.

Theories on treating an existing attack of canker sores are almost as varied as the suspected causes. Among the many treatments that dermatologists and dentists recommend are dental ointments containing a “relative” of cortisone, painting the sores with silver nitrate solution, injecting a cortisone-like drug beneath the ulcers, and using lozenges of one kind or another.

There is, however, only one good, proven reliable method of relieving the pain due to canker sores: using mouthwashes or “compresses” that have tetracycline. Tetracycline is a prescription antibiotic and must be prescribed by your physician. This treatment involves emptying a 250-milligram capsule (not tablet) of tetracycline into one to two ounces of warm water and shaking it up very well. (Tetracycline powder cannot be dissolved in water but forms a suspension when shaken.) Swish this solution around in your mouth for five or ten minutes every two or three hours or soak wads of cotton in it and apply to the sores. Both methods should give prompt relief. (Tetracycline syrup does not give the same, if any, relief of these painful sores. Only the powdered suspension can do it.)

For those who are plagued with recurrent canker sores, I recommend that you eat at least four tablespoonfuls of unflavored yogurt every day and discontinue all nuts. If you do this daily, you may never experience a canker sore again.

For further information about canker sores, log on to:
www.aad.org
1-888-462-DERM x22
or
www.familydoctor.org/handouts/613.html

RECAP

Canker sores – aphthous stomatitis – are painful ulcerations in the mouth affecting about twenty-five percent of the population.
Canker sores can be found anywhere in the mouth: the inside of the cheeks, the lips, the sides of the tongue, the floor of the mouth, the gums, and the palate.
Some people develop canker sores every few weeks, others every few months, and some unlucky few are never without them.

TREATING CANKER SORES

Other than the tetracycline "gargles" mentioned in the chapter on CANKER SORES, there is no good, reliable, over-the-counter preparation that works for everybody.

You can, however, try treating your canker sores with tea bags at home. The tannic acid in tea, for some unexplained reason, helps heal the sores.

Directions: Immerse a tea bag in tepid water, remove it, and squeeze out most of the water. Then apply the tea bag directly to the canker sore. You may be pleasantly surprised at the result.

For those who are plagued with recurrent canker sores, I recommend that you eat at least 4 tablespoonfuls of unflavored yogurt every day. If you do this daily, you may never have a canker sore again!