You may hear your doctor say
you have "aphthous stomatitis"...canker sores or mouth ulcers!
Aphthous stomatitis occur in 80% of the population between
the ages of 10-20 years of age, most often in women. The
occurrence is thought to be related to the individual's immune system.
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.
These are usually
found on the movable parts of the mouth such as the tongue or inside linings of
the lips and cheeks. They are found IN the mouth. They begin as:
Small oval or round reddish swellings,
that generally tingles and that
usually burst within a day.
The ruptured sores are than covered by
a thin grey, white or yellow membrane edged by a red halo.
Usually one quarter inch in
diameter, 1-2mm wide
Occur on non-keratinized mucosa
inside the mouth: the inner side of the lips, the tongue, the
back and floor of the mouth and the wall of the cheeks
They do not occur on the gums or the hard roof of the mouth
They generally heal within
They may leave scares.
Recur monthly or several
times per year.
20% of the population suffer from recurring
They are not associated with other
You will usually have only a few at a
They first appear around ages 10-20.
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that cause these reactions:
- Sodium Lauryl
Sulfate (SLS): is the foaming agent found in most toothpaste
and mouthwash formulations.. Foaming agents fill the mouth with
suds, sending a signal to users that their mouths are clean. Ulcer
may be caused by using SLS because it causes excessive sloughing of
oral mucosa and dries the protective layer of oral tissues which
causes underlying tissues to become damaged. People with
canker sores have fewer outbreaks and less pain if they use SLS free
products made by Rembrandt Extra Whitening Toothpaste Formulated for
Cold Sore Sufferers, Tom's of Maine, Oxyfresh, TheraBreath Products,
Breath RX products, Squigle Enamel Saver Mouth Friendly Toothpaste.
- Women are more susceptible than men due to their menstrual
cycles. Fatigue, stress or allergies increase your likelihood of getting
cancer sores. People with intestinal problems such as ulcerative colitis
and Crohn's disease are more susceptible. They usually heal in a week or
Sore Self Test
or Cold Sore Self Test:
|Where does it strike:
||Outside the mouth
||Inside the mouth
|What does it look like?
||Tiny, clear fever blisters
usually on the lips or under the nose
||Small ulcer with a white or
gray base and red border
|What triggers it?
||Flare-up of herpes simplex
||Trauma-biting cheek, jabbing
|How long does it last?
||About a week
||One or two weeks
|Is it contagious?
|How do I treat it?
|| Aloe Vera, OTC topical
anesthetics to cut pain
OTC medications or prescription antiviral drugs as
|Rinse with antimicrobial
mouthwash or warm water with salt
OTC oral anesthetics
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Visit your doctor to determine the reason for
them, I.E. nutritional deficiency or an allergic reaction to foods.
Use a numbing ointment such as benzocaine
Anti-inflammatory steroid gel
like Denalog, Decadron rinse or Lidex gel
Mouth rinse containing tetracycline can
reduce the unpleasant symptoms of canker sores and speed healing by
preventing bacterial infections in the sores. This mouth wash, used
several times a day, relieves pain for 24 hours and allows complete healing
in 5-7 days. Tetracycline is not to be used by young children or
pregnant women due to staining of teeth.
Use a antimicrobial
mouthrinse to help reduce the irritation.
Avoid abrasive foods like potato
chips and pretzels; acidic drinks such as
lemonade or orange juice; chocolate, nuts,
lemons, figs, tomatoes, apples,
pineapples, strawberries, shellfish, soy
and beer that trigger canker sores in
susceptible people .
toothpastes containing sodium lauryl
sulfate Sodium lauryl
sulfate (SLS) is an irritant detergent
commonly found in toothpaste.
People with recurrent canker sores may
benefit by switching to a
brand of toothpaste that does not contain
SLS, which is believed to
abrade the protective mucus layer in the
mouth and increase the
likelihood of developing canker sores. ***
These products may be helpful:-
Tom's of Maine,
www.tomsofmaine.com - Oxyfresh
www.oxyfresh.com - BreathRx
www.discusdental.com - TheraBreath
www.therabreath.com - Rembrandt
Extra Whitening Formula for Cold Sore
Sufferers (Oral-B) - Squiggle Enamel
Avoid hot, spicy or acidic foods from further
irritating the sore.
Brush your teeth gently so as not to
irritate the area.
the herb licorice that has had the
glycyrrhizic acid removed,
the portion that can increase blood
pressure. A mouthwash made of
powdered DGL mixed with water.
Alternately, DGL tablets can be chewed
with water, swished in the mouth and
things you know can trigger this
and eliminate food sensitivities with
an elimination and challenge
diet. Food sensitivities,
especially to gluten-containing foods
(wheat, rye, barley, oats), have been
found clinically to be associated with
recurrent canker sores.***
a vitamin supplement. Thiamin (vitamin
B1) deficiency has been linked to an
increased risk of canker sores. Other
nutrients that have been found to be
low in people with recurrent canker
sores include riboflavin (vitamin B2),
pyridoxine (vitamin B6) and iron. A
health practitioner can assess
and processed meats, such as bacon,
sausage and ham, are high in
nitrites.**Vitamin C works directly
against viruses, in addition, it
inhibits the formation of nitrosamines
from dietary nitrites, found in bacon,
sausages and other processed meats,
and from dietary nitrates, found
in vegetables and other foods.
excellent oral hygiene care.
injury to the inside of the mouth
caused by toothbrushing, hard candy,
hard food or chewing o pen caps
and other objects.
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You should call your dentist if you have:
- Unusually large sores
- Sores that are spreading
- Sores that last 3 weeks or longer
- Intolerable pain despite avoiding trigger
foods and taking over-the-counter pain medication
- Difficulty drinking enough fluids
- A high fever with the appearance of the
for Treating Aphtous Ulcers
a topical treatment that, with a
single application, completely stops
the pain of canker sores.
is the only canker sore treatment
available that chemically cauterizes
the oral lesion in just ONE treatment,
eliminating pain associated
with the lesion without harming
healthy surrounding tissue.
single application of Debacterol with
a cotton swab has been found to stop
canker sore pain in just five seconds,
sealing damaged oral mucosal tissue and aiding the natural healing
Healing time of the lesion is reduced
as well. 70 percent of the lesions
treated with Debacterol had complete
healing by day six, compared with
other treatments, which needed more
than 10-16 days for complete healing.
now been cleared for Over-the-Counter
Sales by FDA. Northern
Research Laboratories at 4225 White
Bear Parkway, Suite 600,
St. Paul, Minn. 55110 or by calling
Produces without SLS: CloSYSH:
rowpar.com; TheraBreath TheraBreath.com
Soothe-N-Seal ColgateProfessional.com; Zilactin
Zila.com; ORA5 Liquid SaveYourSmile.com
Numbing: Orabase B
ColgateProfessional.com Orajel orajel.com
Antibacterials: Copper sulfate or
Cleaners: Peroxyl Oral
Rinse ColgateProfessional.com Glyoxide gsk.com
Home remedies: 1 tsp Milk of
Magnesia and 1 tsp. Benedryl Allergy. Swish and
expectorate 4-6 ties a day to help minimize pain.
Anti inflammatory Rx: Apthasol
(Amlexanox); Kenalog in Orabase; Synthetic Corticosteriod; Lidex
(fluocinonide); Diprolene (betamethasone); Temovate (clobestasol).
Tetracycline; Chlorhexidine Gluconate.
Nutrition- A lack of specific
vitamins may lead to canker sores: lack of Vitamins B1, B2, B6, B12,
and C, zinc, folic acid, iron, selenium and calcium.
vera anti-viral and anti-inflammatory
properties, aloe vera provides
additional benefits to the skin, such
as amino acids, B1,B2,B6 and C
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Valacyclovir (Valtrex) has just been
approved for one day treatment of canker sores. It shortens outbreaks
of these painful sores by about one day.-acyclovir pills (Zovirax) and
penciclovir cream (Denavir) and docosanol (Abreva) need to be used for four days
or more and the creams must be applied throughout the day.
$26.00 per treatment (two 2gram doses) is costs significantly less than Zovirax
which runs about $71 per course or ($53 for generic). The creams are about
$23 for a course of penciclovir and $14 for docosanol.
you have recurrent sores, ask your doctor to prescribe Valacyclovir or other treatments
you can keep on hand to use at the START of an outbreak. Or ask about
taking acyclovir regularly, which can reduce the number of episodes by
more than 80%.
Consumer Reports on Health pg 7 August 2003
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have no financial investment in this product.
Resource: A.D.A., National Center for Dental
Management; Ms McManus, Ms Pittman, Dentistry Today pg 47-51 January
Herpes simplex and aphthous ulcerations:
presentation, diagnosis and management; Dr. Sciubba ; General Dentistry
pg 510-515 January 2004.
Dentalnotes pg 2 Spring 2003
1. Lininger S, Gaby A, Austin S, Brown DJ, Wright JV, Duncan A. The Natural
Pharmacy, 2nd Edition. Prima Health and Healthnotes, Inc.,1999.
2. Murray M. Dr. Murray's Total Body Tune-Up. New York, New York. Random House,
3. Murray MT, Pizzorno JE. Textbook of Natural Medicine, Vol 1 and 2. Churchill
Livingstone. Edinburgh, 1999
4. Rogers MA, Vaughan TL, Davis S, Thomas DB. Consumption of nitrate, nitrite,
and nitrosodimethylamine and the risk of upper aerodigestive tract cancer.
Cancer Epidemiology Biomarkers Prev 1995 Jan-Feb; 4(1):29-36.
5. Tannenbaum SR, Wishnok JS, Leaf CD. Inhibition of nitrosamine formation by
ascorbic acid. Am J Clin Nutrition 1991 Jan;53(1 Suppl): 247S-250S.
** AGD September 29,01
Mouth Sores, JADA, Vol. 132, November 2001