|
|
What are Canker Sores ?
Canker sores are small ulcer craters
in the lining of the mouth that are frequently painful and
sensitive, medically termed as aphthous stomatitis, ulcerative
stomatitis, or aphthae are mostly self healing and can recur,
can make eating and talking uncomfortable. Canker sores appear
as a whitish round area with a red border. Canker sores usually
occur on the moveable parts of mouth, such as tongue, inside
lining of the lips and cheeks. They are a common form of mouth
ulcer. A canker sore is benign (not harmful). An average canker
sore is about one- quarter of an inch in size to more than an
inch in severe cases. Severe form of the sore may leave scars.
Often several canker sores appear at the same time and may be
grouped in clusters. Canker sores are not infectious. Canker
sores may also occur at the site of a bite when the tongue or
cheek is bitten.
What are some symptoms of Canker
Sores ?
A canker sore is an open wound, and being inside the mouth,
cannot be covered so the exposed nerve endings are irritated
causing extreme pain. This also leaves the canker sore
vulnerable to infection by bacteria creating even more pain.
Anyone can get canker sores, but women people in their teens and
20s get them more often. Therefore they occur more often in
women than in men. They may occur at any age, but usually first
appear at ages between 10-40. They
begin as: |
|
|
|
|
|
|
 |
|
-
Initial symptom is a tingling or mildly itching sensation in the
area where the sore will appear.
-
After one to several days small oval or round swellings appear
that burst within a day.
-
Ruptured sores are then covered with a thin white or yellow
membrane edged by a red halo.
-
Main symptom is pain, canker sores can be very painful,
especially if they are touched repeatedly eg, by the tongue.
-
Usually one quarter inch in diameter and 1-2 mm wide.
-
Occur on the non-keratinized mucosa inside the mouth but not on
the hard roof of the mouth.
-
Generally heal within 4-14 days.
-
They may leave scars.
-
Recur monthly or several times per year.
-
In severe attacks there may be fever, physical sluggishness and
swollen lymph nodes.
Two
Types of canker sores
Simple canker sores: These
may appear 3-4 times a year. They account for about 70% of all
cases, may last upto a week and heal with little or no scarring. |
|
Complex canker sores: These
are less common and occur more often in people who have
previously had them. They are greater than 1 cm in size, take
longer time to heal (upto 3 weeks or longer) and leave scars
after they heal.
Although the vast majority of canker
sore cases are associated with no underlying illness, in a small
percentage of cases, canker sores are indicative of a bodily
(systemic) disorder. People with Behcet's Disease, for instance,
will often have canker sores ( mouth ulcers ) in addition to
genital lesions, eye lesions, and general skin afflictions. HIV
infected patients may also develop canker sore like ulcers. In
the small percentage of cases where an underlying condition may
be suspected, a careful medical history and examination by a
physician will be able to indicate whether canker sores in a
particular patient are associated with an underlying disorder.
Canker sores are sometimes confused with cold sores, although
they are not the same. Cold sores are caused by herpes simplex
virus, also called fever blister. They are a group of painful
fluid filled blisters. Unlike canker sores, cold sores are
contagious, being caused by a virus. Also cold sores typically
appear outside the mouth- usually under the nose, around the
lips, or under the chin, while canker sores occur inside the
mouth.
Causes of Canker Sores ?
|
|
Exact cause of most canker sores is unknown. Current theories on
the causes of canker sores have focused on the following:
Stress/trauma or tissue injury may cause eruption of canker
sores.
Nutritional problems such as deficiency of vitamin B12, zinc,
folic acid or iron.
Gastrointestinal tract disease such as Celiac disease and
Crohn's disease.
Food allergies
Infection with AIDS virus also have been associated with
canker sores.
Acidic foods such as tomatoes, citrus fruits, and other tangy
food items may help to encourage development of canker sores.
Canker sores tend to run in the families and may be an
inherited condition.
|
|
|
Recent research suggests that canker sores may be caused by the
body's own immune system attacking the cells lining the inside of
the mouth(autoimmune disorders). Examples of autoimmune disorders
are systemic lupus erythematosus, Bechet’s syndrome.
Smoking.
Female sex hormones may also apparently play a role in causing
canker sores. Many women experience bouts of the sores only during
certain phases of their menstrual cycles.Additionally, most women
experience improvement or remission of their canker sores during
pregnancy.
Prevention of Canker Sores
Canker sores can recur, but one can reduce their frequency by
addressing factors that seem to trigger canker sores.
Trauma to the inside of the mouth can trigger an outbreak of
canker sores. This trauma includes overzealous tooth brushing,
biting cheek or tongue, and scraping the inside of the mouth with
hard or sharp foods (like hard pretzels). It is therefore
advisable to stop brushing so hard, cut down on eating foods like
potato chips, hard pretzels, cut apples, and hard candies which
might nick, abrade, or otherwise traumatize the oral tissue.
Stress is another factor capable of triggering canker sores. It is
advisable to those patients susceptible to canker sores to try to
reduce the stress in their lives.
Research suggests that reactions to certain food products may be
responsible for many cases of canker sores. Among the foods that may
cause canker sores in certain people are: nuts, peanut butter, sea
food, wheat products, chocolate, and milk.
One of the most exciting advances has been the establishment of the
link between canker sores and an ingredient common to almost all
toothpastes. The additive SLS or sodium lauryl sulfate may be a
culprit in canker sore formation. The thought is that SLS may, in
susceptible individuals, cause microscopic trauma or membrane
disruption to the skin cells in the mouth. This along with trauma or
actions of the immune system may lead to canker sore formation. Many
of the patients have benefited greatly from using toothpastes which
don't contain SLS.
Possible Treatment of Canker Sores
Often treatment isn’t necessary and the canker sore heals on its
own. It may be required if the sores are large, painful or
persistent. Treatment helps ease the pain and may help reduce the
amount of time it takes for the ulcers to go away.
Corticosteroid Rinses and Gels: Often prescribed by a dentist or
physician for severe or painful cases, these medications have
proven extremely effective.Eg, triamcinolone acetonide, steroid
(non-alcoholic) gel of lidex is commonly prescribed. Commonly they
are to be applied to the lesions 3 times daily.More recently
amlexanox is prescribed due to its anti-inflammatory and
anti-allergic effects.
Analgesic (Pain Relieving) and Protective Ointments and Gels:
These are pain relieving medications which can be purchased at
your local drug store. These include compounds such as Zilactin or
Oragel. Many of these compounds, after being applied, dry forming
a protective cover over the sensitive ulcerations.
Anti-microbial Mouthwashes: Surprisingly the use of anti-microbial
mouthwashes has provided effective relief for many. Canker Sores
are not caused by a bacteria or virus so the mechanisms by which
these anti-microbial mouthwashes work remains unclear. Commonly
prescribed are anti-microbial mouthwashes containing the active
ingredient chlorhexidine gluconate . Eg, tetracycline suspensions
(Achromycin, Panmycin) used as mouth wash can relief pain and
accelerate healing.
The doctor may prescribe iron, folic acid, or vitamin B12
supplements if canker sore results from a deficiency of these
vitamins.
Some women may develop new attacks or worsening of canker sores
during their premenstrual phase. An estrogen dominant oral
contraceptive may help.
Recently a new prescription drug debacterol is available which
when applied to the ulcer helps to seal it and allow it to heal.
|
