Is Your Sore Cantankerous?

Canker sores (apthous ulcers) are often confused with fever blisters (cold sores). They appear similar, but there are some differences.

Canker sores are only found inside the mouth on the gums, cheeks, tongue or floor of the mouth. They cannot be transmitted from one individual to another.  They begin as small red circular swellings that usually ulcerate (rupture) within a day, after which they become white, surrounded by reddish inflammation. They last 8-10 days. As open sores, they can be very painful to the touch. Canker sores afflict about 20% of the population.

It’s not totally known what causes these pesky painful spots on the inside of the mouth, although biting your cheek/inside of your lip, braces rubbing, stress, genetics, and a malfunctioning immune response are all possible contributors.  While they can occur in very young children, they are usually first seen between the ages of 10-20. It’s not uncommon for them to erupt 3-4 times a year, but they occur less frequently or stop all together in adults. When experiencing canker sores, avoid rough textured (like chips) or spicy foods that will irritate them. Try not to touch them with eating utensils or your toothbrush.  Treatment options include:

  • Seal the Sore:
    • Over-the-counter products such as Zilactin-B Canker Sore Gel and Colgate Orabase Soothe-N-Seal form a long-lasting protective coating over the sore to speed healing and provide fast pain relief. You may also apply a physical patch (Kankaid) that binds to the surface.  While relief is immediate, they can be unsightly, and cannot be removed without ripping off the skin!
    • A form of licorice known as deglycyrrhizinated licorice, or DGL, also coats canker sores. It’s available in health food stores. Chew one or two 200-milligram tablets two or three times a day.
    • The sap of aloe vera — the ubiquitous “first aid plant”– can bring welcome relief. Squeeze a bit of gel from an aloe vera leaf. Dry the sore with a cotton swab, then dab on the gel. Repeat as often as you like.
    • Cut open a vitamin E capsule and squeeze a bit of the liquid onto the sore.
  • Get that numb feeling:
    • Dab on a topical anesthetic such as Orajel or Anbesol.
    • Let a pain-relieving lozenge, such as Chloraseptic, dissolve in your mouth.
  • Several other natural home remedies can be found in this link from coconut oil to warm salt water

Take Extra Measures 

  • Stressful episodes trigger many cases of canker sores. If you tend to get a little wired, try some of the classic methods of keeping your cool — meditation, yoga, and aerobic exercise.
  • Check the label of your favorite toothpaste for an ingredient called sodium lauryl sulfate, or SLS. This foaming agent, found in many brands of toothpaste, contributes to canker sores in some people. And it really isn’t necessary for teeth cleaning. If you get frequent sores, look for brands that are free of SLS such as Biotene and Arm & Hammer Dental Care Tooth Powder. For children, look for Tanner’s Tasty Paste online.
  • People plagued with frequent canker sores may have a deficiency in certain B vitamins or iron. Try taking a daily B-vitamin complex and a daily multivitamin/multimineral for iron. To get more B vitamins into your diet, look to beans, wheat germ, and fortified cereal. Lean beef is a good source of iron.
  • Many experts think lysine, an amino acid, may be needed to fix a deficiency associated with canker sores. Take 500 milligrams of L-lysine three times a day on an empty stomach until your sore is healed.
  • Echinacea is an herb that strengthens your immune system. Take 200 milligrams two or three times a day when you first notice a sore starting to appear.
  • Vitamin C helps heal your mouth’s mucous membranes. Normally, we would turn to citrus fruits for vitamin C, but these may actually cause canker sores in some people. Instead, take vitamin C supplements. Try 1,000 milligrams three times a day. If you develop diarrhea with dosages this high, switch to 500-milligram supplements instead.
  • Zinc may help mouth injuries like canker sores heal faster. As soon as you detect a sore developing, take 30 milligrams of zinc lozenges each day until it’s gone.
  • There are foods that may trigger canker sores. Potential troublemakers include whole wheat, rye, barley, shellfish, pineapple or citrus fruits, figs, chocolate, tomatoes, green peppers, and strawberries. To find out which, if any, cause your cankers, cut all of them out of your diet. Then slowly reintroduce them, one at a time, and see which one makes the problem recur.

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Cold sores are a cluster of blisters that first appear clear then become cloudy and crust over. First infection may be inside the mouth, but cold sores generally appear outside the mouth on the lips. The cycle takes 7-14 days to heal. Cold sores, caused by the Herpes Simplex Virus, are contagious, being transmitted by skin-to-skin contact. The virus is dormant most of the time and is carried by almost everyone. Fever blisters occur most often in young adults and adolescents and decline as you get older. Certain factors activate its outbreak, particularly stress, colds, fevers and/or sunburn.

To reduce occurrences, avoid “swapping spit” (via shared silverware or kissing) when the blisters are visible; don’t squeeze or scrape the blister; wash your hands thoroughly before touching someone else; and use UV sunscreen on your lips before spending time in the sun.

Treatment of cold sores includes avoiding spicy and hot foods that will irritate them, application of home remedies, over-the-counter ointments and administration of some anti-viral antibiotics that will shorten their duration but not prevent their outbreak.

Regardless of its identity, we understand that the little crater in your mouth causes you or your child more pain than anything so small deserves to. Rest assured that in a week or two, the cold sore or canker sore will most likely be history.