Canker Sore Treatment
What Is a Canker Sore
Canker sores, also known as aphthous ulcers or aphthous stomatitis, are small, painful ulcers that develop on the soft tissues inside the mouth. They commonly occur inside the lips and cheeks, under or along the sides of the tongue, at the base of the gums, or on the soft palate. A typical canker sore is round or oval with a white, yellow, or grayish center surrounded by a red, inflamed border. Some people notice tingling, burning, or sensitivity before the ulcer becomes visible.
Although canker sores are usually harmless, they can be surprisingly painful and may interfere with eating, drinking, brushing, and speaking. Unlike cold sores, canker sores are not contagious and are not caused by the herpes simplex virus. Most minor canker sores heal naturally within approximately one to two weeks without professional treatment. However, patients who are experiencing significant discomfort may prefer treatment rather than waiting for the sore to resolve on its own.
At our office, we use Debacterol®, a prescription topical chemical cautery treatment containing sulfonated phenolics and sulfuric acid. It is applied directly to the canker sore for only a few seconds, chemically cauterizing the surface of the ulcer. Treatment may cause brief but noticeable discomfort, typically lasting only several seconds, followed by a significant reduction in pain. One clinical study reported approximately a 70% reduction in pain by day 3 and an 80% reduction by day 6 following treatment. Individual results can vary. Because Debacterol is a powerful cauterizing agent, precise application is important, as contact with surrounding healthy tissue can cause chemical injury. We therefore evaluate the lesion first to confirm that it is consistent with a canker sore and determine whether Debacterol is an appropriate treatment.
Canker Sore vs. Cold Sore
Canker sores and cold sores are often confused, but they are different conditions. Correctly identifying the type of sore is important because the treatment for a cold sore is different from the treatment for a canker sore.
Canker sores:
▸Develop primarily inside the mouth
▸Are not caused by the herpes virus
▸Are not contagious
▸Usually appear as round or oval ulcers with a white or yellow center and red border
Cold sores:
▸Commonly develop on or around the lips
▸Are caused by the herpes simplex virus
▸Are contagious
▸Often begin as groups of fluid-filled blisters
What Causes Canker Sores?
The exact cause of canker sores is not completely understood. In many people, several factors may contribute to their development. Common triggers include minor trauma, certain foods, stress, and nutritional deficiencies. Frequent, severe, or unusually persistent mouth ulcers may occasionally be associated with an underlying medical condition. For this reason, recurrent or unusual sores should not automatically be assumed to be ordinary canker sores.
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Types of Canker Sores
Several types of dentures are available. The appropriate choice depends on your oral condition, treatment goals, budget, and whether dental implants are being used.
Minor Canker Sores
Minor aphthous ulcers are the most common type. They are generally small, round or oval, and heal within approximately one to two weeks without leaving a scar.
Major Canker Sores
Major aphthous ulcers are larger and deeper. They may be extremely painful, can take several weeks to heal, and may occasionally leave a scar.
Herpetiform Canker Sores
Despite their name, herpetiform canker sores are not caused by the herpes virus. They consist of numerous very small ulcers that may occur in clusters and sometimes merge together to form a larger irregular ulcer.
At-Home Canker Sore Care
Most minor canker sores heal naturally within one to two weeks. In the meantime, several simple measures can help reduce pain, protect the ulcer, and prevent additional irritation while it heals.
Avoid Irritating Foods
Minor aphthous ulcers are the most common type. They are generally small, round or oval, and heal within approximately one to two weeks without leaving a scar.
Saltwater Rinses
Minor aphthous ulcers are the most common type. They are generally small, round or oval, and heal within approximately one to two weeks without leaving a scar.
Over-the-Counter Topical Pain Relief and Protective Products
Several over-the-counter products can provide temporary relief from canker sore pain and irritation. Topical anesthetics, such as products containing benzocaine, temporarily numb the affected area and may make eating, drinking, and speaking more comfortable.
Protective pastes, gels, and bioadhesive products work differently by forming a barrier over the ulcer. This helps shield the sensitive area from food, saliva, and repeated irritation while the sore heals. These products can help manage symptoms, but they do not prevent the underlying tendency to develop canker sores.
Antiseptic Mouth Rinses
In some cases, an antiseptic mouth rinse such as chlorhexidine gluconate may be recommended, particularly for patients with recurrent or multiple canker sores. Chlorhexidine helps reduce bacteria in the mouth and may decrease ulcer severity, reduce discomfort, and shorten healing time. However, it does not prevent the underlying tendency to develop canker sores. With extended use, chlorhexidine can cause temporary staining of the teeth and tongue and changes in taste, so it should be used as directed by your dentist.
Protect the Area From Trauma
Repeated rubbing, biting, or irritation can aggravate a canker sore and delay healing. A sharp tooth, rough filling or crown, poorly fitting denture, or orthodontic appliance may repeatedly rub against the ulcer and prevent the area from healing comfortably. If a dental appliance, tooth, or restoration is irritating the sore, your dentist should evaluate the area and correct the source of irritation when appropriate.
Maintain Gentle Oral Hygiene
Continue brushing and flossing while the canker sore heals, but take care to avoid irritating the affected area. Use a soft-bristled toothbrush and brush gently around the sore to minimize additional trauma and discomfort. Maintaining good oral hygiene helps keep the mouth clean while allowing the ulcer to heal.
Prescription Canker Sore Treatment
Patients with particularly painful, large, persistent, or recurrent ulcers may benefit from prescription treatment. One commonly used approach involves a topical corticosteroid, which can reduce inflammation associated with aphthous ulcers. Depending on the location and number of sores, medication may be prescribed as a paste, gel, or mouth rinse. Other prescription medications may sometimes be considered for severe or recurrent cases. Treatment should be selected after evaluating the lesion because not every sore inside the mouth is a canker sore. Triamcinolone acetonide dental paste (e.g., in Orabase) is FDA-approved for oral inflammatory lesions. It lowers swelling, pain, and redness from mouth sores, canker sores, or minor injuries inside the mouth.
Treating the Source of Irritation
Sometimes what appears to be a recurring “canker sore” is being repeatedly irritated by something inside the mouth. Correcting the source of trauma may allow the ulcer to heal and help prevent it from repeatedly returning in the same location. Possible sources include:
Recurrent Canker Sores
Occasional canker sores are common. However, frequent or repeatedly occurring mouth ulcers may warrant further investigation. Recurrent canker sores have been associated with nutritional deficiencies, including iron, vitamin B12, folate, and zinc deficiencies, as well as certain gastrointestinal, inflammatory, immune, and other systemic conditions.
Having recurrent canker sores does not necessarily mean that an underlying medical condition is present. However, if the sores occur frequently, are unusually severe, or persist for extended periods, we recommend discussing them with your physician for a medical evaluation. Your physician may review your medical history, medications, and diet and, when appropriate, order laboratory testing to identify nutritional deficiencies or other possible contributing conditions.
How Long Does a Canker Sore Last?
Most minor canker sores heal naturally within approximately 7 to 14 days. Larger aphthous ulcers can take considerably longer to heal. The ulcer should gradually become smaller and less painful. A mouth sore that remains present for approximately two weeks or longer, particularly if it is not clearly improving, should be evaluated rather than repeatedly treated at home.
When Should You See a Dentist for a Canker Sore?
Persistent oral lesions can have many causes. A sore that does not heal should be professionally evaluated to determine the appropriate diagnosis and treatment. Schedule an evaluation if you have:
- A mouth sore lasting approximately two weeks or longer
- An unusually large ulcer
- Severe or increasing pain
- Frequent recurring ulcers
- Multiple sores developing repeatedly
- Difficulty eating or drinking
- A sore that repeatedly develops in exactly the same location
- A sharp tooth or dental restoration irritating the area
- A lesion that looks different from your usual canker sores
Are canker sores contagious?
No. Canker sores are not contagious and cannot be spread through kissing, sharing food, or sharing utensils.
Are canker sores herpes?
No. Canker sores are not caused by the herpes simplex virus. Cold sores, also called fever blisters, are associated with herpes simplex virus and are a different condition.
Can stress cause canker sores?
Stress appears to be a trigger for some people who are susceptible to recurrent canker sores, although it is usually not possible to identify one specific cause.
Can certain foods cause canker sores?
Certain foods may trigger or irritate canker sores in susceptible individuals. Acidic, spicy, salty, or abrasive foods can also make an existing ulcer considerably more painful.
Can toothpaste cause canker sores?
Some individuals who frequently develop canker sores may be sensitive to toothpastes containing sodium lauryl sulfate (SLS). Trying an SLS-free toothpaste may be reasonable for patients who experience recurrent ulcers.
Should I put hydrogen peroxide directly on a canker sore?
Concentrated hydrogen peroxide can irritate oral tissues. Products specifically formulated as oral rinses should be used according to their directions rather than repeatedly applying household hydrogen peroxide directly to the ulcer.
Should I pop a canker sore?
No. A canker sore is an ulcer rather than a fluid-filled blister, so there is nothing that needs to be popped. Manipulating the area can cause additional irritation and pain.
Why do I keep getting canker sores?
Recurrent canker sores can have multiple triggers, including trauma, stress, certain foods, nutritional deficiencies, and individual susceptibility. Frequent or severe outbreaks should be evaluated to determine whether another contributing factor may be present.
Is a mouth sore that does not heal always a canker sore?
No. Many different conditions can cause ulcers or lesions inside the mouth. A persistent lesion should not automatically be assumed to be a canker sore.
Back To TopRecommended External Links
You can obtain more information on canker sores (recurrent aphthous stomatitis) at this sites:
American Academy of Oral Medicine (AAOM)
National Institute of Dental and Craniofacial Research
American Dental Association (ADA)
Canker Sore Treatment in Royal Palm Beach, FL
If you have a painful, persistent, or frequently recurring canker sore, Lakeview Dental in Royal Palm Beach, Florida can evaluate the area and recommend appropriate treatment. A mouth sore that does not heal should not be ignored. Contact Lakeview Dental to schedule an evaluation with Dr. Ghodsi.
OR CALL (561) 898-1010 TO GET STARTED.
(561) 898-1010
