Canker sores or mouth ulcers are normally small lesions that develop in your mouth or at the base of your gums. They are annoying and can make eating, drinking, and talking uncomfortable. Factors that can put you at risk for developing mouth ulcers are being a woman or having a family history of mouth ulcers.
Mouth ulcers are not contagious and usually go away within a week. However, if you get a canker sore that is large or extremely painful or if it lasts for a long time without healing, you should seek the care of a physician.
There is no definite cause behind mouth ulcers. However, certain factors and/or triggers have been identified. These include:
- minor injury to mouth from dental work, hard brushing, sports injury, or accidental bite
- toothpastes and mouth rinses that contain sodium lauryl sulfate
- food sensitivities to acidic foods like strawberries, citrus, and pineapples and other trigger foods like chocolate and coffee
- lack of essential vitamins like B-12, zinc, folate, and iron
- allergic response to mouth bacteria
- hormonal influxes during menstruation
- emotional stress
- bacterial, viral, or fungal infections
Mouth ulcers also can be a sign of conditions that are more serious and require medical treatment, such as:
- celiac disease (a condition in which the body is unable to tolerate gluten)
- inflammatory bowel disease (IBD)
- Bechet’s disease (a condition that causes inflammation throughout the body)
- a malfunctioning immune system that causes your body to attack the healthy mouth cells instead of viruses and bacteria
There are three types of canker sores: minor, major, and herpetiform.
Minor canker sores are small, oval-shaped ulcers that heal within one to two weeks with no scarring.
Major canker sores are larger and deeper than minor ones. They have irregular edges and can take up to six weeks to heal. Major mouth ulcers can result in extensive scarring.
Herpetiform canker sores are pinpoint size, occur in clusters of 10 to 100, and often affect adults. This type of mouth ulcer has irregular edges and will often heal without scarring within one to two weeks.
If you develop any of the following, you should see a physician:
- unusually large mouth ulcers
- new mouth ulcers before the old ones heal
- sores that last more than three weeks
- sores that don’t hurt
- mouth ulcers that extend to the lips
- pain that can’t be controlled with over-the-counter or natural medication
- severe problems eating and drinking
- high fever or diarrhea whenever the canker sores appear
Your doctor will be able to diagnose mouth ulcers with only a visual exam. If you are having frequent, severe mouth ulcers, you might be tested for other medical conditions.
Most mouth ulcers do not need treatment. However, if you get mouth ulcers often or they are extremely painful, there are a number of treatments that can decrease pain and healing time. These include:
- using a rinse of saltwater and baking soda
- placing milk of magnesia on the mouth ulcer
- covering mouth ulcers with baking soda paste
- using over-the-counter benzocaine products like Orajel or Anbesol
- applying ice to canker sores
- using mouth rinse that contains a steroid to reduce pain and swelling
- using topical pastes
- using oral steroids
- placing damp tea bags on your mouth ulcer
- cauterizing or burn sealing the tissue with a chemical cauterizer like silver nitrate
- taking nutritional supplements like folic acid, vitamin B6, vitamin B12, and zinc
- trying natural remedies such as chamomile tea, echinacea, myrrh, and licorice
There are steps you can take to reduce the occurrence of mouth ulcers. Avoiding foods that irritate your mouth can be helpful. That includes acidic fruits like pineapple, grapefruit, oranges, or lemon, as well as nuts, chips, or anything spicy. Instead, choose whole grains and alkaline (nonacidic) fruits and vegetables.
Try to avoid talking while you are chewing your food. Reducing stress and maintaining good oral hygiene by using dental floss daily and brushing after meals may also help.
Some people find avoiding soft bristle toothbrushes and mouthwashes that contain sodium lauryl sulfate also helps. If you have dental or orthodontic mouth devices with sharp edges, you should cover those edges with wax your dentist can give you.