Treat Canker Sores or Mouth Ulcers

Canker sores, also known as mouth ulcers, or aphthous stomatitis, can form on the gums, inner cheeks and lips (anywhere inside of the mouth). Canker sores, while annoying, are common, and usually heal in a week or two. They are not to be confused with cold sores, which form on the outside of the mouth. Here are a few suggestions to help deal with these pesky ulcers.

Steps

Avoiding Canker Sores

  1. Try to stop the cause. Canker sores can be caused by a variety of factors. If you have several cankers or you get them repeatedly, consider[1]:
    • Brushing your teeth more gently. Brush your teeth gently with a soft-bristled toothbrush. Floss daily.
    • Changing your toothpaste. Toothpastes or mouthwashes that contain sodium lauryl sulfate can cause canker sores and continue to aggravate them. Try substituting natural toothpaste into your regimen.
    • Relaxing. Many people get canker sores during times of intense emotional stress. Like acne and eczema, canker sores can be exacerbated by stressors.
  2. Pay attention to your diet. Diet can have a significant effect — beneficial and detrimental — on canker sores.
    • Avoid spicy or acidic foods, which can irritate sores further. Peppers and sodas should be shunned. Fruits and vegetables such as lemons, oranges, pineapples, apples, figs, tomatoes, and strawberries may also cause canker sores.[2]
    • Get more B12, zinc, iron, and folic acid.[2] Take a vitamin supplement, or multiple supplements, that contain these every morning.
  3. Try not to irritate the inside of your mouth if at all possible. Canker sores often appear after cuts and lesions break open the skin inside the mouth.
    • If you have braces or other orthodontics, eliminate areas that protrude into the skin. Talk to your orthodontist about eliminating sharp corners or wires that may cut into the skin. Ask for orally-safe wax that can be applied to orthodontics to help ward off cuts and other injuries.
    • Ill-fitting dentures may also cause canker sores.[2] Talk to your dentist about options concerning your dentures.
  4. Treat other medical conditions that may cause or make canker sores worse. Simple canker sores, which are common and appear three or four times a year and last up to a week, are likely not caused by underlying health problems. If the lesions last longer or recur often, they may not be canker sores, and may be due to underlying health problems.[2]
    • Individuals with compromised immune systems may be at higher risk for canker sores.
    • Individuals with gastrointestinal tract diseases, such as Celiac disease and Crohn's disease, may also be at higher risk for complex canker sores.

Treating Canker Sores with Home Remedies

  1. Use a salt or baking soda rinse. Mix a few pinches of salt in a glass of warm water. Swish around inside your mouth and spit out, repeating two or three times a day.
    • An alternative to this is baking soda. Mix one teaspoon baking soda with several ounces of warm water. Swish and spit out.
    • Alternatively, create a paste with equal parts baking soda and water. Dab the paste over the canker sore with a Q-tip and let dry.
    • Salt water and baking soda both help the mouth heal itself by reducing the acidity and bacteria in the mouth.
  2. Use a 3% hydrogen peroxide solution.
    • Pour a little bit of it into a plastic soda cap and dilute with an equal amount of water.
    • Dip the Q-tip into the peroxide solution and dab it only on the canker sore.
    • Turn the Q-tip around and repeat.
    • Empty the cap and rinse it with water.
    • Take care not to swallow any of the hydrogen peroxide if possible.
    • Hydrogen peroxide is an antiseptic that will reduce the amount of bacteria in your mouth and help the canker sore heal.
    • The canker sore should go away in about 2-3 days if you do it twice a day.
  3. Use milk of magnesia. Dab it on active spots a few times a day. The antacid effect of milk of magnesia neutralizes the acidic environment, changing the pH, and making it less supportive of the bacteria in the mouth that aggravate the canker sore.[3]
  4. Use an antihistamine/antacid mix. Combine one part diphenhydramine (sold as Benadryl) with 1 part antacid, such as Maalox or Kaopectate. Swish around your mouth and spit out.
  5. Use OTC mouthwash. Regular old mouthwash does work, although there are different OTC mouthwash solutions that are specifically targeted to help treat canker sores. They include:
    • Diphenhydramine suspension washes (Benadryl Allergy liquid and others). These types of washes generally treat the pain of the canker sore. The mouthwash solution should not be swallowed.[4]
  6. Treat the pain (optional). You can take over-the-counter painkillers, or apply benzocaine gels (such as Anbesol and Orajel) directly onto active sores.
    • Suck on ice chips. Try to hold them over the sores, allowing them to melt over the area. Ice should help numb the pain and reduce inflammation.
  7. Try other miscellaneous remedies. Three of these remedies are designed to change the pH in your mouth. The theory here is that changing the pH will make your mouth less hospitable to the bacteria that are causing the canker sore:
    • Eat yogurt daily.
    • Apply a wet black teabag to the ulcer.
    • Squeeze the oil of a Vitamin E capsule onto the sore, repeating several times per day.
  8. Use a lemon. Squeeze the lemon with a lemon squeezer or just squeeze is on the ulcer straight away.
    • If you squeezed the lemon with a lemon squeezer, wash your hands, put your finger in the juice then dab it on your ulcer.
    • Repeat it before breakfast, after breakfast, before lunch, after lunch, before tea, after tea, before dinner, after dinner and right before you sleep.
    • Leave it on for 1-5 minutes. Then rinse off, if needed.

Knowing When to See a Doctor

  1. Visit a specialist if you get frequent sores. If you're constantly battling canker sores and none of the above fixes are working, perhaps there's an underlying issue.[1] For some conditions, canker sores are an early and important sign that something else is wrong.
  2. Schedule an appointment with a gastroenterologist. Consider investigating whether you have Celiac Disease, Crohn's Disease, or inflammatory bowel disease. All three are autoimmune conditions that can cause frequent mouth sores.
    • You might also ask the doctor if it's possible you have Helicobacter pylori, more commonly known as H. pylori, which can cause stomach ulcers.
  3. Schedule an appointment with an immunologist. If you've ruled out gastrointestinal disease, consider visiting an immunologist. There are a few rare immune conditions that can manifest as persistent mouth sores.

Treating Canker Sores with Prescription Medications

  1. Request a prescription mouth rinse. You have two options for prescription mouth rinses:
    • Dexamethasone, a steroid mouth rinse that should reduce pain and inflammation. Dexamethasone should reduce the number of recurrences, but is generally reserved for more severe cases.[4]
    • Tetracycline, an antibiotic used for more extreme cases. Your sores will heal quickly, but your mouth will be susceptible to a fungal condition called thrush. Thrush is an infection of yeast fungus in the mucous membranes of the mouth.
  2. Request topical gels and ointments. Topical ointments such as benzocaine (Anbesol), amlexanox (Aphthasol) and fluocinonide (Lidex, Vanos) may relieve pain and speed healing if applied as soon as canker sores appear.[5] Doctors usually suggest treating sores with ointments 2-4 times during the day.
    • Other oral medication not specifically intended to treat canker sores may be helpful in treating canker sores. Cimetidine (Tagamet) and colchicine, gout medicines, are sometimes effective in treating canker sores.[5]
    • Steroidal oral medications are generally used as a last resort, only when canker sores don't respond to other medications. Doctors still don't know what exactly causes canker sores.[2]
  3. Request cauterization. Cauterizing — or burning the surface tissue — sores can keep open sores from getting bigger, and the burn will eventually heal over. Most cauterizations are performed with chemical solutions, such as silver nitrate.

Tips

  • Don't play around with your canker sores using your tongue as this will cause the healing process to take longer.
  • As with most illnesses, drinking lots of water will help your body to heal itself.
  • Sometimes canker sores have the appearance of a blister. While it may seem like a good idea to "pop" it or open it up in some way, this is not recommended. Doing this will simply prolong the healing process.
  • Unlike cold sores, canker sores or mouth ulcers are not contagious, kissing someone with a canker sore will not harm your partner but may still be uncomfortable for you.
  • Cold sores are different from canker sores — they form on the lips or outside the mouth.
  • If you're constantly getting canker sores in the exact same place, you may have a sharp ridge or point on one of your teeth. A dentist can grind this sharp edge away with little to no pain.
  • Boil your toothbrush in water.
  • Avoid using hydrogen peroxide more than twice weekly or on an ongoing basis as repeated use can prolong the ulcers due to the oxidizing nature of this chemical.
  • You may use an oral pain reliever on your ulcers, as long as you don't put too much -- it will sting a little bit depending on the size of your ulcer, but it will help relieve the pain.
  • Natural maple syrup can speed up the healing process.
  • It may be difficult, but try to avoid biting your cheeks or the inside of your lip, especially after dental procedures where novocaine has been injected. Frequently, trauma such as biting will lead to an aphthous ulcer. Also, keep mental notes when you accidentally bite your mouth to see if you develop a sore there.
  • Use alum (granulated or powdered) and applied to the canker sore with a moist Q-tip. Buy alum in the baking/spice section at the grocery store. Apply it once in the morning and once before bed until the sore is gone. They are usually healed in 3-5 days.
  • Try to keep it dry, as it will help reduce the pain. But just remember that this doesn't work for everyone.
  • Try to not touch, bite or fiddle with it or it might get worse.
  • Do not drink citric drinks, such as lemon or orange juice. The acidic solution may irritate the soreness, and prolong the healing process.
  • Do a salt water rinse 5-10 times a day. This will help calm the annoying ulcer and will kill the bacteria sitting on it. Do not put pure salt on it as this can ruin the healing process which will add more acidity and make it worse! You could place an ice pack over it(on your skin-not directly on the ulcer!) as this will numb the pain! Works like a genius!
  • Put bonjela on the spot.
  • If it is on your tongue then try to keep them from touching your teeth.
  • Do not eat chocolate or sugar. The canker sores and mouth ulcers feed on those. Your sore shall expand immensely due to the sugar, so it's best that you avoid it.
  • Stay away from citric acids because they slow down the healing process, making the canker sore hurt.
  • Sometimes a good night's sleep will kick start the healing.
  • Himalayan sea salt may help it overnight. Apply a large grain or two to the spot and allow to dissolve.
  • Applying turmeric powder on the canker sore and leaving it overnight can help reduce the size quickly.
  • If your canker sore really hurts you, then put an ice cube on it and that will numb the pain. Also, if your canker sore is still around for more than 2-3 weeks than schedule an appointment with your dentist!

Warnings

  • If using any method involving salt or baking soda, do not swallow the mixture! It can cause you to throw up. This will bring stomach acid to to your mouth which will irritate the canker sore further.
  • When using OTC mouthwash,make sure that it's not expired! This will just make things worse.

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 http://www.mayoclinic.com/health/canker-sore/DS00354/DSECTION=causes
  2. ↑ 2.0 2.1 2.2 2.3 2.4 http://www.webmd.com/oral-health/guide/canker-sores
  3. ↑ http://www.pitt.edu/~cjm6/s98canker.html
  4. ↑ 4.0 4.1 http://www.medicinenet.com/canker_sores/page4.htm
  5. ↑ 5.0 5.1 http://www.mayoclinic.com/health/canker-sore/DS00354/DSECTION=treatments-and-drugs
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