Overview
A canker sore is a very common but dangerous disease. Sometimes people avoid them because they understand that these sores are there due to indigestion or stomach problem.
But this is half true, if canker sores are left untreated they can be fatal.
Aphthous stomatitis is a common condition characterized by the repeated formation of benign and non-contagious mouth ulcers in otherwise healthy individuals.
The informal term canker sore is also used, mainly in North America, although it may also refer to other types of mouth ulcers.
The cause is not completely understood but involves a T cell-mediated immune response triggered by a variety of factors which may include nutritional deficiencies, local trauma, stress, hormonal influences, allergies, genetic predisposition, certain foods, dehydration, or some food additives.
These ulcers occur periodically and heal completely between attacks.
In the majority of cases, the individual ulcers last about 7–10 days, and ulceration episodes occur 3–6 times per year.
Most appear on the non-keratinizing epithelial surfaces anywhere in the mouth except the attached gingival, the hard palate, and the dorsum of the tongue – although the more severe forms, which are less common, may also involve keratinizing epithelial surfaces.
The condition is very common, affecting about 20% of the general population to some degree. The onset is often during childhood or adolescence, and the condition usually lasts for several years before gradually disappearing.
There is no cure, and treatments such as corticosteroids aim to manage pain, reduce healing time and reduce the frequency of episodes of ulceration.
So we will discuss canker sores in this article. So let’s know about canker sores….
Epidemiology
Aphthous stomatitis affects between 5% and 66% of people, with about 20% of individuals in most populations having the condition to some degree. This makes it the most common disease of the oral mucosa. Aphthous stomatitis occurs worldwide, but is more common in developed countries.
Within nations, it is more common in higher socioeconomic groups. Males and females are affected in an equal ratio and the peak age of onset is between 10 and 19 years. About 80% of people with aphthous stomatitis first developed the condition before the age of 30. There have been reports of ethnic variation. For example, in the United States, aphthous stomatitis maybe three times more common in white-skinned people than black-skinned people.
What is a canker sore?
Canker sores are small, shallow ulcers that occur in the lining of the mouth and lips.
There is a medical term for canker sore, and that is – “aphthous ulcers.”
Canker sores (aphthous ulcers) appear as small, painful swellings on the lips or inside the mouth.
The painful sores are covered by a mixture of fluids, white blood cells, and bacteria.
They typically have a white, gray, or yellowish film with a red border
In the beginning stages, the sores may appear as small red dots. In some cases, they can be as large as a quarter.
As a canker sore is forming, it is not uncommon to feel irritation, tingling, and burning sensations around the infected area.
Canker sores can also cause swollen lymph nodes in your neck. This is especially true if you get recurrent, aphthous stomatitis (canker sores or mouth ulcers).
Canker sores are among the most common types of oral lesions, affecting about 20% of people.
Women get canker sores more often than men.
Canker sore susceptibility may be inherited, and the condition can run in families.
By definition, there is no serious underlying medical condition, and most importantly, the ulcers do not represent oral cancer nor are they infectious. However, aphthae are capable of causing significant discomfort.
There is a spectrum of severity, with symptoms ranging from a minor nuisance to disabling. Due to pain during eating, weight loss may develop as a result of not eating in severe cases of aphthous stomatitis.
Usually, the condition lasts for several years before spontaneously disappearing in later life.
Note:- Cancer sores never develop outside of the mouth.
“Canker sores start as white to yellowish ulcers that are surrounded by redness. They’re usually very small (less than 1 mm) but may enlarge to ½ to 1 inch in diameter. Canker sores can be painful and often make eating and talking uncomfortable”.
The sores may develop in or around the mouth, these areas are;-
• Lowest part of the lips
• Inside of the cheeks
• In the inner lip region
• On the soft palate.
• On the tongue
• Under the tongue
Types of canker sores:- There are the following types of known canker sores;-
There are three types of canker sores, minor sores, major sores, and herpetiform sores.
Minor canker sore:-
Minor canker sores are the most common type, affecting more than 80 percent of sore sufferers. It generally happens in people between 10–20 years old. They are about less than 1 cm. Length and heal in about one week. It left no scars.
There are the following characteristics of minor canker sores;-
1. Typically less than 5 mm in diameter
2. Do not require treatment
3. Heal in 7 to 14 days
4. Do not scar
Major canker sore:-
Major canker sores are more severe and appear less commonly than miner canker sores. These can be bigger and last up to 2 weeks.
They often heal with scarring.
There are the following characteristics of major canker sores;-
- They are much bigger than minor canker sores (over 1 centimeter in diameter)
- Often require treatment
- Do not heal for two or more weeks
- Can last for weeks or months
- Typically extremely painful
- May form a scar
Herpetiform sores
Herpetiform sores are the least common type of canker sore. These are rare and show up as clusters of tiny ulcers. Usually, heal in about a week.
• Appear as a cluster of small sores
• May require treatment
• Individual sores are less than a few millimeters in diameter
• Small sores often form into larger ulcers
• Typically extremely painful
• Heal in about one month
Symptoms of canker sore
Persons with aphthous stomatitis have no detectable systemic symptoms or signs (outside the mouth).
Generally, symptoms may include;-
• Burning sensation
• Itching sensation
• Stinging sensation
Which may precede the appearance of any lesion by some hours; and pain, which is often out of proportion to the extent of the ulceration and is worsened by physical contact, especially with certain foods and drinks (e.g., if they are acidic or abrasive). Pain is worst in the days immediately following the initial formation of the ulcer and then recedes as healing progresses.
If there are lesions on the tongue, speaking and chewing can be uncomfortable, and ulcers on the soft palate, back of the throat, or esophagus can cause painful swallowing. Signs are limited to the lesions themselves.
Ulceration episodes usually occur about 3–6 times per year.
However, severe disease is characterized by virtually constant ulceration (new lesions developing before old ones have healed) and may cause debilitating chronic pain and interfere with comfortable eating. In severe cases, this prevents adequate nutrient intake leading to malnutrition and weight loss.
Causes of canker sores
There are the following causes that can produce canker sores;-
Poor hygiene:- Brushing twice a day, flossing at least once a day, and rinsing the mouth regularly kills bacteria and keeps the mouth healthy. To avoid them, it is also important to limit hard, crunchy, unhealthy, or irritating foods (acidic).
Oral injuries:- Sometimes, while brushing due to the wrong brushing technique, there can be small cuts inside the mouth, jaws, and gums. These cuts can be the reason for the growth of bacterial infections and canker sores.
Certain food allergies:- Acidic foods, spicy foods, coffee, strawberries, eggs, nuts, eggplants, cheese, tomatoes, and gluten may cause allergic reactions in some people. These reactions can lead to the formation of canker sores.
Presence of Sodium lauryl sulfate in the toothpaste:- Toothpaste containing sodium lauryl sulfate (SLS) can cause canker sores. The ingredient is known to irritate the tissues inside the mouth and gums. If ulcers are recurrent, toothpaste can likely be a reason.
Nutritional deficiencies:- Excessive intake of sugar, processed foods, and citrus fruits can cause aphthous ulcers. It is recommended to eat salads with raw onions because they contain sulfur, which has antibacterial effects.
Hormonal imbalance:- During pregnancy, menopause, lactation, and periods the hormonal flow in the blood increases, resulting in inflammation in soft tissues. The inner and around the skin of the mouth is made from soft tissues. So inflammation in the mouth can be a cause of canker sore.
Vitamin deficiencies:- To avoid canker sores, the body needs a proper balance of acidity, minerals, and alkalinity. Iron, zinc, vitamin B12, and folic acid deficiencies have been linked to canker sores. Calcium deficiencies also cause canker sores and can even make the sores worse.
Natural remedies for canker sores
Canker sores usually disappear on their own within 7 to 10 days. There are a few natural home remedies that can be used to help speed up the healing process and decrease irritation.
Natural remedies for canker sore speed healing include;-
- Swish with salt water:- Saltwater tops the list and used since times immemorial for curing mouth ulcers. This must have often been prescribed to you by your grandparents. This is a time-tested natural remedy for mouth ulcers. Saltwater gargling helps in drying out canker sores.
Ways to use salt water:- Dissolve 1 teaspoon of salt water with half a cup of warm water and swirl the mixture in the mouth for a few seconds, and repeat this several times a day for quickly healing ulcers.
- Apple cider vinegar:- Here’s a super effective home remedy for mouth ulcers, thanks to the goodness of apple cider vinegar whose acidity can kill ulcer-causing bacteria.
Ways to use apple cider vinegar:- Mix one tbsp of the vinegar in half a cup of warm water. Swish this in your mouth for a couple of minutes and then rinse your mouth with regular water.
DOSE:- Do this twice a day till the swelling subsides.
- Honey:- As we all know, honey has antibacterial properties. Plus, it can be a good natural emollient. The anti-inflammatory properties of honey work amazingly well to heal mouth ulcers. Honey, when applied on the affected region, moisturizes the skin and prevents it from becoming dry, and reduces itching and irritation.
Ways to use honey:- when you have mouth ulcers, just take a little bit of cotton and apply honey on the ulcers with the help of the cotton. Keep on repeating till you feel that the swelling is diminishing and it’s feeling less painful.
- Cloves:- Again, this can be a simple home remedy for mouth ulcers. Cloves are known to kill off bacteria—experts say that cloves can also help in reducing stomach ulcers.
Ways to use cloves:- Put the cloves under the teeth and chew them until the pain goes off.
- Garlic:- Allicin in garlic can work against a host of microorganisms. Garlic is a proven natural remedy that is valuable in curing canker cores. The powerful compound allicin in garlic is effective in alleviating pain and reducing the size of the mouth ulcer.
Ways to use garlic:- Gently rub a small piece of garlic on the affected region for 3-5 minutes and flush the mouth after 20 minutes.
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