Canker Sores
GENERAL INFORMATION:
What are canker sores? Canker (KANG-ker) sores are ulcers in your mouth. Ulcers are open sores. Canker sores are also called recurrent aphthous stomatitis or RAS.
What are the severity levels of canker sores? Your symptoms and treatment may be different depending on how bad your canker sores are. Canker sores can be minor, major or herpetiform:
- Minor: Minor canker sores are usually less than one-half inch in size. They heal 10 to 14 days after you get them. After they heal, they do not leave a scar.
- Major: Major canker sores are usually larger than one-half inch in size. They take more than two weeks to heal, and can leave a scar.
- Herpetiform: Herpetiform canker sores are a cluster of 10 to 100 sores. Up to 100 smaller sores can join together and create a larger sore. While smaller sores can heal in a week, they may leave scars. Larger sores are deep and may take up to 30 days to heal. Herpetiform canker sores are not the same as, or related to, the herpes virus infection.
What causes canker sores? The cause of canker sores is not known. If your family members get canker sores, you may have a greater chance of getting them. Any of the following may increase your risk for having canker sores:
- Having a medical condition such as cancer or celiac disease.
- Changes in hormones (body chemicals) that happen with women's monthly periods.
- Foods such as chocolate, coffee, peanuts, almonds, strawberries, tomatoes and gluten. Gluten is found in oats, rye, wheat and barley. If you are allergic to these foods, you may be at higher risk of getting canker sores.
- Infections such as human immunodeficiency virus (HIV).
- Mouth injuries caused by biting, dentures, braces, or brushing your teeth too hard.
- Medicines, such as aspirin, ibuprofen, and some blood pressure medicines.
- Poor nutrition, such as not getting enough iron, zinc, vitamin B, or folic acid from your diet.
- Stress or anxiety (worry).
What are the signs and symptoms of canker sores?
- Canker sores may occur anywhere inside of your mouth. This includes the insides of your cheeks, your gums, and your tongue. They may also appear on the top and the bottom of your mouth, and inside your lips. You may feel pain, burning or tingling in your mouth even before the sores appear. You may also have a fever and feel very tired. The sores are round or egg-shaped. They are red, and may have a white or yellow covering over them.
- You may have one or more sores at a time, and they may grow in clusters or be spread out. The sores can be shallow, or deep. Canker sores can be painful, and make it hard for you to chew and swallow. The sores may go away for a time, and then come back again. Canker sores cannot be passed on from one person to another through touching, or by any other way.
How are canker sores diagnosed? Your caregiver will ask you about health problems that you had in the past and have now. He will also ask about medicines you are taking. He will need to know how many times you have had canker sores. Tell him if any of your family members have had them. Your caregiver will check the roof and corners of your mouth. He will also check the inner linings of your cheeks and lips. You may need to have tests to see if another condition or disease is causing the sores in your mouth.
How are canker sores treated? There is no cure for canker sores. Treatment is given to take away symptoms such as pain, and help your sores heal faster. Treatment can also decrease your chances of having canker sores again.
- Diet changes: Avoid sharp, crunchy, or dry foods as they can hurt your mouth. This may include dry toast and popcorn. Avoid chips, pretzels, and other salty foods as these can also make the sores in your mouth painful. Avoid foods and drinks that contain citric acid such as grapefruit, grapefruit juice, oranges, orange juice, lemons and limes. They may make your pain worse or cause more sores to form. Eat soft, plain foods until your canker sores heal. Ask your caregiver what foods and liquids would be best for you to have until the canker sores heal. Ask caregivers if changing your diet to include more of certain vitamins and minerals may help prevent you from getting canker sores again.
- Medicines:
- Anaesthetic medicine: This may be given to numb the area where you have sores, and help control pain.
- Antibacterial medicine: This may be given to kill germs. It may be given to use as a mouthwash.
- Anti-inflammatory medicine: This may be used to decrease swelling in your mouth.
- Pain medicine: This may be given to decrease pain in your mouth.
- Steroid medicine: This may be given to help your canker sores heal faster.
- Anaesthetic medicine: This may be given to numb the area where you have sores, and help control pain.
- Mouth care: Gently brush your teeth, gums, and tongue every day. Use a soft toothbrush. If you have dentures, clean them every day. If your braces or dentures do not feel comfortable, have a dentist check them to see that they fit well.
When should I call my caregiver? Call your caregiver if:
- You have shaking chills or a fever.
- You are dizzy or more tired than usual after starting new medicine to treat your canker sores.
- Your canker sores are not gone after 3 to 4 weeks.
- Your pain does not go away even after taking medicines.
- You have questions about your condition, medicine, or care.
- Your sores are getting worse, or you are getting more of them even though you are being treated for them.
When should I seek care immediately?
- You cannot eat or drink because of your mouth pain.
Where can I find more information?
- American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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