Canker Sores

WHEN TO SEE YOUR DOCTOR

* A sore in your mouth does not heal within two weeks.

* You develop a painless sore in your mouth.

What Your Symptom Is Telling You

Canker. Even the name sounds decidedly unhealthy and a little disgusting. But these painful little sores actually are quite harmless. Their evil twin, herpes-caused cold sores or fever blisters, are the highly contagious ulcerations that you have to be more concerned about.

Both kinds of ulcers look a lot alike—they're round, red and possibly pus-filled. Canker sores usually don't grow together like herpes blisters, though, and they typically erupt on the movable, flexible parts of the mouth, such as the tongue and tissue below it, the cheeks and the upper soft palate. When you have a canker sore, you probably won't feel the tingling or burning that signals the onset of a herpes cold sore.

Doctors don't really know why some people get canker sores, which are technically known as aphthous ulcers. Heredity appears to play a role, says Eric Z. Shapira, D.D.S., a trustee on the national board of the Academy of General Dentistry and a dentist in private practice in Half Moon Bay, California. Some people are just more sensitive to the Streptococcus sanguis bacteria that cause the eruptions. If you get canker sores once, you're likely to get them again.

Women are much more vulnerable to outbreaks of canker sores, dentists say, especially during pregnancy and during parts of their menstrual cycles. Stress might also encourage a sore to appear, as can food allergies, Dr. Shapira says. Denture wearers can get them from the pressure and rubbing of their false teeth on their gums. Bites and abrasions also can lead to an eruption in people prone to developing canker sores.

Symptom Relief

Canker sores can really sting. In very vulnerable people, they'll hurt like heck. They will go away on their own in 10 to 14 days. But you probably don't want to live with pain for that long, so here's what you can do.

Cover it with hydrocortisone. A prescription gel or paste containing hydrocortisone will seal off the canker sore and make you feel better and usually speed the healing, says D'Anne Kleinsmith, M.D., a dermatologist in private practice in West Bloomfield, Michigan.

Rub some salve on the sore. Over-the-counter ointments, such as Zilactin or Blistex, will coat the sore and sterilize it to some extent, Dr. Shapira says. Ointments will at least numb the pain so you can eat more easily.

Try a Kaopectate quencher. For a canker sore or any other minor mouth pain, mix equal parts of Kaopectate with Benadryl elixir, both of which you can find at pharmacies, says Louis M. Abbey, D.M.D., a professor of oral pathology at Virginia Commonwealth University/ Medical College of Virginia School of Dentistry in Richmond. Swish the concoction in your mouth for at least a minute before eating, to soothe your mouth. The Benadryl numbs the pain, while the Kaopectate helps the anesthetic stick to the inside of your mouth, he explains.

Soothe it with saline. Rinsing your mouth with some salt water several times a day will help ease the pain from a canker sore, Dr. Shapira says. Mix a teaspoon of salt in an eight-ounce glass of warm water and swish it around in your mouth.

Don't eat the acid. Spicy or highly acidic foods like tomatoes and citrus juices will burn and irritate the ulceration. Avoid them until the sore heals, Dr. Shapira says.

Lysine gets the red out? Several years ago, researchers showed some interest in treating canker sores with supplements of the amino acid lysine. "It works for some people and doesn't work for others," Dr. Shapira says. Check with your doctor before taking any supplements on your own.

Handle with care. Because your hand can slip while you're vigorously or hastily brushing your teeth, take your time and gently go through your oral hygiene routines, dentists say.

See also Cold Sores