Aphthous Stomatitis (Canker Sores)

Aphthous stomatitis, also known as "canker sores" are oneof the most common problems that occur in the mouth. About 20%, 1 out of5, people will have canker sores at any one time. Canker sores are smallulcers in the mouth that may be painful and generally last for 10-14 days.Canker sores can be caused by a number of things including viruses, chemicalsin toothpaste, a diet which is poor in vitamin-12, folic acid, and iron.Other causes of canker sores are injury to the gums from brushing and stress.Additionally, there are a number of illnesses that can cause canker sores.Among these are systemic lupus, Crohn's disease, and Reiter's syndrome. Smokingand dentures may also contribute to the problem.

When you notice that you get canker sores a lot than contactyour health care professional. Most cases of canker sores are nothing toworry about. However, if you are having canker sores frequently, your healthcare professional can check some very simple things to make sure that thereis nothing serious going on. The treatment depends on the cause. If the causeis another illness such as lupus, treating the underlying illness can help.Most viral canker sores will get better by themselves. In some cases, somethingas simple as changing toothpastes may get rid of recurrent canker sores.A "natural" toothpaste such as Tom's of Maine or another toothpaste thatdoesn't contain additives (especially sodium lauryl sulfate) may help.

A number of medications have been used for canker sores.Among these are diphenhydramine suspension (Benadryl and others). This canbe used as a mouth rinse in adults to provide temporary relief from the painof aphthous stomatitis. Do not swallow the diphenhydramine, simply use isas a mouth rinse. There are other topical medications that your health careworker can prescribe to help the discomfort. Medications such as steroids(trimacinalone) or antibiotics (tetracycline) used on the ulcers may promotehealing. There is no evidence that antibiotics taken orally (swallowed) helps.If the canker sores are caused by a yeast infection topical anti-fungalmedication can be used (nystatin).

The use of steroid mouth rinses has been shown to reducethe number of recurrences that people get so if you are having multiple episodesof canker sores, this may be something that you might want to discuss withyour health care professional. A number of other medications such a zinchave been tried but there is no evidence that zinc works.

As always, please contact your health care professionalif you have questions, concerns, or a problem that is not getting better.This information may not apply to your particular case.

Dr. Song's Oral Medicine Forum