Aphthous ulcers, are small and shallow lesions that form on the soft tissues in the mouth or at the base of the gums. Unlike cold sores, aphthous ulcers are not contagious and do not appear on the surface of the lips. However, they can be painful and can cause difficulties with eating and speaking.
Most aphthous ulcers heal on their own within a week or two. If you have unusually large or painful canker sores or if they don’t seem to heal, it is advisable to consult with your doctor or dentist.
Symptoms of aphthous ulcers typically include round or oval-shaped sores with a white or yellow center and a red border. They develop inside the mouth, such as under the tongue, inside the cheeks or lips, at the base of the gums, or on the soft palate. A tingling or burning sensation may be felt a day or two before the appearance of the sores.
There are different types of aphthous ulcers, including minor, major, and herpetiform sores.
Minor aphthous ulcers:
- Usually small in size
- Oval-shaped with a red edge
- Heal without scarring within one to two weeks
Major aphthous ulcers:
- Less common than minor aphthous ulcers
- Larger and deeper in size
- Usually round with defined borders, but can have irregular edges when very large
- Can be extremely painful
- May take up to six weeks to heal and can leave extensive scarring
Herpetiform aphthous ulcers:
- Uncommon and tend to develop later in life (not caused by herpes virus infection)
- Pinpoint in size
- Often occur in clusters of 10 to 100 sores, which may merge into one large ulcer
- Have irregular edges
- Heal without scarring within one to two weeks
The exact cause of canker sores is still unknown, but it is believed that a combination of factors contributes to their development. Possible triggers include minor mouth injuries from dental work, overzealous brushing, sports accidents, or accidental cheek bites. Toothpaste and mouth rinses containing sodium lauryl sulfate, food sensitivities (e.g., chocolate, coffee, strawberries, eggs, nuts, cheese, spicy or acidic foods), deficiencies in vitamin B-12, zinc, folate, or iron, allergic reactions to certain bacteria in the mouth, Helicobacter pylori bacteria (which also cause peptic ulcers), hormonal shifts during menstruation, and emotional stress.
aphthous ulcers may also be associated with certain conditions and diseases such as celiac disease, inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, Behcet’s disease, a faulty immune system that attacks healthy cells in the mouth, and HIV/AIDS.
While canker sores can’t be completely prevented, you may be able to reduce their frequency by following these recommendations:
Avoid foods that irritate your mouth, such as nuts, chips, pretzels, certain spices, salty foods, and acidic fruits like pineapple, grapefruit, and oranges. Also, avoid any foods to which you are sensitive or allergic.
Maintain a healthy diet rich in fruits, vegetables, and whole grains to prevent nutritional deficiencies.
Practice good oral hygiene by brushing after meals and flossing daily to keep your mouth clean and free from potential irritants. Use a soft brush to prevent irritation and avoid toothpaste and mouth rinses containing sodium lauryl sulfate.
If you have braces or other dental appliances, ask your dentist about orthodontic waxes to cover sharp edges and protect your mouth.
Learn and utilize stress-reduction techniques like meditation and guided imagery if stress seems to be a factor in your aphthous ulcers.