What Is It?
This disease causes painful, round ulcers to develop on the linings of the cheeks
and lips, the tongue or the base of the gums. The tendency to develop these ulcers
is inherited. Ulcers also can be associated with other diseases, particularly
connective tissue diseases such as lupus or Behçet's syndrome, which cause
symptoms on the eyes and genitals as well as the mouth. There can be one or many
ulcers at the same time, and they are recurrent, which means they keep returning.
Multiple ulcers are scattered across the lining of the mouth, not clustered.
Most people get one to three of these lesions at each episode, but a small number
of people get more than a dozen ulcers at a time.
The cause of canker sores is not known, but most theories involve an
immune abnormality. Certain blood diseases, vitamin and mineral deficiencies,
allergies, trauma and Crohn's disease cause similar ulcers. Canker sores
are often confused with cold sores, which are caused by a herpes virus.
Approximately 17% of the population has recurrent aphthous stomatitis,
which is classified into three categories:
- Minor ulcers are less than 1 centimeter (slightly
less then ½inch) in diameter and do not leave scars. The sores
usually heal within two weeks.
- Major ulcers (also called Sutton's disease) are
almost ½ inch or more in diameter, take longer than minor ulcers
to heal and may leave scars.
- Herpetiform ulcers are clusters of dozens of smaller
ulcers. This form is rare.
People tend to have two to six ulcers per episode and have several episodes
each year. For most people, canker sores are merely an annoyance, but
some people experience large, painful, frequent sores that can reach
2 to 4 centimeters in diameter. The ulcers can interfere with speech
and eating and can last for weeks to months, causing significant pain
and disability. When they do heal, they may leave scars that can make
it more difficult to move the tongue and can destroy oral tissue.
Symptoms
You may feel a burning or tingling sensation in an area of inflammation
before an ulcer appears. An ulcer takes two to three days to form completely.
The sores are round, shallow and symmetric, which means they are the
same on all sides. The are painful. They usually are found on the inner
part of the lips and cheeks and the tongue.
Diagnosis
Canker sores are the most common recurring oral ulcers and are diagnosed
mostly by process of elimination. If the ulcers become more frequent
or severe, are accompanied by other symptoms (such as rashes, joint pain,
fevers or diarrhea) or are larger than about ½inch in diameter,
you should visit your dentist or physician. He or she will try to rule
out blood diseases, connective tissue diseases, drug reactions and skin
disorders. A biopsy and blood tests may be required to rule out other
conditions or diseases.
Expected Duration
The painful stage lasts 3 to 10 days, and most canker sores disappear
within 2 weeks.
Prevention
There is no way to prevent canker sores. Treatment
Treatment focuses on relieving symptoms. Rinsing with a warm-water solution
and eating bland foods can minimize discomfort. Anesthetic medications
or over-the-counter agents that are placed directly on the sores to coat
them also may help.
People with more severe disease may need steroid medications placed
on the lesions. These medications significantly shorten the healing time
of the ulcers and prevent them from becoming larger. Other possible treatments
include placing a medication called chlortetracycline (Aureomycin) on
the sores or injecting steroids into the sores. In very severe, disabling
cases, your dentist may prescribe oral medication.
When To Call a Professional
Canker sores usually are painful but are not a significant risk to your
health. However, if you have severe, recurring canker sores, or if they
are becoming worse, consult your dentist or physician. He or she may
do tests to look for blood problems such as anemias or deficiencies of
iron, folate or vitamin B12. Some research has shown that canker sores
improve when these deficiencies are treated. Persistent or large ulcers
can also occur as a part of other, more significant, disorders, including
inflammatory bowel disease, connective tissue diseases, drug allergies,
arthritic disorders, inflammatory skin disorders and cancer.
Prognosis
Most canker sores clear up without treatment and do not leave scars,
although they usually return.
Additional Info
American Academy of Family Physicians
Consumer Information Site
11400 Tomahawk Creek Parkway
Leawood, KS 66211-2672
Toll-Free: 1-800-274-2237
E-mail: email@familydoctor.org
http://familydoctor.org/
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