Canker sores (aphthous ulcers) are small, painful lesions on the soft tissues inside the mouth, such as the inner cheeks, lips, or tongue. These shallow sores typically have a white or yellowish center surrounded by a bright red border. While uncomfortable, canker sores are not contagious and are distinct from cold sores, which are caused by the herpes simplex virus. Many people experience an increase in frequency or severity during pregnancy, which is a common physiological response to the profound changes occurring in the body. The appearance of these ulcers is generally a benign inconvenience related to the pregnant state.
Why Canker Sores Increase During Pregnancy
The surge in canker sores during gestation is largely attributed to the complex hormonal and immunological shifts that define pregnancy. Elevated levels of hormones like estrogen and progesterone can alter the oral mucosa, making the mouth tissues more sensitive and reactive to minor irritation. This hormonal environment can exacerbate the body’s response to oral bacteria, potentially leading to increased inflammation and ulcer formation.
A temporary alteration in the immune system is also a contributing factor. The body slightly modulates its immune response to successfully carry the pregnancy. This change can lower the resistance of the oral tissues to triggers. Minor trauma, like accidental cheek biting, can more easily develop into a full ulcer.
Furthermore, the increased metabolic demands of supporting a developing fetus can lead to subtle nutritional deficiencies. Deficiencies in iron, folate, and vitamin B12 are associated with increased aphthous ulcers. Since the fetus prioritizes nutrient absorption, the mother may experience a relative deficit in these nutrients, even while taking prenatal supplements.
Increased emotional or physical stress and general fatigue, common throughout pregnancy, also play a role in triggering flare-ups. Stress is known to affect the body’s immune regulatory processes. The mechanical irritation from frequent vomiting associated with morning sickness can also increase the acidity in the mouth, creating an environment conducive to ulcer development.
Fetal Safety and Pregnancy Risk Assessment
A primary concern for expectant mothers is whether the canker sore poses any risk to the developing baby. Standard aphthous ulcers are localized, non-infectious lesions that affect only the superficial lining of the mouth. These ulcers are not caused by a virus or bacterial infection that can cross the placental barrier.
The condition remains confined to the oral cavity and does not affect the systemic health of the pregnancy itself. There is no evidence suggesting that the presence of canker sores can lead to complications for the fetus. The focus should remain on safe and effective relief for the mother’s symptoms.
Pregnancy-Approved Treatments and Relief
Managing canker sores during pregnancy centers on alleviating pain and promoting natural healing while prioritizing fetal safety. Simple, pregnancy-approved home remedies should be the first line of defense for mild to moderate ulcers.
Home Remedies
Rinsing the mouth several times a day with a warm saline solution (one teaspoon of salt dissolved in warm water) can help soothe the sore and keep the area clean. Applying a paste made from baking soda and a small amount of water directly to the ulcer can also help neutralize acids and provide temporary relief from the burning sensation.
Dietary Adjustments
Dietary adjustments are important for preventing further irritation and supporting the healing process. Avoiding highly acidic foods, such as citrus fruits, tomatoes, and vinegars, as well as spicy, salty, or coarse-textured foods, can significantly reduce pain.
Over-the-Counter Options
For over-the-counter options, topical oral gels containing low concentrations of benzocaine or other pregnancy-safe anesthetics can numb the area and make eating more comfortable. However, any use of topical treatments should first be discussed with a healthcare provider to confirm safety. It is advisable to avoid strong prescription medications, such as steroid-based pastes or potent anti-inflammatory mouthwashes, unless specifically prescribed by a medical professional aware of the pregnancy.
Nutritional Support
Focusing on a diet rich in B vitamins, iron, and folate supports the body’s natural healing mechanisms. While prenatal vitamins address general needs, temporarily increasing intake of foods like leafy greens, lean meats, and fortified cereals may assist in correcting localized deficiencies contributing to the sores. Choosing soft, bland foods that require minimal chewing can also prevent mechanical irritation and allow the ulcer to resolve more quickly.
Recognizing When to Consult a Healthcare Provider
While most canker sores are harmless and resolve within one to two weeks, certain features should prompt a consultation with a healthcare provider or dentist. A persistent sore that does not show signs of healing after 14 days or one that rapidly increases in size should be evaluated. Sores exceeding one centimeter in diameter may indicate a more severe form of aphthous ulceration requiring specific medical management.
It is also important to rule out other possible oral conditions that may mimic a canker sore. A professional can differentiate between a common aphthous ulcer and lesions like oral herpes or oral thrush. Signs of a secondary infection, including spreading redness, significant swelling, pus, or an accompanying fever, necessitate immediate medical attention.