This article provides information on managing and preventing canker sores, particularly when they affect gum tissue.
What Are Canker Sores and Why Do They Appear?
Canker sores, medically known as aphthous ulcers, are small lesions that form on the soft tissues inside the mouth. They typically appear as white or yellowish spots surrounded by a bright red border and are not contagious. These ulcers can make chewing and speaking uncomfortable.
While the cause of canker sores is not always clear, several factors can trigger their development. Minor injuries to the mouth, such as those from dental work, aggressive brushing, or accidental cheek bites, are common contributors. Certain foods, especially those that are acidic, spicy, or abrasive, can also provoke sores. Nutritional deficiencies such as vitamin B12, zinc, iron, or folate have been linked to their occurrence. Stress, hormonal shifts, and certain toothpastes containing sodium lauryl sulfate (SLS) are additional triggers.
At-Home and Over-the-Counter Treatments
Several treatments can help manage the discomfort and promote the healing of canker sores on the gums. Saltwater rinses are a common home remedy, working as a disinfectant to reduce bacteria and swelling. To prepare, dissolve one teaspoon of salt in half a cup of warm water, swish the solution around the mouth for 15 to 30 seconds, and then spit it out, repeating every few hours as needed.
Baking soda rinses can also offer relief by neutralizing acids in the mouth, which helps reduce irritation and inflammation. Mix one teaspoon of baking soda into half a cup of warm water, swishing for about 30 seconds before spitting. Over-the-counter topical products containing benzocaine can provide temporary pain relief by numbing the affected area. These gels should be applied directly to the sore as directed.
Hydrogen peroxide rinses serve as an antiseptic, cleaning the sore and reducing bacteria. Dilute a 3% hydrogen peroxide solution with an equal amount of water, then dab it onto the sore with a cotton swab or swish it as a rinse for about a minute before spitting. Additionally, magnesium hydroxide can be dabbed onto the sore to neutralize acids, coat the lesion, and alleviate pain. Applying ice or allowing ice chips to slowly dissolve over the sore can also help numb the pain and reduce inflammation.
Professional Medical Treatments
When home remedies are insufficient, professional medical treatments can provide more targeted relief and promote healing. Prescription mouth rinses may be recommended, such as those containing chlorhexidine gluconate, which possesses antiseptic properties to reduce bacteria and inflammation. Dexamethasone solutions, a type of corticosteroid rinse, can also be prescribed to reduce inflammation and discomfort, with some formulations including lidocaine for additional numbing.
For severe or recurrent canker sores that do not respond to topical treatments, oral corticosteroids might be prescribed. These medications are generally reserved for more challenging cases due to potential side effects. Cautery methods, which use an instrument or chemical to treat the tissue, are another option. Chemical cautery can provide immediate pain relief by burning nerve endings and creating a protective layer, though it may not always accelerate healing. Laser treatment is another professional procedure that can offer pain relief and accelerate the healing process for persistent sores.
When to See a Dentist
While most canker sores heal on their own, there are specific situations when professional dental or medical attention is advisable. You should consult a dentist if a canker sore is unusually large or causes severe pain that interferes with eating or drinking. Persistent sores that last longer than two weeks, or new sores that develop before older ones have healed, also warrant a professional evaluation.
Seeking medical advice is also important if you experience frequent outbreaks of canker sores. Additionally, if the canker sore is accompanied by a fever, or if it appears unusually irregular or red, see a healthcare provider. These signs can sometimes indicate an underlying condition that requires diagnosis and treatment.
Preventing Canker Sores
Proactive strategies can help reduce the frequency and severity of canker sore outbreaks. Avoiding certain trigger foods, including highly acidic items like citrus fruits, spicy foods, or abrasive snacks, can irritate mouth tissues. Being mindful of food sensitivities may also help.
Maintaining good oral hygiene is important, including gentle brushing with a soft-bristled toothbrush. Opting for toothpastes that do not contain sodium lauryl sulfate (SLS) can also be helpful, as this ingredient has been linked to canker sore development in some individuals. Managing stress through various techniques can reduce the likelihood of sores, as stress is a known trigger. Addressing any identified nutritional deficiencies, such as vitamin B12, zinc, iron, or folate, through dietary adjustments or supplements, may also contribute to prevention. Finally, minimizing mouth trauma, such as avoiding aggressive chewing or biting the inside of the cheek, can prevent physical irritation that leads to sores.