Finding painful sores in the mouth following a major dental procedure like wisdom teeth removal is common. These shallow, non-contagious lesions are known as aphthous ulcers, or more commonly, canker sores. Recognizing this temporary post-operative occurrence can alleviate worry during recovery. The ulcers typically appear as small, round or oval spots with a distinct white or yellowish center and a surrounding red border.
The Link Between Oral Surgery and Canker Sores
Wisdom tooth extraction creates an environment that favors the development of these ulcers. The surgical process subjects the delicate oral mucosa to mechanical trauma. This trauma can result from dental instruments, the need to retract the cheek or tongue for access, or accidental biting of the cheek while the mouth is numb after the local anesthetic wears off.
The physiological stress of undergoing surgery and the subsequent recovery period is another major trigger. Stress hormones, such as cortisol, can temporarily alter the immune system’s response, making an individual more susceptible to a canker sore outbreak. For those genetically predisposed to aphthous ulcers, this combination of physical injury and emotional strain can predictably cause a flare-up.
Chemical irritants present in some common oral care products can also contribute to the problem. The detergent sodium lauryl sulfate (SLS), a foaming agent found in many toothpastes, is known to irritate the sensitive lining of the mouth and potentially break down the protective mucosal barrier. Using toothpaste containing SLS on an already compromised post-surgical mouth can increase the likelihood of developing or worsening a canker sore.
Distinguishing Canker Sores from Other Post-Operative Complications
It is important to distinguish a canker sore from other post-operative issues. A canker sore is a lesion on the soft, movable tissues inside the cheeks, lips, tongue, or floor of the mouth, distinctly separate from the extraction site itself. Unlike an infection, a canker sore is typically an isolated, shallow ulcer that does not produce pus and is not accompanied by spreading redness or a high fever.
A dry socket, or alveolar osteitis, occurs when the blood clot protecting the surgical site is dislodged or dissolves prematurely. The pain is typically described as intense, deep, and throbbing, radiating from the extraction hole up to the ear or temple, usually starting three to five days after surgery. In contrast, the pain from a canker sore is a sharp, stinging sensation localized to the ulcer’s surface, particularly when touched by food or drink.
Surgical site irritation, such as a sore spot caused by a stitch or a rough bony edge, is also different from an aphthous ulcer. Irritation from stitches will be localized directly on the incision line. A true canker sore is a round or oval ulcer with a crater-like white or yellow base and a distinct red halo, making location and specific appearance the most reliable visual cues for self-assessment.
Managing and Accelerating Healing
Fortunately, there are several steps you can take to manage the discomfort and speed up healing. A simple home remedy is a warm saltwater rinse or a baking soda solution, using a half-teaspoon of salt or baking soda dissolved in eight ounces of warm water. When rinsing, use a gentle tilting motion rather than aggressive swishing or spitting, which could dislodge the blood clot and cause a dry socket.
For localized pain relief, over-the-counter topical treatments can be applied directly to the sore. These often contain a mild anesthetic like benzocaine to numb the area temporarily, or a corticosteroid like fluocinonide to reduce inflammation. Specific adhesive pastes are designed to coat the ulcer, protecting it from irritation from food and saliva, which can accelerate healing.
Dietary adjustments are essential for comfort and recovery. You should avoid acidic foods, such as citrus fruits and tomatoes, as well as spicy or crunchy foods that can abrade the tender ulcers. Temporarily switching to a soft-bristled toothbrush and using an SLS-free toothpaste is advisable, as eliminating the foaming agent minimizes further irritation to the delicate oral lining.
When to Consult Your Dentist
While most canker sores heal without intervention, certain symptoms indicate seeking professional advice from your dental or oral surgery team. Contact your provider if the canker sore persists for longer than two weeks without showing signs of healing, as a non-healing lesion requires evaluation. This is especially true for any ulcer that is growing rapidly or spreading across the mouth.
Immediate consultation is necessary if the ulcer is accompanied by systemic symptoms like a high fever, unexplained chills, or significant difficulty swallowing, as these may signal a broader infection. Similarly, if the pain becomes unmanageable even with over-the-counter medications, your dentist can prescribe prescription-strength mouth rinses containing steroids or potent anesthetics to provide relief.