Canker sores, also known as aphthous ulcers, are common, painful oral lesions that frequently recur on the tongue. They can make eating and speaking challenging. While generally harmless, understanding their characteristics and causes can help manage these recurring irritations.
What Are Canker Sores?
Canker sores are small, shallow ulcers that develop on the soft tissues inside the mouth, including the tongue, inner cheeks, and lips. They typically present as round or oval lesions with a white or yellowish center, surrounded by a distinct red border. Before a sore becomes visible, individuals may experience a tingling or burning sensation in the affected area. These ulcers can appear on various parts of the tongue, such as the sides, tip, or underneath.
Most canker sores are classified as minor, being small and healing within one to two weeks without scarring. Less common types include major canker sores, which are larger and deeper, and herpetiform canker sores, appearing as clusters of tiny sores that can merge into a larger ulcer. Canker sores are not contagious and differ from cold sores, which are caused by the herpes simplex virus.
Common Triggers for Recurrence
Several factors contribute to recurrent canker sores. Physical injury to the mouth, such as accidentally biting the tongue, aggressive brushing, or irritation from dental work or braces, often precedes an outbreak. Certain dietary elements also act as triggers; acidic foods like citrus fruits and tomatoes, spicy dishes, or abrasive foods like chips and pretzels may irritate the mouth and lead to sore formation.
Nutritional deficiencies are frequently linked to recurrent canker sores, with low levels of iron, zinc, folate, and vitamin B12 identified as contributors. Emotional or psychological stress is another trigger, as elevated stress levels are linked to increased outbreaks. Hormonal shifts, such as those during menstruation, can also make some women more susceptible. Additionally, some toothpastes and mouthwashes containing sodium lauryl sulfate (SLS) may irritate sensitive oral tissues and contribute to recurrence. Less commonly, recurrent sores may signal underlying conditions like celiac disease, inflammatory bowel disease, or a weakened immune system.
At-Home Care and Over-the-Counter Solutions
Managing canker sores on the tongue involves alleviating pain and supporting healing. Over-the-counter topical anesthetics, such as those containing benzocaine, provide temporary pain relief by numbing the affected area. These are typically applied directly to the sore using a swab or applicator. Oral pain relievers like ibuprofen or acetaminophen may also help reduce discomfort.
Rinsing with specific solutions offers relief and promotes a cleaner oral environment. A saltwater rinse (one teaspoon of salt in half a cup of warm water) can reduce inflammation and aid healing. Similarly, a baking soda rinse (one teaspoon of baking soda in half a cup of warm water) can neutralize acids and soothe irritation. Diluted hydrogen peroxide rinses can also be used to clean the sore and prevent infection. Oral pastes or gels designed to coat the sore create a protective barrier, shielding it from further irritation while it heals. During an outbreak, avoid abrasive, acidic, or spicy foods that exacerbate pain. Maintain good oral hygiene with gentle brushing, avoiding the sore itself.
Preventing Future Outbreaks
Proactive strategies can reduce recurrent canker sores. Identifying and avoiding personal triggers is key; a food diary can pinpoint specific foods, like acidic fruits or spicy dishes, that precipitate outbreaks. Switching to toothpastes and mouthwashes that do not contain sodium lauryl sulfate (SLS) can also be beneficial for some individuals.
Ensuring adequate nutritional intake is another preventive measure. A balanced diet rich in fruits, vegetables, and whole grains helps prevent deficiencies. If deficiencies in vitamin B12, iron, or folate are suspected, discuss potential supplements with a healthcare provider. Managing stress through techniques like meditation, yoga, or regular exercise can also reduce the likelihood of outbreaks. Practice gentle oral care with a soft-bristled toothbrush, avoiding aggressive brushing to prevent minor trauma that might trigger sores. Staying well-hydrated also supports overall oral health.
When to Consult a Doctor
While most canker sores heal on their own, certain situations warrant medical attention. Consult a doctor if sores are unusually large or painful, causing difficulty eating or drinking. Sores persisting over two to three weeks without healing also warrant evaluation. Frequent or persistent outbreaks, where new sores appear before old ones resolve, suggest further investigation. Also see a doctor if canker sores accompany fever, diarrhea, skin rashes, or other systemic symptoms, as these may indicate an underlying health condition requiring diagnosis and treatment.