Introduction
Call your doctor if you are concerned about any of the following:
-
A bacterial infection may develop (symptoms may include severe pain,
fever
, and swollen lymph nodes).
-
Lesions may worsen or continue beyond several weeks.
-
A more serious problem may be present, such as inflammatory bowel disease or an oral cancer. Factors that may lead to oral cancer include
smoking, tobacco chewing, and use of alcohol.
Exams and Tests
Canker sores are diagnosed by their typical appearance. No testing is needed in the majority of cases.
The doctor, however, must consider the possibility of herpes or fungal infections, trauma, or sores that will not heal that could signal
Cancer. The oral lesions of hand-foot-and-mouth
disease
can appear similar to canker sores.
Canker sores may be seen in people with
HIV
infection, with inflammatory and other bowel diseases, and with certain medical conditions.
Herpetiform aphthous ulcers may be distinguished from true herpes sores by the fact that with the herpetiform canker sores, no vesicles (small blisters) appear before the ulcers do.
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Self-Care at Home
Try rinsing your mouth with a solution of ½ teaspoon salt dissolved in 8 ounces of water.
Another mixture that may be helpful consists of 1-2 tablespoons of Maalox mixed with ½ tablespoon of liquid diphenhydramine (Benadryl). Swish a teaspoonful in your mouth and spit it out. This can be done four times a day.
A number of
medication
are available over the counter, for example, calamine (Calamox) lotion.
Liquids or ointments with a numbing ingredient such as benzocaine (Anbesol, Oragel, Orabase, Zilactin-B, Tanac) help relieve the discomfort of canker sores.
Prevention
Avoid anything that could cause trauma—even minor trauma—to the mouth, such as hard toothbrushes and rough foods.
Avoid toothpastes that contain sodium lauryl sulfate if you tend to get canker sores.
Do not talk while chewing.
Have any irregular dental surfaces repaired.
Hormonal factors can sometimes trigger an outbreak during the premenstrual phase. Oral contraceptives may be helpful in this regard.
If you have a deficiency of iron, folic acid, or vitamin B12, make sure you are taking the appropriate supplements.
Outlook
Most people are minimally inconvenienced by canker sores, because attacks usually are infrequent and last only a matter of days.
The more severe form, however, tends to last longer.
As you age, canker sores may not return.
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