Mouth Sores: Information, Research, Causes, Symptoms and Treatment
Aphthous / Mouth Ulcer or Canker Sore
An aphthous ulcer, also known as a canker sore, is a type of oral ulcer, which presents as a painful, shallow open sore inside the mouth, at the base of the gums or upper throat. Unlike cold sores, canker sores don't occur on the surface of your lips and aren't contagious.
📊 Statistics
20%-40% of the U.S. population suffer from canker sores at some point in their lives
👥 Demographics
Most common in adolescence and young adulthood. Women are more often affected than men
Important distinction: Canker sores and cold sores or fever blisters are often confused for each other. Fever blisters typically appear outside the mouth (around the lips), while canker sores occur inside the mouth. Unlike canker sores, fever blisters are caused by a virus and are extremely contagious.
Canker Sore Types & Symptoms
Aphthous ulcers are sores inside your mouth - on the tongue, soft palate (the back portion of the roof of your mouth), or inside your cheeks. They usually begin with a tingling or burning sensation at the site of the ulcer prior to its appearance.
🔸 Minor Canker Sores
Most common type. Oval, yellowish or grayish colored lesions with a white center and red border, between 2-10 mm (up to 1/3 inch) in size. Painful but clear up within 3-14 days without scarring.
🔸 Major Canker Ulcers
Similar appearance to minor ulcers, but larger than 10 mm (greater than 1/3 inch) in diameter. Extremely painful and may take a month or longer to heal. Frequently leave a scar.
🔸 Herpetiform Ulcerations
Small, numerous, 1–3 mm lesions that form large irregular clusters. Most frequent in adult females. Typically last 7-10 days and heal without scarring.
⚠️ When to be concerned: Open sores that won't go away within a week or two can be a sign of oral cancer. A doctor or dentist visit is recommended.
Potential Causes / Triggers
🍊 Common Triggers
- • Citrus fruits (oranges, lemons)
- • Physical trauma (toothbrush, sharp foods, biting)
- • Stress and hormonal changes
- • Food allergies (especially cow's milk)
💊 Nutritional Factors
- • Vitamin B12 deficiency
- • Iron deficiency
- • Folic acid deficiency
- • Gluten sensitivity (Celiac disease)
🏥 Medical Conditions
Less commonly, mouth sores can indicate underlying illnesses such as Crohn's Disease, autoimmune diseases, bleeding disorders, cancer, or weakened immune system.
Home Treatments
Pain from a canker sore generally lessens in a few days and the sores usually heal without treatment in about a week or two. However, there are things you can do to relieve discomfort and expedite healing.
🛡️ Protection & Prevention
- • Avoid spicy or acidic foods that may irritate sores
- • Brush gently with a soft-bristled toothbrush
- • Protect from poorly fitting dentures or braces
- • Consider using a topical ointment as protective barrier
🧪 Rinses & Applications
- • Baking soda paste: Apply thin paste of baking soda and water
- • Hydrogen peroxide: Mix 1:1 with water, apply with cotton swab
- • Salt rinse: 4 oz water + 1 tsp salt + 1 tsp baking soda (rinse 4x daily)
- • Milk of magnesia: Apply topically after hydrogen peroxide
🌿 Natural Remedies
- • Black tea bags: Contains tannin for pain relief
- • Lysine supplements: Reduce ulcer growth and aid healing
- • Licorice root: Speeds healing rate
- • Vitamin B12: 1mg under tongue nightly (effective for recurrent ulcers)
⚕️ Consult Your Doctor or Dentist If...
🚨 Urgent Signs
- • Unusually large or spreading sores
- • Sores lasting 2+ weeks
- • Intolerable pain
- • Difficulty drinking fluids
⚠️ Special Conditions
- • Immunocompromised patients
- • Fever, skin rash, or drooling
- • Sores after starting new medication