A canker sore is a painful, open sore in the mouth. Canker sores are white or yellow and surrounded by a bright red area. They are not cancerous. Show A canker sore is not the same as a fever blister (cold sore). Canker sores are a common form of mouth ulcer. They may occur with viral infections. In some cases, the cause is unknown. Canker sores may also be linked to problems with the body's immune system. The sores may also be brought on by:
Other things that can trigger canker sores include:
Anyone can develop a canker sore. Women are more likely to get them than men. Canker sores may run in families.
Canker sores most often appear on the inner surface of the cheeks and lips, tongue, upper surface of the mouth, and the base of the gums. Symptoms include:
Less common symptoms include:
Pain often goes away in 7 to 10 days. It can take 1 to 3 weeks for a canker sore to completely heal. Large ulcers can take longer to heal. Your health care provider can often make the diagnosis by looking at the sore. If canker sores persist or continue to return, tests should be done to look for other causes, such as erythema multiforme, drug allergies, herpes infection, and bullous lichen planus. You may need further testing or a biopsy to look for other causes of mouth ulcers. Canker sores are not cancer and do not cause cancer. There are types of cancer, however, that may first appear as a mouth ulcer that does not heal. In most cases, the canker sores go away without treatment. Try not to eat hot or spicy foods, which can cause pain. Use over-the-counter medicines that ease pain in the area.
Medicines prescribed by your provider may be needed for severe cases. These may include:
Brush your teeth twice a day and floss your teeth every day. Also, get routine dental check-ups. In some cases, gastric acid-reducing medicines can decrease the discomfort. Canker sores almost always heal on their own. The pain should decrease in a few days. Other symptoms disappear in 10 to 14 days. Call your provider if:
Aphthous ulcer; Ulcer - aphthous Daniels TE, Jordan RC. Diseases of the mouth and salivary glands. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 397. Dhar V. Common lesions of the oral soft tissues. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 341. Klatt EC. Head and neck. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Atlas of Pathology. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 6. Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Canker sores are easily identified in the mouth; they are a widespread, well-known condition. Although they can be very uncomfortable, they are rarely a cause for concern. In this article, we ask if there is anything that can be done to relieve canker sores, and if there are times when they require medical attention.
A canker sore is a type of mouth ulcer, known medically as an aphthous ulcer. Canker sores are one of the most common complaints of the mouth. They can occur at any age but are more likely in younger adults and women. Children as young as 2 years may develop canker sores, but they do not normally appear until adolescence. Although most people only have occasional canker sores, around 20-30 percent of people have recurrent episodes. Canker sores are sometimes split into two categories: Simple canker sores: they appear 3-4 times a year; they generally occur in people aged 10-20, and last about 1 week. Complex canker sores: less common, larger, and more painful. They may last up to 1 month and leave a scar. Complex canker sores are often due to an underlying condition, such as a compromised immune system, Crohn’s disease, or vitamin deficiency. Researchers have not yet provided a scientific explanation of why canker sores develop; however, there are some factors that are known to be involved, including viral infection. The causes of recurrent cases of canker sore – known as recurrent oral aphthous ulcers or recurrent aphthous stomatitis – are also unclear, although there are links with a number of factors including a family history of aphthous ulcers, and allergies. Ulcers are sometimes associated with other conditions needing medical attention, such as inflammatory bowel disease, compromised immunity, allergies, and nutritional deficiency. The following factors are thought to be involved in the development of canker sores:
A report by the United States Surgeon General estimates that up to 25 percent of the general population are affected by recurrent canker sores, noting there may be higher numbers among selected groups, such as health professional students. Canker sores cause local pain and can be easily irritated. In simple cases, these are the only symptoms, although the pain may cause feelings of being fed up with the mouth ulcer. Common features of canker sores include:
In some, more severe cases, symptoms can include:
Canker sores and cold sores are different conditions:
Common canker sores usually heal without the need for medical treatment. More severe or recurrent cases may be eased by prescribed treatments, although these do not “cure” the ulcers. As a general guide, canker sores should be brought to the attention of a dentist or doctor when they:
The good news is that the pain and discomfort of canker sores can be reduced by readily available prescription and non-prescription treatments and home remedies. Simple cases of occasional canker sores are self-limiting; they will heal over and disappear without intervention. No remedies are proven to change the course of canker sores themselves or stop them returning – treatments mostly just reduce pain, discomfort, and complication. Few treatments marketed for canker sores have been through extensive clinical testing. The management of canker sores is focused on treating symptoms, reducing inflammation, and promoting the healing process by countering secondary effects that could slow this down, such as bacterial infection. Treatments may include steroid mouth rinses, topical anesthetics, antiseptic ointments/rinses, or nutritional supplements. Home remedies for canker soresThe home remedy below is suggested by the U.S. Library of Medicine and can be followed three or four times a day:
So-called alternative therapies may also be worth trying. A review of the management of canker sores written for the journal American Family Physician, listed a number of options, although it noted that there had been no randomized controlled trials to properly test safety and efficacy:
Prescription therapies for canker soresShare on PinterestA doctor may prescribe antibiotics to minimise inflammatory irritation.More severe or persistent cases of canker sores need to be checked by a doctor to rule out associated conditions or to access prescription treatments. Again, any treatments aimed at the ulcers themselves are not certain to change their course, but can ease the symptoms. Antibiotics may be prescribed to minimize inflammatory irritation whether or not a bacterial infection is present. Anesthetics, as well as being available in consumer products for canker sores, may also be prescribed as topical preparations to ease irritation and pain. Some medicines designed for other conditions can sometimes be used. The American Academy of Oral & Maxillofacial Pathology, for example, cites an association between recurrent cases of canker sores and an overactive immune system, so topical immunosuppressant medications may help, such as locally applied cortisone. With a similar mode of action, topical corticosteroids are often considered by doctors; these include clobetasol ointment, dexamethasone rinse, and fluocinonide gel (Lidex). One possible side effect of using corticosteroids against canker sores is a fungal infection in the mouth. Particularly severe or recurrent cases of canker sores may be referred to an oral specialist who might consider systemic rather than locally applied (topical) drugs. These specialists may also be needed to make a more specific diagnosis – some rare cases of recurrent canker sores are diagnosed as Sutton disease, for example. The question of what can be done to prevent canker sores in the first place has no clear answer. However, there are ways to prevent canker sores from getting or feeling worse. Prevent aggravation of canker sores by avoiding:
How do you get rid of canker sores in the mouth?Rinse your mouth.
Use salt water or baking soda rinse (dissolve 1 teaspoon of baking soda in 1/2 cup warm water). Dab a small amount of milk of magnesia on your canker sore a few times a day. Avoid abrasive, acidic or spicy foods that can cause further irritation and pain.
Is a canker sore contagious?Aside from the annoying pain in the mouth, you'll generally feel OK. Canker sores are not contagious like some other mouth sores, such as cold sores. You can't get canker sores by sharing food or kissing someone.
How long do canker sores last?Treatment usually isn't necessary for minor canker sores, which tend to clear on their own in a week or two. But large, persistent or unusually painful sores often need medical care.
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