Canker sores or apthous ulcers occur quite commonly. These are very painful ulcers that occur in the mouth specifically in areas that are not bound firmly to the underlying tissues. As a result, we see them on the cheeks, the soft palate, underneath the tongue, the floor of the mouth and on the gums. They appear suddenly as white or pink ulcers surrounded by a halo of red, inflamed tissue that will generally heal on their own in about 14 days.
The cause for these ulcers is unknown. It is thought that they are a result of an exaggerated immune response to a local irritant.
There can be many triggers to this reaction and if you are prone to getting them, it may be difficult to pinpoint the cause. Citrus fruits such as oranges and lemons, physical trauma, stress, lack of sleep, sudden weight loss, hormonal changes, food allergies (e.g. dairy, glutens, chocolate, nuts, cinnamon, spices, and preservatives) and disorders that depress the immune system are thought to contribute to aphthous formation. Deficiencies in iron, vitamin B12, folic acid, and possibly zinc appear to be associated with chronic aphthous ulcers.
Minor injuries to the mouth can also trigger these ulcers. Examples include a burn from hot coffee or pizza or a cut from hard crusty breads.
The key to controlling the occurrence of ulcers is to recognize what your particular trigger might be. This may involve keeping track of what you eat on a daily basis and eliminating foods that are commonly triggers.
Once you have an ulcer, the treatment is primarily to treat the symptoms until the ulcer heals. Your dentist or physician can prescribe a corticosteroid cream that is formulated to be used in the mouth, which can reduce the pain and help the ulcer heal quicker.
If you tend to get very large ulcers on a very frequent basis this could be indicative of an underlying condition such as an immune problem, or an underlying chronic illness such as Behçet’s, Crohn’s or celiac disease. If this is the case, then a consult with your physician is highly recommended.