Canker sores(Apthous ulcers),Mouth ulcers(Cold sores)

Canker sores are a type of mouth ulcer. Some of the medical terms used to refer to canker sores are "recurrent minor aphthous ulcers" and "recurrent minor aphthous stomatitis" (thus differentiating canker sores from other forms of aphthous ulcers or aphthous stomatitis). Canker sores are the most commonly occurring type of mouth ulcer.What causes canker sores?The precise mechanism by which canker sores form has not been definitively determined but it is likely that their development is related to a reaction of an individual's own immune system.Canker sores are thought to form when, for unexplained reasons, a person's immune system identifies the presence of chemical molecules that it does not recognize. The presence of these molecules activates an attack by the immune system's lymphocytes (a type of white blood cell), somewhat similar as when a person's immune system attacks a transplanted organ. The carnage created by the lymphocytes' attack on these unrecognized molecules results in the formation of mouth ulcers. We term these ulcers canker sores.

What triggers outbreaks of canker sores? Several factors that seem to be triggers for outbreaks of canker sores have been identified. Any one or a combination of the following items may play a role in the formation of canker sores for any one individual:Toothpastes and mouthwashes that contain sodium lauryl sulfate.Research has suggested that the use of products that contain sodium lauryl sulfate ("SLS"), a foaming agent found in most toothpaste and mouthwash formulations, can be associated with an increased recurrence rate of canker sores for an individual. There are SLS-free toothpastes on the market, especially at Health Stores but now traditional Pharmacy stores are starting to carry them. Mechanical trauma.People state that they often recall some sort of physical trauma preceding the formation of their canker sores. This trauma might take the form of a self-inflicted bite, irritation from a sharp tooth edge, or possibly trauma from some type of food such as a crisp chip. Emotional stress /Psychological stress has been shown to adversely affect the health of people in a number of ways. Many people who suffer from canker sores report that the appearances of their ulcers coincide with periods of stress. Nutritional deficiencies. Some of the nutritional deficiencies that have been correlated with the presence of canker sores are:Vitamin deficiencies: B1, B2, B6, B12, C other nutrients: zinc, folic acid, iron, selenium, calcium Allergies and sensitivities. Allergies to foods and other substances have been postulated as being triggers for canker sore breakouts. Some of the substances identified by researchers as being potential triggers for canker sore outbreaks are:Cereal grains: buckwheat, wheat, oats, rye, barley, the gluten protein found in grainsFruits and vegetables: lemons, oranges, pineapples, apples, figs, tomatoes, strawberriesDairy: milk, cheeses Other foods: nuts, chocolate, shellfish, soy, vinegar, French mustard Additives: cinnamonaldehyde (a flavoring agent), benzoic acid (a preservative)Other substances: toothpastes, mints, gums, dental materials, metals, medicationsHormonal changes. Some women have reported that they find a relationship between the presence of canker sores and certain phases of their menstrual period. It has also been reported that a woman may notice a remission of canker sores during pregnancy. One study found that 35% of those persons who experience canker sores have at least one parent who suffers from these ulcers also. Another study found that 91% of identical twins both suffered from canker sores whereas only 57% of fraternal twins did.Infectious agents (both bacterial and viral).The fact that chemical compounds typically associated with bacterial and viral infections have been isolated from canker sores suggests that bacteria or viruses could be causative agents in the formation of these mouth ulcers.Medical conditions.Several different medical conditions can be associated with the presence of canker sores (and other forms of aphthous ulcers as well). For those patients who experience persistent difficulties with canker sores consideration must be given to the presence of an underlying undiagnosed systemic disease and the need for an evaluation and testing by a physician.A few of the medical conditions that have been associated with the presence of mouth ulcers are: Behcet's disease, neutrophil dysfunction diseases, inflammatory bowel diseases (celiac and Crohn's), and HIV-AIDS. Medications.The use of nonsteroidal anti-inflammatory drugs (NSAIDs), beta blockers, chemotherapeutic agents, and nicorandil have each been reported as possibly acting as a trigger for outbreaks of canker sores. Prescription MedicationsAntiral agents like Zovirax and Denavir oitments and pills affect the replications of the virus and decrease both the duration and intensity of the cold sore. Over-the-counter Medications1. Virus inhibiting medicationsB products containing docosanol. Place cream repeatedly throughout the day as soon as tingle begins.2. Numbing agentsB benzocaine, camphor, lidocaine, benzyl alcohol, and phenol . Good during the crusting stage.3. Products that limit formation or speed healing. Zinc, lysine, phenol, and tannic acid. 4. Antibacterial agents will not help but can prevent secondary infection from setting in.5. Medications that moisturize and soften. Like lip balms and oitments (petroleum-based, allantoin), especially during crusting stage.6. Sun screens (zinc oxide) help prevent.Home Remedies1. Ice 5-10 minutes during the tingle stage will reduce rate of formation, and lessen the pain.2. Tea bag -moistened few minutes every hour reduces swelling.3. Vaseline helps moisten and prevents craking and bleeding.4. L-lysine reduces outbreaks in some, but not scientifically confirmed.5. Sage and Tea Tree Oil and the herbal sedative Violet seem to help some. Use with caution as always. And finally 6. Avoid certain foods and drinks, sun exposure, injury to lips, and stress.

In the interest of better oral health,

Dr. GJA Belsito BSc,DDS,FAGD,FADI, FACD, Cert. IV sedation / Belsitodental.com

519.258.1240