posted
My wife gets these really bad canker sores a couple times a month. They really hurt, to the point that she can barely stand to brush her teeth, eat, etc. They get kind of red and inflamed around them. She saw a doctor at the student health center for them about a year and a half ago, and she really didn't have any instructive suggestions for her. The doctor suggested that they were maybe an allergic reaction or something and that they were definately not cold sores, but beyond that wasn't very helpful.
There's a walk in physician assistant that she can see here at my job for free. If she is unable to help we'll probably make an appointment with a doctor.
Two questions:
1) Does anyone here know what might cause these canker sores, and how to remedy them? 2) Assuming the PA here can't help her, is there a specialist that she should go to?
Posts: 1412 | Registered: Oct 2005
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posted
Well, there are many causes of mouth ulcers. Sometimes people have them without any identifiable cause. A friend in medschool has them, usually more than one. She's used special toothpaste and some prescription medications that keep them in remission. Other people treat with topical steroids and so on. If she has them regularly she really should see a doctor to work it up. If the PA is no help, then an internist or a dermatologist might be the best.
Here's a general article, it's not particularly great, but demonstrates the many possibilities of diagnosis and treatment, and has a good picture.
The proper name is aphthous ulcer, if you want to do some searching online.
posted
I had trouble with that before my very back teeth came in. The dentist gave me some kind of cream to put on them. But food can definitely make them show up. For me, it's a lot of sweets or (especially) sour candy type things.
Rinsing with Listerine usually helped mine clear up pretty quickly. Has she tried that?
posted
I am prone to horrible ones, and aside from a recent, short-lived bout (during a high-stress period), have not had them for several years. I don't know the causes, but I'm pretty sure that in my case they are aggravated by three things: stress, fatigue, and too much sugar in my diet.
I attribute the improvement in my mouth sores over the past few years mainly to the change in my work circumstances. I sleep better and am much less stressed working from home than I was commuting in to a 9-5 job.
Whether or not there is any research/evidence backing up my particular observations, I can't say.
I never did find a really effective treatment.
Posts: 3149 | Registered: Jul 2005
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posted
Well, she sleeps 8 hours a night, and she brushes, flosses, and uses floride treatment religiously. It could be stress related but she doesn't feel particularly stressed when she gets them. I'm guessing it may be food related, but tracking down what does it won't be easy.
We don't eat much sugar at all- at most we'll go out for ice cream once or twice a week. No soda, candy, snacks, etc. She does chew gum a lot and likes to chew on some mints a few times a day. Is gum or mints a common cause?
I get them if I eat lots of sour candy (or walnuts) too pH. We change types of toothpaste pretty much every time we buy it, but I guess there could be a common ingredient in all of them. Our dental hygenist isn't big on toothpaste anyway-she has us using the SonicCare brushes and recommends little to no toothpaste. Maybe she can try the no toothpaste for a while.
Thanks for the suggestions all. Any more would be appreciated Posts: 1412 | Registered: Oct 2005
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posted
There is an ingredient in most toothpastes that I've heard blamed for flare-ups. It's SLS, which I believe is Sodium Laural Sulfate. Not entirely sure, as it's been awhile since I looked into it. The only toothpaste I've found that doesn't have it is Weleda, which is pretty much only available at natural food co-ops and health food stores. If she's not stressed, gets enough sleep, and has no obvious other triggers, it might be worth a try.
Posts: 7954 | Registered: Mar 2004
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posted
The Wiki article linked above mentions artificial sweetners and SLS (foaming agent in toothpaste) as causes.
It's not easy to find toothpaste w/o SLS, but they do exist in natural food stores. (that was one of the things I tried in my search for relief)
I did find one particular treatment that seemed to make them go away faster, but it wasn't pleasant to use. It's been so long that I don't remember the name; I'll do some googling and if I find it I'll post the link.
Posts: 3149 | Registered: Jul 2005
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posted
OK, I found it, here is the product that was most helpful in speeding healing of my canker sores. Caveat: it hurts like Hades when you first apply it. But if your wife's sores are slow to heal, this might be a boon if she can stand to use as directed.
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posted
I had this same problem every couple months for most of my life. It started to become very irritating. I tried special toothpaste, it didn't work. I researched it, bought stuff on the internet, it didn't work.
So I tried Listerine. However, Listerine won't work well if you follow the instructions and rinse for 30 seconds. If she currently has sores, she needs to rinse morning and night. If she is preventing them, once a day works for me, though I guess this would depend.
The way I rinse is to rinse every section of my mouth until the pain subsides. i.e., I may puff up my left cheek and rinse on the left side of my mouth until the burning stops, then do the right side, then the front of the mouth (with the lips puffed out), then lift your tongue up and rinse under it. She needs to try and get every part of the mouth where this germ may hide. I am not a doctor, so I don't know if the pain is related to how much of this bacteria is present, but it seems like the places that I am most likely to get them hurt the most when using Listerine. So, I make sure all pain is gone in the mouth before I finish rinsing. The more ways you find to stretch your cheeks, lips and tongue while rinsing, the more nooks and crannies the Listerine will be able to get in.
Now I suppose some experts would say you shouldn't rinse with Listerine this long or thoroughly, but when you've had canker sore problems like me, and this prevents them 100%, you don't care. I have been doing this for over a year and the only times I have ever gotten a canker sore are the few days I got lazy and stopped using it. I have never had one while rinsing at least once a day, whereas I always got several sores every month or two without Listerine. So I know this works excellently, at least for me.
It is possible that her sores are a different strain then mine, so Listerine might now work. But I say give it a try doing it the way I do. Keep in mind that if she already has sores, Listerine is not very fast at getting rid of them. It does ease the pain for me (after rinsing that it is), and speed up the healing a little bit. But by and large, canker sores just go away on their own. Once they're gone, though, thank goodness for Listerine! (or any generic brand with the exact same ingredients )
I also tried toothpaste without SLS, and that didn't help, though my gums looked better. SLS does inflame the gums, making them weaker. If the Listerine isn't enough alone, try using it while using non-SLS toothpaste, too. I got lazy and went back to regular toothpaste, since it's cheaper and easier to find, and the Listerine alone works.
There are products, like Uprooted mentioned, that help heal these sores. They do work to some degree, and can ease the pain, so they are a good idea while trying to get rid of a sore. But prevention is the best medicine!
If you have any questions, let me know.
Posts: 684 | Registered: Aug 2001
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quote:Originally posted by BaoQingTian: Well, she sleeps 8 hours a night, and she brushes, flosses, and uses floride treatment religiously. It could be stress related but she doesn't feel particularly stressed when she gets them. I'm guessing it may be food related, but tracking down what does it won't be easy.
We don't eat much sugar at all- at most we'll go out for ice cream once or twice a week. No soda, candy, snacks, etc. She does chew gum a lot and likes to chew on some mints a few times a day. Is gum or mints a common cause?
I get them if I eat lots of sour candy (or walnuts) too pH. We change types of toothpaste pretty much every time we buy it, but I guess there could be a common ingredient in all of them. Our dental hygenist isn't big on toothpaste anyway-she has us using the SonicCare brushes and recommends little to no toothpaste. Maybe she can try the no toothpaste for a while.
Thanks for the suggestions all. Any more would be appreciated
What flavor of gum? Too much cinnamon gum can burn my mouth, I know. And mints that are too harsh could also cause irritation.
posted
pH- Trident gum and she changes mints all the time. She hates cinnamin anything with a passion. From the Wiki article, I'm wondering if any of the artificial sweeteners have anything to do with it.
Marlozhan- We used Listerine ever since we've been married up until 6 months ago. Our dentist recommended using ACT instead because of the floride treatment. I haven't really noticed if the frequency has increased at all since stopping with the Listerine, but perhaps if she uses one in the morning and the other at night?
Unless the PA has anything different to say, I think we may start with trying to change the toothpaste to a non SLS kind and add the Listerine, and then move on to eliminating gum and mints if that doesn't work.
Uprooted- I don't suppose there's anywhere to buy that ora5 locally is there- like a drugstore or something? By the time we get it in the mail, this bout will probably be gone.
Posts: 1412 | Registered: Oct 2005
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posted
Sometimes if I cut the inside of my mouth, or bite my lip, the healing cut will turn into a canker sore. There's medication you can buy that will numb the area of the sore. It's either a cream, or a liquid that you rub on the infected area. I believe the one I use is called Orajel. it doesn't help heal the canker sore, but it will take away the pain. I always find that if you leave the sores alone, they will go away faster.
Posts: 1401 | Registered: Jun 2004
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My best friend uses carmex liberally whenever his canker sores show up. It sooths the pain for him and he keeps applying until they are gone.
From Wikipedia: The exact cause of aphthous ulcers is unknown. In some cases they are thought to be caused by an overreaction by the body's own immune system. Factors that appear to provoke them include stress, fatigue, illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies, and deficiencies in vitamin B12, iron, and folic acid. Some drugs, such as nicorandil, have been linked with mouth ulcers.
Aphthous ulcers are thought to form when the body becomes aware of and attacks chemicals which it does not recognize.[citation needed] The presence of the unrecognized molecules garners a reaction by the lymphocytes, which trigger a reaction that causes the damage of a mouth ulcer.
Trauma to the mouth is a common cause of aphthous ulcers.[citation needed] Physical trauma, such as toothbrush abrasion, poking with sharp food, accidental biting (this can be particularly common with sharp canine teeth), or dental braces can cause mouth ulcers by breaking the mucous membrane. Other factors, such as chemical irritants or thermal injury, may also lead to the development of ulcers. However, in many cases the cause is unknown.
A common cause of aphthous ulcers is gluten intolerance,[citation needed] in which case consumption of wheat, rye, or barley can result in chronic mouth ulcers. If gluten intolerance is the cause, prevention means taking most breads, pastas, cakes, pies, cookies, scones, biscuits, beers, etc. out of the diet and substituting gluten-free varieties where available. Artificial sugars, such as those found in diet cola and sugarless gum, have been reported as causes of apthous ulcers as well. They can also be linked to an increased intake of acids such as ascorbic acid (one form of Vitamin C) or citric acid. In this case the sores disappear after intake decreases (for example, by substituting ascorbate salts for ascorbic acid).
Another possible cause of aphthous ulcers may be opportunistic activity by combinations of otherwise normal bacterial flora, such as aerobic streptococci, Neisseria, Actinomyces, spirochetes, and bacteroides.[1] According to small-scale experiments by at least one patent applicant (Hau, US Patent No. 6,248,718), topical preparations of high doses of penicillin resulted in accelerated healing of mouth ulcers.
Repeat episodes of aphthous ulcers can be indicative of an immunodeficiency, signalling low levels of immunoglobulin in the mucous membrane of the mouth.[citation needed] Certain types of chemotherapy cause mouth ulcers as a side effect.[3] Mouth ulcers may also be symptoms or complications of several diseases listed in the following section. The treatment depends on the believed cause.
A common urban myth is that aphthous ulcers are directly connected to the onset of the herpes simplex virus. In reality, ulcers associated with herpes (or cold sores) are of an entirely different nature from mouth ulcers, which are not contagious.
Sodium lauryl sulfate (SLS) is known to cause canker sores.[citation needed] Using a toothpaste without SLS will speed healing.[citation needed]Nitrites found in many cured and processed meats also are thought to cause canker sores.[citation needed] Elimination of processed meats with nitrites may reduce canker sore prevalence.
Posts: 14316 | Registered: Jul 2005
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posted
I wouldn't put too much stock in the wikipedia article. It does mention that the exact cause is unknown, and that the sores generally heal within a week or two without treatment, which should be kept in mind.
If anyone can find a trigger or treatment that works in their case, that's great, but don't discount the placebo effect, or coincidence. I wouldn't start using poor quality toothpaste, or not eating any leaf vegetables, just because wikipedia mentioned those as possible solutions.
Don't make the cure worse than the problem, especially when it might not even be a cure, as Marlozhan found out that the SLS toothpaste didn't seem to be a factor in treatment.
Posts: 3950 | Registered: Mar 2006
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posted
SLS does not cause canker sores. It only weakens the gums so that they are more susceptible to the canker bacteria. So, using non-SLS toothpaste is not a direct treatment, it just makes your gums a little stronger and may decrease the frequency and intensity of canker sores.
And if you have been using Listerine, keep in mind that a regular rinse, even if you do it twice a day, will not work well unless you are very thorough as I explained. I used to use Listerine a lot when I was younger, and I still always got canker sores because I just rinsed as the bottle directed. It's all about getting every part of the mouth until the tingling stops, which can take 2-5 minutes. It's worth a try.
Posts: 684 | Registered: Aug 2001
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posted
Your going to have a really difficult time avoiding SLS altogether, since its in nearly every soap too. (Thats why its in the toothpaste.) Generally with some closely related compounds as well.
Posts: 1621 | Registered: Oct 2001
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My Dad had canker sores like mad (one the size of his whole tounge) when I was a child. He told me they were caused by a virus. He was also in Vietnam and was sprayed with Agent Orange, and after that is when they started getting really bad. They have since faded and are not nearly so bad today.
I used to get them all the time when I was younger too, but I haven't had one in years. Whenever I brushed too hard or cut my mouth in any way it would turn into a canker sore.
Posts: 4953 | Registered: Jan 2004
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quote:Originally posted by HollowEarth: Your going to have a really difficult time avoiding SLS altogether, since its in nearly every soap too.
Yeah, but you generally don't put soap in your mouth.
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Mighty Cow, what makes you think toothpaste without SLS is poor quality toothpaste? All SLS is is a foaming agent, it doesn't do anything to clean your teeth. I like Weleda, and think it works better than most other brands. I don't always use it, because I have to go out of my way to get it and I'm lazy. It's one potential drawback is that it doesn't contain floride, but if you're using a floride rinse that shouldn't matter. (I switched from Listerine to ACT on the advice of my dentist. I have touchy gums, and my dentist said Listerine would make them worse because the alcohol dries them out. I don't get canker sores, but my gums seem healthier in general with the Weleda and ACT.)
Posts: 7954 | Registered: Mar 2004
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posted
ElJay, the floride was my main reason for concern. Many natural toothpastes do not contain floride, or have poor quality floride, for lack of a better way to describe it. The floride in modern, big-brand toothpaste is the main reason to use it; otherwise baking soda is just as good for tooth cleaning.
Posts: 3950 | Registered: Mar 2006
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It works wonders, doesn't burn, and really helped my mouth sores when I went through chemo. There is a prescription strength oral pain reliever "Gel-Kote" or something like that, which they prescribed but I don't think it really helped all that much. The Biotene, though - it was really helpful.
Posts: 14428 | Registered: Aug 2001
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posted
BaoQingTian-If you find out the underlying cause of your wife's canker sores, let me know. I get horrible ones several times a month. Sometimes they seem to arise from a cut, but other times I have no clue what is causing them. Often, I get more than one that covers a large area and it becomes so red and inflammed that eating and brushing my teeth become very painful. I brush and floss(usually) and even use listerine on occasion and it doesn't seem to do anything. Usually, they last for at least a week too.
I have asked my dentist before and the only advice they ever give me is to use Gly-Oxide which is an antiseptic oral cleaner that is supposed to make it go away sooner and/or to use Anebesol(liquid form is easiest) to help take away some of the pain associated with eating anything. For me, Gly-Oxide doesn't seem to make it go away faster, but I do think it helps the painful part to not last quite as long. Anebesol works for me for pain because it basically just numbs the area. I usually use it before I eat so it isn't as painful. Hopefully it helps your wife a little. If you find anything else that helps...let me know.
Posts: 306 | Registered: Jun 2003
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posted
I've gotten these frequently my whole adult life. If I get bumped in the mouth at all, I get one or more. Gotta quit headbutting with my daughter... LOL.
Anyway, here is a home remedy that I've used since I was a teen-ager. No assurances it works, but...
I keep a bottle of Alum in our spice cabinet. It used in pickling. Its a white rock like substance (looks slightly bigger than a grain of salt). I simply wet my finger, dip it in the Alum, apply to sore in mouth. It hurts like crazy for the first minute. And you have to keep it on there for a minute or two. Then spit and rinse.
When I do this, my sore is usually gone within 48 hours.
Take it for what its worth.
Posts: 176 | Registered: Sep 2006
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posted
My great-aunt (who was in her 90s when she told me this) used to swear by drinking buttermilk any time she got a canker sore, and she said it cleared it right up. I have no idea why she would think that would work, and I hate buttermilk enough I would rather have the canker sore -- but hey - apparently it was some old folk remedy she knew from growing up in the pioneer days.
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