FACTS ABOUT Canker Sores
Aphthous stomatitis or as it`s named in non-scientific world – canker sore are small craters on the inner surface of the oral cavity. Canker sores usually occur on the moving parts of the mouth. Ulcers can occur for several reasons. Treatment of canker sores depends on the cause of its occurrence. It`s neither healthy nor esthetical to have these kinds of sores. Moreover, they do not pose any death threat to a general health of a patient. Nevertheless, it does not mean that they have to be left unnoticed and untreated.
What is aphthous stomatitis?
Aphthous stomatitis is a small ulcer crater on the inner surface of the mouth, which are often painful. Canker sores are very common. About 20% of the population pf the Earth had canker sores at least once in life. Aphthous stomatitis is also known in medicine as a gangrenous ulcer.
Unfortunately, women suffer from the canker sores more than men. The chance of the occurrence of aphthous stomatitis is higher in puberty period. Genetic studies show that if parents suffered from the canker sore, then their kids are more prone to get the same problems, as the chances of occurrence depend on genetics. This partially explains why family members have the same problem.
Aphthous stomatitis is usually divided into three groups, depending on the size.
- Small ulcers have a diameter from one millimeter to ten millimeters. They are most common (80% of all gangrenous sores) and usually last for seven to ten days.
- Large ulcers (10% of all gangrenous ulcers) have a diameter greater than 10 millimeters and treatment can take from ten to thirty days. The patient may have a scar after the treatment.
- Herpes-like ulcers (10% of all ulcers) it`s formed of a group of multiple small individual sores (less than three millimeters). They usually heal within seven to ten days.
What are the symptoms of canker sores?
Aphthous stomatitis usually appears on the movable parts of the mouth such as the tongue or the inside surface of the lips and cheeks, and at the base of the gums. Ulcers appear first as small oval or round reddish tumors that usually appear during the day. It`s a ruptured ulcer covered with a thin white or yellow membrane and surrounded by the edge of the red circle. In general, the ulcer heals within two weeks without forming scars. Fever is rare, and canker sores are rarely associated with other diseases. A person usually gets more than one ulcer at one time.
In most cases, canker sores appear in the age range between ten and twenty. Two years’ children also have a possibility to get canker sores. Often the re-emergence of canker sores varies considerably. In some people, it appears once or twice a year, while in othersaphthous stomatitis may occur constantly.
What are the causes of occurrence canker sores?
The cause of canker sores is not entirely understood. Usually, there are several reasons, even for one individual patient. Aphthous stomatitis does not seem to appear due to viruses or bacteria, although an allergy to a type of bacteria can serve as one of the factors of their appearance in some people. Ulcers may be an allergic reaction to certain foods. Furthermore, there is a study which suggests thatcanker sores may be caused by the damaged immune system that uses the body protective mechanisms against disease to attack and destroys normal cells of the mouth or tongue.
British studies show that 20 percent of patients have aphthous stomatitis partly because of the lack of nutrition, especially lack of vitamin B12, folic acid, and iron. Similar studies in the United States have confirmed this finding. In a small percentage of patients, aphthous stomatitis occurs with gastrointestinal problems, such as the inability to digest certain cereals. These patients` canker sores appear to part of the common disorders of the digestive tract. Lack of vitamin C is also associated with aphthous stomatitis.
Emotional stress and local trauma or damage to the mouth, caused by sharp metal braces, cleaning brushes and drinking hot foods can lead to canker sores. Smoking and dentures can also exacerbate the problem. Some studies have shown an association of the disease with toothpaste containing sodium lauryl sulfate. Nevertheless, other studies have shown that there is no connection with sodium lauryl sulfate and canker sores.
Other possible causes of canker sores include diseases in which the immune system causes swelling or inflammation of the body tissue. Examples of autoimmune disorders – it is systemic lupus erythematosus, Crohn’s disease, and Behcet’s disease.
Female sex hormones are also likely to play a role in the appearance of canker sores. Many women can have flash ulcers during certain phases of the menstrual cycle. Also, most women experience an improvement or remission of canker sores during pregnancy. Researchers have successfully used hormone therapy in clinical trials for the treatment of aphthous stomatitis of some women.
Aphthous stomatitis – it’s the same thing as herpes?
The simple answer is – no. Aphthous stomatitis usually appears inside the mouth, and it is not contagious. Herpes sores often appear on the lips and outside of the mouth, and they are highly contagious. Herpes sores or herpes simplex is an infection caused by the herpes virus.
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What steps in the treatment of canker sores can be done?
If you have canker sores:
- Avoid rough foods such as chips, which can become lodged in the cheek or gingiva and make the ulcer deeper;
- Gently brush your teeth so that you wouldn`t pierce the gums or cheek with a toothbrush;
- Avoid acidic or spicy foods;
- Aphthous stomatitis is not contagious, so patients do not have to worry about the transfer of ulcers to other people;
- Some patients may benefit from a toothpaste without sodium lauryl sulfate and other ingredients that irritate tissue of the mouth, as well as toothpaste, which retards the growth of plaque irritant. Therefore, something as simple as changing the toothpaste can help with frequently appearing of aphthous stomatitis
How to treat canker sores or aphthous stomatitis?
Aphthous stomatitis usually resolves without specific treatment. But you can take steps to ease the pain and discomfort, and expedite treatment. Treatments include topical medicaments, mouthwash, and oral medications.
What medical products can help with canker sores?
Medications include topical ointments, which cause numbing, such as benzocaine, which are sold without a prescription from pharmacies. The ointment should be applied several times a day directly on the ulcer to reduce irritation from eating, drinking or brushing. 2% lidocaine gel effectively used by some patients, but it may have toxic effects, particularly witnessed in children. In very painful cases, injection of anesthetic can effectively help relieve symptoms, but it is usually temporary. Nevertheless, in April 2011, the Food and Drug Administration (USA) issued a warning on the link between benzocaine and methemoglobinemia. It`s a rare but dangerous condition in which oxygen is hampered in delivery to the tissues. Due to this connection, the Food and Drug Administration states that benzocaine products should not be used by children who are less than two years old, except in cases when it`s needed by a doctor’s recommendation and under the supervision of a specialist. Later, the adults who use benzocaine gels or liquids to relieve pain in the mouth, are to follow the recommendations on the product label. Products that contain benzocaine should be kept out of reach of children, and by the Food and Drug Administration recommendation the customers should consult with their doctors about using benzocaine.
Anti-inflammatory gels may also be used locally to decrease inflammation. These products are available on prescription from a physician or dentist. The main ingredient in these drugs is usually – an anti-inflammatory corticosteroid or triamcinolone. Antibiotics may also be recommended by your doctor.
Can mouthwashes be used to treat canker sores?
Yes, there are several options of mouthwashes that you can use. One type of option of getting rid of aphthous stomatitis is a suspension of diphenhydramine. This liquid drug can be used as rinses for adults to temporarily relieve the pain of aphthous stomatitis. Patients should not swallow diphenhydramine, and just use it as mouthwash. It is usually available without a prescription.
Further, the steroidal anti-inflammatory drugs for mouthwash may be prescribed for patients who have severe ulceration. Steroid rinses are proven to reduce inflammation and the number of re-occurrence causes of ulcers and are used only in more severe cases because of possible side effects. These potent drugs can cause unwanted side effects, and should be used only under the close supervision of a dentist or physician.
There are several types of mouthwash containing the antibiotic tetracycline, which can reduce the undesirable symptoms ofaphthous stomatitis and accelerate the treatment, preventing bacterial infection in wounds. Clinical studies conducted by the National Institute of Dental Research of the USA showed that tetracycline mouthwash applied several times a day usually relieves pain in the mouth for 24 hours and gives a complete healing over a period of five to seven days. Management on sanitary inspection of the Food and Drug Administration (USA) warns that pregnant women and young children should avoid using tetracycline, as it can cause permanent stains on teeth.
The treatment with steroids and using tetracycline requires a doctor’s prescription and supervision of a dentist or physician.
Which oral medications help to cure canker sores?
Oral painkillers, such as ibuprofen or acetaminophen can be taken to relieve pain if the ulcer is unbearable. Some patients may bring relief by sucking zinc tablets or use a complex of vitamins B and C.
There is no evidence that antibiotics, which are taken by medication way may help. If the aphthous stomatitis caused by thrush, the antifungal drug can be used in this situation. Thalidomide helps people with AIDS who have resurfaced aphthous stomatitis. This medicine may be used in the treatment of severe aphthous stomatitis which is not associated with AIDS. Thalidomide is used in very serious birth defects and, therefore, its use is very limited.
Patients who often have severe and incurable aphthous stomatitis may also need to take steroids or other immunosuppressive agents medication, but they are associated with serious side effects if taken for a long time, and their use should be carefully monitored by a doctor who prescribed them.
In other cases, if it`s the alleged cause of another disease, such as lupus, then the treatment of the underlying disease often affects the healing of ulcers. Vitamins and other food supplements often prevent re-occurrence of canker sores or reduce the severity of them in patients with malnutrition. A lysine is a good option for a preventive measure. It is available without the prescription. Patients allergic to any food can reduce the frequency of appearance of canker sores, avoiding this kind of products.
What do I do if aphthous stomatitis often appears in my life?
Contact your specialist for health care. Most cases of aphthous stomatitis do not reflect the underlying disease. Whatever it was, ifaphthous stomatitis frequently appears in your life, your specialist for health can take advantage of a medical history and conduct tests to order to convince you that there is no serious cause of the horrible disease. Certain diseases are sometimes associated with recurrent ofaphthous stomatitis. Examples include Crohn’s disease, celiac disease, Behcet’s disease, lupus or AIDS. It should be noted that these are complex diseases, and aphthous stomatitis may only be part of the disease and not the only sign of disease. Aphthous stomatitis may not appear at all in some people who have these diseases.
Most doctors also advise patients who often have flash aphthous stomatitis, to donate blood and test it for allergy to determine whether they are caused by ulcers, malnutrition or any other preventable cause.
What research were conducted in canker sores sphere?
Researchers try to determine a malfunction of the immune system of the patient, due to which they are subject to repeated outbreaks ofcanker sores. Through blood analysis of people with aphthous stomatitis, and without it, the scientists found few differences in the immune systems of two groups. Make these differences cause aphthous stomatitis or not is still unknown, and probably, more research should be conducted?
Researchers also develop and test new drugs created to treat recurrent aphthous stomatitis in patients with a possible origin of the disease on the immune system. Most of these drugs change the function of the immune system of the patient. Although some drugs appear to be effective in the treatment of canker sores in some patients, the information is still inconclusive. While there is no proof of perfect safety and efficacy of these drugs, they will not be available for general use.
One of the new drugs that have been tested is called amlexanox. It is anti-inflammatory and anti-allergic medicine. It has shown success in treating the symptoms of canker sores and the disease itself.
Scientists have studied More invasive options for the treatment of canker sores, but today they are somewhat limited, inconsistent and impractical. These options include laser therapy, ultrasound of low intensity, and silver nitrate removal surgically. Before these options can be recommended for the treatment of canker sores, more research should be conducted.