What are Canker Sores? Symptoms, Causes, and Effective Treatment Methods

Canker sores, also known as aphthous ulcers, are painful lesions that appear inside the mouth on the lips, cheeks, gums, and tongue. They can be small, round or oval, and white or yellow in color. Canker sores usually heal on their own within 1-2 weeks, but they cause discomfort while eating, speaking, or moving the mouth during this process. A weakened immune system, vitamin and mineral deficiencies, stress, hormonal changes, and oral trauma can lead to the emergence of canker sores. Additionally, acidic foods, certain other foods, and allergic reactions can also influence the formation of canker sores. Canker sores are not contagious and usually heal on their own under medical supervision, but if they recur very frequently, there may be an underlying health issue. For treatment, antiseptic mouthwashes, pain-relieving gels, or other medications recommended by a doctor can be used.

What is a Canker Sore?

A canker sore is a painful, open wound in the mouth. It can appear white or yellow. It is surrounded by a bright red area. They are usually very small, but in some cases, their diameter can increase. They can form on the tongue, gums, palate, inside the lips, or under the tongue. These sores are mostly painful and can make eating and speaking uncomfortable. Simple canker sores can appear three or four times a year and symptoms can last up to a week. Complex canker sores are less common and are frequently seen in individuals who have had canker sores before.

What Are the Symptoms of Canker Sores?

A tingling or burning sensation may be felt in the area where the discomfort is located one or two days before the canker sore becomes apparent. Some of the symptoms of canker sores are:

Painful sore: The most prominent symptom of a canker sore is a small but very painful sore inside the mouth, which is white-yellow in color and surrounded by a red ring. Pain may increase when this area is touched while eating, speaking, or brushing teeth. The pain continues until the beginning of the healing process of the canker sore, and this process can usually take longer than a week.

Burning and stinging sensation: This sensation usually signals the area where the canker sore will appear. After the canker sore appears, the burning sensation may continue and may become more severe, especially when it comes into contact with acidic or spicy foods. The burning and stinging sensation is one of the most troublesome symptoms of a canker sore and can affect daily activities.

Swelling and redness: Slight swelling and redness can be observed around the area where the canker sore is located. This swelling causes sensitivity when touched. The sore may look as if it is infected, but canker sores are usually not caused by infection.

Difficulty in eating and speaking: The pain and sensitivity caused by the canker sore can cause serious discomfort while eating or speaking. Especially when hard or acidic foods are consumed, the canker sore area becomes irritated and the pain increases. During speech, the tongue, lip, or inside of the cheek may touch the sore, which causes difficulty in speaking. Eating difficulties can also negatively affect a person's nutritional habits.

In severe cases of canker sores, the following symptoms may also be seen:

Fever: In severe cases of canker sores, fever can rarely be seen. This situation may indicate that the body is fighting an infection or that the immune system is overreacting. It usually occurs in cases where canker sores are widespread. The presence of fever can affect the body's general health status and cause a feeling of fatigue.

Physical numbness: In cases where canker sores are severe, especially in areas where pain is widespread, a feeling of numbness may be experienced. This numbness may be caused by the irritation of the nerves inside the mouth.

Swollen lymph nodes: In severe cases of canker sores, the lymph nodes located under the chin and in the neck area may swell. Swelling of the lymph nodes is a natural defense mechanism that the body provides against infection or immune response.

What Causes Canker Sores?

The exact cause of canker sores is currently unknown, but some risk factors that can be effective in the occurrence of the disease are:

Weakness of the immune system: When the immune system is weakened, the body's defense against infections decreases, which can make it easier for canker sores to appear. While the immune system protects the body from germs, it can sometimes give a wrong reaction against cells inside the mouth. This situation can cause the formation of small sores that manifest themselves as canker sores in the mouth.

Vitamin and mineral deficiencies: Deficiency of important vitamins and minerals such as iron, vitamin B12, and folic acid can trigger the formation of canker sores. In case of deficiency, the oral mucosa weakens and sores begin to form.

Stress and hormonal changes: Especially during periods of intense stress, the body's resistance drops, which causes sensitive tissues inside the mouth to be damaged more easily. Hormonal changes can increase the risk of canker sores, especially in women during periods such as the menstrual cycle or pregnancy.

Oral trauma: Accidentally biting the cheek or tongue, brushing too hard with a toothbrush, or irritation caused by dentures can lead to oral trauma. Since oral tissue is sensitive, minor injuries can quickly turn into canker sores. Especially areas such as the inside of the lips or the inside of the cheeks can frequently face canker sores due to such trauma.

Acidic and spicy foods: Acidic foods such as citrus fruits and spicy foods can irritate sensitive tissues inside the mouth and trigger the formation of canker sores. Consuming these foods in the presence of canker sores can delay the healing of the sore and increase the pain.

Allergic reactions: Allergic reactions to certain foods and chemical substances can also lead to the formation of canker sores. Especially some allergies, such as gluten sensitivity, can manifest themselves in the form of sores and inflammation in the mouth. Chemicals found in toothpastes and oral care products can also cause allergic reactions.

How is a Canker Sore Diagnosed?

Diagnosis of a canker sore is usually made with a simple examination, but further examinations may be needed in severe and recurrent cases. The doctor first investigates the possible causes of the canker sore by taking the patient's medical history. In recurrent canker sore cases, the conditions of factors such as vitamin and mineral deficiencies, stress, and immune system disorders are examined. Following the patient's anamnesis, a physical examination is performed. The doctor carefully examines the inside of the mouth to evaluate the size, shape, and location of the canker sore. White or yellow sores, which are typical symptoms of a canker sore, and the red rings around them are observed by the doctor. In addition to the physical examination, the doctor may request blood tests in recurrent or severe canker sore cases. Also, in some cases, if it is thought that the canker sores may be caused by food allergies or allergic reactions to chemical substances, the doctor may request allergy tests. In very rare cases, especially if the canker sore is constantly growing or not healing, the doctor may recommend a biopsy. This method is used to determine whether there is a serious underlying disease behind the canker sore.

How is a Canker Sore Treated?

For small canker sores, they usually heal on their own within one or two weeks under doctor supervision. However, for large, persistent, or unusually painful sores, the doctor may recommend medical intervention. Some of the canker sore treatment methods are:

Topical creams and gels: One of the most common methods used in the treatment of canker sores is topical creams and gels applied directly to mouth sores under doctor supervision. These products relieve pain and accelerate healing by covering the sore. Creams containing corticosteroids can help relieve symptoms by reducing the inflammation of the canker sore. When applied regularly to the canker sore, these creams can ensure that the sore heals faster.

Mouth rinse solutions: These solutions can support healing by cleaning the sores inside the mouth. Antiseptic mouthwash solutions can prevent infections by killing bacteria in the mouth and can relieve the pain caused by the canker sore. Especially in painful and widespread canker sores, rinse solutions can offer effective support during the treatment process.

B12 and iron supplements: In cases where canker sores occur due to vitamin and mineral deficiencies, the doctor may recommend dietary changes and mineral and vitamin supplements. Eliminating vitamin and mineral deficiencies can prevent the recurrence of canker sores and helps protect oral health.

Nutritional habits: Since acidic and spicy foods can trigger the formation of canker sores, such foods are limited in the treatment of canker sores. It is recommended that people with canker sores consume softer and non-irritating foods. Increasing fluid intake also helps the healing of canker sores by maintaining the moisture balance inside the mouth.

Laser treatment: In advanced cases and especially in frequently recurring canker sores, laser treatment can be applied. Laser treatment can be performed with a simple procedure that lasts a few minutes depending on the size of the canker sore. This method offers an effective solution, especially in severe cases that do not respond to other treatment methods.

Frequently Asked Questions

A canker sore is mostly not a dangerous condition and heals on its own within a few days under doctor supervision. However, constantly recurring or large-sized canker sores can be a sign of different underlying health problems in the body. Many factors can cause the formation of canker sores. A weakened immune system, stress, nutritional deficiencies, oral trauma, and acidic foods are some of the main reasons that trigger the formation of canker sores. Canker sores usually heal on their own under doctor supervision within 7-10 days. While small canker sores disappear during this period, larger and more severe ones can take a few weeks. The healing time may vary depending on the person's immune system, nutritional status, and stress level. Putting salt on a canker sore is generally not recommended as a treatment method. Salt can cause an intense burning sensation and pain on the canker sore. Instead, keeping the inside of the mouth clean and using antiseptic mouthwashes with doctor's recommendation is a more effective and soothing method. Stress is one of the common factors that trigger the formation of canker sores. When the body is under stress, the immune system weakens, and this leads to damage to sensitive tissues inside the mouth. Frequently recurring canker sores can be a sign of some serious diseases. Especially immune system disorders such as Behçet's disease, Crohn's disease, celiac disease, and lupus can cause canker sores. Also, nutritional disorders such as vitamin B12 deficiency or iron deficiency anemia can lead to the formation of canker sores in the mouth. Recurrent canker sores are usually caused by immune system problems or vitamin deficiencies. Stress, malnutrition, allergic reactions, oral trauma, and hormonal changes can also cause canker sores to recur constantly. For canker sore complaints, one usually applies to a dentist or an ear, nose, and throat specialist. Specialist doctors can evaluate the condition of the canker sore inside the mouth and start the correct diagnosis and treatment process.

Canker sores can appear under the influence of factors such as oral injuries, stress, and immune system disorders and can lead to serious discomfort in daily life. If you are experiencing similar symptoms, you can make an appointment with our specialist physicians by contacting Hisar Hospital Intercontinental's Oral and Dental Health or Ear, Nose, and Throat clinics and start your personalized treatment process.