Canker Sores

Summer Skin Hazards Slideshow

• Canker Sore Overview
• Canker Sore Causes
• Canker Sore Symptoms
• When to Seek Medical Care
• Exams and Tests
• Canker Sore Treatment
• Self-Care at Home
• Medical Treatment
• Next Steps
• Prevention
• Outlook
• Multimedia
• Synonyms and Keywords
• Authors and Editors
• Related canker sores articles:
  Canker sores - on WebMD
  Canker sores - on MedicineNet

Canker Sore Overview

Canker sores, also known as aphthous stomatitis, are among the most common causes of painful sores in the mouth.

• From 20%-40% of the U.S. population have them at some point in their lives.
  
  
• The peak incidence occurs among people in adolescence and young adulthood. They become less frequent as we get older.
  
  
• They are not contagious.
  
  
• Canker sores are not the same thing as cold sores. Cold sores ("fever blisters") occur on the outer lip, whereas canker sores are found inside the mouth.

Canker Sore Causes

No one knows what causes canker sores. The vast majority of people who develop canker sores do not have another problem as the cause.

• The disease is suspected to result from a reaction of the immune system.
  
  
• Additional causative factors may include the following:
  
  
  • bacterial infections
    
    
  • hormonal disorders
    
    
  • stress
    
    
  • trauma
    
    
  • heredity
    
    
  • drugs (including anti-inflammatory drugs, such as ibuprofen, and beta-blockers, such as atenolol)
    
    
  • food allergies or sensitivities (chocolate, tomatoes, nuts, and acidic foods such as pineapple)
    
    
  • toothpastes containing sodium lauryl sulfate
    
    
  • deficiencies of iron, folic acid, or vitamin B12

• Some studies have suggested an association with Helicobacter pylori, the same bacteria that cause peptic ulcers.

• Recurrent canker sores have been associated with inflammatory bowel diseases, such as Crohn disease and ulcerative colitis. In these cases, the development of canker sores may signal a flare-up of the bowel disease.
  
  
• Celiac, or abdominal, sprue, a disease of the intestines caused by sensitivity to gluten, causes malabsorption and is associated with development of canker sores. Gluten refers to a group of proteins found in wheat, barley, and rye.
  
  
• Behçet disease is a condition characterized by canker sores, genital sores that resemble canker sores, and inflammation of the eye.
  
  
• Infection with the AIDS virus also has been associated with canker sores.
  
  
• It is a common misconception that canker sores are a form of herpes infection. This is not the case.

Canker Sore Symptoms

Canker sores occur in several forms. They can involve any area of the mouth except for the gums, lips, and hard palate.

• Minor canker sores (which account for the majority of aphthous ulcers) are oval and less than 10 mm (1/3 inch) across. Most are 2-3 mm with a white center. They are painful but clear up within three to 14 days without scarring. It is unusual for them to become infected.
  
  
• Major canker sores consist of deep ulcers measuring greater than 1 cm (1/3 inch). These ulcers, which are very painful, have irregular margins and often last for three to six weeks. They tend to heal with extensive scarring.
  
  
• A third form of canker sores, termed "herpetiform," resemble herpes infections and consist of many small shallow punched-out lesions, pinhead-sized (1-3 mm) in diameter, or less than one-tenth of an inch. Clusters of these sores may merge together to form large irregular ulcers. They last from seven to 10 days.
  
  
• Canker sores commonly come back. Some people have a few outbreaks a year, while others can have them almost all the time.