Canker sores are ulcers that appear inside the mouth. They are often felt and seen in the inside of the cheeks, the gums and other soft tissues. The medical term for canker sores is "apthous ulcers." These ulcers do not appear outside of the mouth area like cold sores do and they cannot be passed from person to person. These ulcers are usually only temporary and will heal on their own over time.

Most canker sores are mild and have a very small oval shape. There may be mild pain or tingling, but they usually do not interfere with eating or drinking and heal within one or two weeks on their own. If you develop a major canker sore the impression may be large and deep in the tissues. Major canker sores have borders that are oddly shaped and can take up to six weeks to heal. You may even notice a scar in your mouth. These may cause significant pain and they may interfere with eating and drinking. Later in life, you can develop what is known as herpetiform canker sores that tend to cluster in groups of 10 to 100 small pin sized holes. The borders are oddly shaped, but these also heal in a shorter time up to 2 weeks. They usually do not leave scars and the pain can be from mild to moderate. They may interfere with eating or drinking depending on the amount of sores present.

Causes of Canker Sores

Researchers do not completely understand what causes canker sores. There are some conditions that canker sores are more commonly seen when people: brush their teeth to roughly, eat acidic or spicy foods, use toothpaste that contains the chemical sodium lauryl sulfate, or from mouth injuries. Less commonly they are associated with internal conditions such as, food allergies to nuts, acidic foods, berries and chocolate. Other conditions that can cause canker sores are: vitamin B12 deficiency, autoimmune diseases (Lupus, Behcet's disease, Crohn's disease, etc.), AIDS and Celiac disease. There is also an increased genetic risk of these ulcers if others in your family get them.

Canker Sore Remedies

1. Home Remedies and Lifestyle for Canker Sore

• Take Pain Relievers. Try taking an over-the-counter pain medication that contains ingredients such as, aspirin, acetaminophen or ibuprofen. Make sure you take it prior to eating to help relieve pain.
• Rinse Your Mouth. Make your own special mouthwash and rinse gently. To make mouthwash for canker sores mix the following: you use sea salt or 1 Tsp. Baking soda to ½ c. tepid water to rinse.
• Try Aloe Vera Juice. Make an aloe vera mouth rinse from the straight juice of an aloe vera leaf. Squeeze the juice right on to the affected area and swish.
• Apply Cold Compresses. Place a piece of ice or a wet frozen washcloth directly on the ulcer. This will temporarily relieve the pain.
• Go Cayenne. The capsaicin in cayenne pepper is a natural pain reliever. You can use it in candy recipes to make it more tolerable.
• Use a Styptic Pencil. The styptic pencils that can control bleeding are also a good remedy for numbing cold sore pain.
• Avoid Irritating Foods. When you have a cold sore, try not to eat anything acidic, spicy or crunchy.
• Practice Gentle Tooth Brushing. Try switching to a soft or children's toothbrush until the sore heals. Use only mild toothpaste that does not foam.
• Try a DIY Remedy. 1 Tsp. liquid diphenhydramine (Benadryl©) to 1 Tsp. Kaopectate© or Maalox©. Swish them and spit back out.
• Use Over-The-Counter Products. Try and over-the-counter canker sore medicine that contains benzocaine or zylocaine to help coat the ulcer and relieve the pain.
• Watch What You Eat. Canker sores could be a sign of a food allergy. If you get frequent canker sores, try keeping a "food diary" to see if they are related to something you are eating.
• Change Your Habits. Certain lifestyle changes may be needed if canker sores are caused by stress. Try some relaxation methods and take time for yourself daily. You may also need to quit smoking or drinking alcohol if they irritate the ulcers.

2. Medical Treatments for Canker Sore

There are medical treatments available for relief. Once evaluated by a physician, they may try the following:

• Mouth Rinses. Doctors often try prescription mouthwashes that contain the ingredients: dexamethasone (steroid) or tetracycline (antibiotic), to help reduce inflammation and relieve pain.
• Topical Pastes. The doctor may want you to try a topical paste up to 4 times daily to try and heal the ulcer. Pastes containing benzocaine, fluocinonide and amlexanox help to heal up ulcers and relieve pain quickly.
• Oral Medications. The medication cimetidine used for reflux can actually be helpful for canker sores. Colchicine for gout also helps the ulcers. If the ulcers are severe, the doctor may prescribe a course of steroids.
• Cautery of sores. Canker sores can be heated up with an electro-cautery device or a chemical called, debacterol or silver nitrate can be applied to burn the ulcers.
• Nutritional Supplements. You may need to take extra vitamin B6, B12, Zinc and/or Folic Acid to help replace needed nutrients and help the ulcers heal faster.

When to See a Doctor

If canker sores do not respond to home remedies and you are concerned, it may be time to have them evaluated and treated by a doctor. Watch for signs of concern like: canker sores with high fever, canker sores that are very large, sores that do not heal after 3 or more weeks, if they have an irregular border, severe pain, interference with eating and drinking and/or sores that also affect the lip area.