What is canker sores?

Canker sores are painful white sores in the mouth. They usually begin with a tingling feeling, followed by a red spot or bump that turns white. Canker sores appear most often on the tongue, inside the cheeks, and inside the lips. They can be very painful and can make talking, eating, and drinking difficult.

A canker sore may form after an injury or stretching of tissues in the mouth, which can happen, for example, during a dental procedure or teeth cleaning. If you accidentally bite your tongue or the inside of your cheek, you may end up with a canker sore. Other possible causes are infection, certain foods, and stress. Canker sores are not contagious.

The pain from your canker sore should decrease in about a week, and it should heal in a few weeks. In most cases, a canker sore will go away by itself. Home treatment can ease pain and discomfort. If you have a large or deep canker sore that does not seem to be getting better after a few weeks, your doctor may prescribe medicine. Canker sores often come back again.

The main symptom of a canker sore is getting a shallow ulcer on your tongue or on the inside of your lip or cheek. The sore may be large or small, and it will have a red border and a white or yellow center. You might have more than one canker sore at a time.

Canker sores usually begin with a burning or tingling feeling. They may be swollen and painful. Having a canker sore can make it hard to talk or eat.

Canker sores may hurt for about a week. Minor canker sores heal in about 2 weeks, but major canker sores can take longer to heal. Some people get another canker sore after the first sore has healed. Most canker sores heal without a scar.

You do not need to see a doctor for most canker sores. They will get better on their own. There are many things you can try at home to relieve the pain caused by your canker sores:

• Eat soft, bland foods that are easy to swallow, such as yogurt or cream soup. Cut your food into small pieces or mash or puree it. Avoid coffee, chocolate, spicy or salty foods, citrus fruits or juices, nuts, seeds, and tomatoes.
• Drink cold fluids, such as water or iced tea, or eat Popsicles. Sometimes fluid touching the canker sore can cause a stinging pain. Use a straw so the fluid doesn't touch the canker sore. Hold ice on the canker sore until it is numb.
• Carefully brush your teeth so you don't touch the sore with the toothbrush bristles.
• Rinse your mouth with salt water. To make a saltwater rinse, dissolve 1 tsp (5 mL) of salt in 1 cup (240 mL) of water.
• Buy an over-the-counter numbing medicine, such as Anbesol or Orabase, to put on your canker sores. Use a cotton swab to apply the medicine. Put it on your sores 3 to 4 times a day. Ask your doctor before using mouth-numbing medicine for children of any age. The U.S. Food and Drug Administration (FDA) warns that some of these can be dangerous.
• Take a pain reliever, such as nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve). Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome. Be safe with medicines. Read and follow all instructions on the label.

If your canker sores do not feel better after you try these steps at home for a few weeks, you may need to see your doctor or dentist. They may recommend medicines that will help relieve pain caused by your canker sores. Usually these medicines are swished or gargled in your mouth, or they are painted on the sore. Your doctor may prescribe steroid cream or paste to rub on your canker sore and/or a prescription mouthwash to use.

Talk to your doctor if you have a fever, have trouble swallowing, or if your canker sores keep coming back. You may have another problem that is causing your symptoms.

Most of the time the cause of canker sores is unknown. Unless you know what causes your canker sores, you cannot prevent them from happening. If you do know what causes your canker sores, you can help prevent them by avoiding what you know causes them. For example, if you have gotten canker sores in the past from hurting the inside of your mouth, you might help prevent them by chewing your food slowly and carefully, trying not to talk and chew at the same time, and using a soft-bristled toothbrush when you brush your teeth.

If you have gotten canker sores in the past by eating foods that have a lot of acid (such as citrus fruits or tomatoes) and sharp or harsh foods (such as bread crusts, corn chips, or potato chips), it might help to avoid these. Other ways that might help to prevent canker sores include limiting your use of alcohol and tobacco and controlling the stress in your life.

In general, it is important to get enough vitamins and minerals in your diet, like folic acid, vitamin B12, zinc, and iron.

If you see your doctor or dentist about the pain caused by your canker sores, the doctor or dentist will do a physical exam by looking in your mouth to diagnose the canker sores.

• Drink cold liquids, such as water or iced tea, or eat flavored ice pops or frozen juices. Use a straw to keep the liquid from coming in contact with your canker sore.
• Eat soft, bland foods that are easy to chew and swallow, such as ice cream, custard, applesauce, cottage cheese, macaroni and cheese, soft-cooked eggs, yogurt, or cream soups.
• Cut foods into small pieces, or grind, mash, blend, or puree foods to make them easier to chew and swallow.
• While your canker sore heals, avoid coffee, chocolate, spicy and salty foods, citrus fruits, nuts, seeds, and tomatoes.
• To soothe your canker sore and help it heal:
  • Use an over-the-counter numbing medicine, such as Orabase or Anbesol.
  • Dab a bit of Milk of Magnesia on the canker sore 3 or 4 times a day.
• Put ice on your sore to reduce the pain.
• Take anti-inflammatory medicines to reduce pain, as needed. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). Read and follow all instructions on the label.
• Use a soft-bristle toothbrush, and brush your teeth well but carefully.
• Do not smoke or use spit tobacco. Tobacco can cause mouth problems and slow healing. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

The cause of canker sores is unknown, but they tend to run in families. Canker sores are not contagious.

Canker sores may also develop when you:

• Are stressed or tired.
• Hurt your mouth, such as biting your lip.
• Have braces on your teeth.
• Are sensitive to certain foods that irritate your mouth.
• Do not get enough vitamins or minerals in your diet, such as iron, vitamin B12, and folic acid.