The Painful Truth About Canker Sores

Have you ever experienced a painful sore inside your mouth that just won’t go away? It might be a canker sore, which is a common condition that affects millions of people worldwide. Canker sores, also known as aphthous ulcers, are small, shallow ulcers that can develop on the inside of the mouth, cheeks, gums, and tongue, and can cause a range of symptoms, including pain, swelling, and difficulty eating and speaking. While canker sores are usually harmless and will heal on their own within a week or two, they can be a chronic condition for some people, causing frequent outbreaks and persistent discomfort. 


The exact cause is unknown, but there are several factors that may contribute to its development. One of the most common triggers is stress, which can weaken the immune system and make it more susceptible to infections and inflammation. Other potential causes include: 

  • Nutritional deficiencies: A lack of certain vitamins and minerals, such as vitamin B12, iron, and folic acid, can lead to canker sores. 


  • Certain foods, such as citrus fruits, chocolate, and coffee, can trigger canker sores in some people. Toothpaste and mouthwash that contain sodium lauryl sulfate can cause irritation to the mouth’s lining and result in the formation of ulcers. 


  • Hormonal changes: Women may experience canker sores during their menstrual cycle, pregnancy, or menopause, when hormone levels fluctuate. 
  • Some medical conditions can cause canker sores including celiac disease, inflammatory bowel disease, and HIV/AIDS. 


  • Injury or trauma to the mouth: Accidentally biting the inside of your cheek, brushing your teeth too hard, or getting hit in the mouth can cause canker sores. 


The symptoms can vary from person to person, but typically include: 

  • Small, round or oval-shaped ulcers that are white or yellow in the center and surrounded by a red border 


  • Pain or discomfort in the affected area, especially when eating, drinking, or speaking 


  • Swelling or inflammation of the surrounding tissues 


  • Fever and swollen lymph nodes in severe cases 


  • Fatigue 

Treatment Options

Most cases of canker sores will heal on their own within a week or two, but there are several treatments that can help alleviate the symptoms and speed up the healing process. These include: 

  • Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help reduce pain and inflammation. 
  • Topical medications: Creams, gels, and pastes containing benzocaine, lidocaine, or hydrocortisone can provide temporary relief from pain and discomfort. 


  • Mouth rinses: Salt water rinses or mouthwashes containing hydrogen peroxide or chlorhexidine can help reduce inflammation and prevent infection. 


  • Prescription medications: In severe cases, your doctor may prescribe corticosteroids or immune-suppressing drugs to reduce inflammation and prevent further outbreaks. 


While there is no surefire way to prevent canker sores, there are several measures you can take to reduce your risk of developing them. These include: 

  • Practicing good oral hygiene: Brushing your teeth twice a day and flossing regularly can help prevent infections and inflammation in the mouth. 


  • Avoiding trigger foods: If you notice that certain foods or drinks seem to trigger canker sores, try to avoid them or limit your intake. 


  • Managing stress: Stress can weaken the immune system and make it more susceptible to infections and inflammation, so try to find ways to manage your stress levels, such as through exercise, meditation, or therapy. 


  • Getting enough vitamins and minerals: Eating a balanced diet rich in fruits, vegetables, and whole grains can help 

ensure you are getting enough vitamins and minerals, such as vitamin B12, iron, and folic acid, which are essential for oral health.

  • Using a soft-bristled toothbrush: A hard-bristled toothbrush can irritate the gums and lead to canker sores, so choose a soft-bristled toothbrush and brush gently. 


  • Avoiding tobacco and alcohol: Smoking and drinking alcohol can irritate the lining of the mouth and increase the risk of canker sores. 

When to See a Doctor

Most cases of canker sores will heal on their own within a week or two, but you should see a doctor if: 

  • You have large, painful sores that do not heal within two weeks 


  • You have a high fever or swollen lymph nodes 


  • You have frequent outbreaks of canker sores 


  • You have sores that spread to other areas of the mouth or throat 


In some cases, canker sores may be a symptom of an underlying condition, such as Crohn’s disease or celiac disease, so your doctor may recommend further testing if you have recurrent or severe canker sores. 

With a range of potential causes and treatments available, it’s important to take steps to manage and prevent canker sores to reduce discomfort and improve oral health. 


About The Author

Dr. Coco is a highly-educated and well-qualified primary care physician who graduated from the University of the Philippines Baguio with a Bachelor of Science in Biology and her Doctor of Medicine degree from the University of the East Ramon Magsaysay Memorial Medical Center. She completed her three-year residency training in Family Medicine at Brokenshire Medical Center. She passed her diplomate exams in Family Medicine, given by the Philippine Academy of Family Physicians in 2018. 


Dr. Coco is dedicated to providing comprehensive and holistic care for her patients. She is a primary care physician who believes in delivering continuing comprehensive health care for all. To her, patients are not just a number as she takes time to analyse how she can improve their overall health every chance they can get. 

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