Condition Care Guide

What are canker sores?
Canker sores, otherwise known as mouth ulcers or aphthous ulcers, are disruptions of oral mucosa and can be extremely painful. They form on the inside of the lips, cheeks or under the tongue. They're very common and occur most often among teens or young adults in their twenties. Even with effective treatment, recurrences are common.

What are the symptoms of canker sores?
Canker sores usually are red with a whitish coating. The cause a burning pain that gets worse when the sores are irritated by food or acidic beverages such as orange juice. Most heal without treatment within a week to 10 days. Unfortunately, there's no treatment that reliably eliminates them or relieves the pain they cause. Unlike cold sores (or fever blisters) canker sores are not contagious.

What are the causes of canker sores?

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Canker sores can be a symptom of sensitivity to gluten (gluten is the protein in wheat and other grains). To find out if that's the problem, ask your doctor to test you for gluten intolerance, also known as celiac disease. Beyond that, we don't know for sure what causes recurrent canker sores. They may be due to an immune system problem; some experts believe that bacteria or viruses may be involved. Fatigue, stress or allergies can increase the likelihood of a canker sore. Another possible cause is physical trauma (accidentally biting the inside of your cheeks) or a reaction to hot foods or beverages. Canker sores tend to occur among women during menstruation, so hormonal changes may also be a factor. Deficiencies of vitamin B-12, zinc, folic acid, and iron are also suspected as contributing to the development canker sores, but there's not much scientific evidence to back up these theories.

What is the conventional treatment of canker sores?
Conventional medicine treats severe canker sores with prescription anti-inflammatory ointments (such as Aphthasol or Kenalog in Orabase) applied directly to the sore. These agents don't cure the sores, but they may prevent them from becoming irritated and more painful when you eat, drink or brush your teeth. You can also try taking ibuprofen or acetaminophen for pain relief. Other pain remedies include equal amounts of milk of magnesia and Benadryl Allergy Liquid mixed together; swish a teaspoon in your mouth for about one minute and then spit it out. Doing this every four to six hours may reduce canker sore pain.

Sucking on zinc lozenges, taking vitamin C or vitamin B complex, using a sage-and-chamomile mouthwash or taking a lysine supplement are other approaches occasionally recommended to address discomfort.

What natural therapies for canker sores does Dr. Weil recommend?

• Use goldenseal mouth rinse. In one cup of warm water, mix one quarter teaspoon of salt and one half teaspoon or the contents of one capsule of goldenseal powder (it will not dissolve completely).
• Take a B-100 B complex vitamin supplement daily.
• Try applying tincture of propolis, available at health food stores. Propolis, the cement made by honeybees to construct their hives, has remarkable antiseptic and healing properties.
• Use DGL (deglycyrrhizinated licorice), a licorice extract with mucosa healing properties that you can buy in the health food store as chewable tablets or powder. Make a paste of the substance with saliva and apply it to the sore area.
• Take slippery elm powder mixed to a paste with water; alternatively, suck on slippery elm lozenges, available in both drug and health food stores.
• Topically apply alum powder, available in the spice sections of supermarkets, directly to an ulcer. It will burn for a few minutes and will promote rapid healing.
• Mind/body medicine, such as hypnosis or guided imagery, can be effective.
• Probiotics (products that help replenish the friendly bacteria in the digestive tract) may also be helpful.
• Try to minimize the discomfort of canker sores by avoiding acidic and spicy foods as well as abrasive foods such as nuts, all of which can be irritating.
• Switch to a toothpaste that does not contain sodium lauryl sulfate (SLS), a foaming agent that may contribute to recurrences.