Canker sores, also known as aphthous ulcers, are painful ulcers of the skin lining the mouth and tongue. Canker sores are usually small: about one to two mm long and appear as white, painful, non-contagious, inflammatory lesions. They appear on the soft tissues and folds of the inner cheeks and lips, or the floor of the mouth. Most ulcers heal without scarring in 2 weeks. Recurrent attacks are common. About 20% of the population is affected at one time or another. They appear most commonly in adolescents. Women are twice as likely as men to get them. In the United States about 20 percent of women between the ages of 20 and 40 suffer from painful recurrent canker sores. Canker sores can be painful but generally are not a cause for concern. However, if canker sores last longer than two weeks, and especially if they are not painful, schedule an appointment with a doctor for an evaluation.

Canker sores appear with the following characteristics:

• Ulcers appear on lips, gums, inner cheeks, tongue, palate, and throat.
• Ulcers are small, painful, shallow, and covered by a gray membrane.
• Borders are surrounded by an intense red halo.

To prevent canker sores, good oral hygiene and a balanced, nutritional diet are significantly helpful. People who are prone to canker sores should avoid heavily spiced foods, highly acidic foods, and be careful when brushing teeth. Anything that can injure or irritate the lining of the mouth such as hard bristled toothbrushes, foods such as potato chips, nuts and all salty or very spicy foods should be avoided. If the sore is caught early enough, drinking water every 10 minutes for an hour can inhibit further development. A healthy diet high in raw foods and low in meats and fat maintains body chemistry in an acid/alkaline balance. Therefore these food items should be incorporated in the diet. Supplementation of C vitamin can help prevent canker sores. These can be obtained through citrus fruits or supplements of up to 500 mg. A diet high in iron, folic acid and vitamin B would help prevent canker sores. Therefore it is recommended that peas, beans and lentils be incorporated in the diet. A stress free life would go a long way in promoting life span and quality.

The cause of canker sores is still unknown; however, there is some evidence that the following factors may somehow trigger the ulcers off:

• Injury to the mouth lining caused by hot food, vigorous tooth brushing, or dental work
• Irritation from foods, such as chocolate, citrus, acid foods (vinegar, pickles), salted nuts, or potato chips
• Virus infection
• Nutritional deficiencies of iron, folic acid or vitamin B12
• Emotional or physical stress, anxiety, or premenstrual tension
• Possible genetic predisposition, especially in people with recurrent ulcer problems

Canker sores are diagnosed by observation of the blister. A distinction between canker sores and cold sores must be made because cold sores are infectious and the herpes infection can be transmitted to other people. The two sores can usually be distinguished visually and there are specific diagnostic tests for herpes infection.

Eat plenty of salads and raw onions as onions contain sulfur and promote healing. Try to eat foods with active bacteria cultures such as yogurt or buttermilk. Vitamin C can be obtained from foods such as broccoli, cantaloupe, bell peppers, cabbage and cranberry juice. Identifying foods that can cause initiate the creation of canker sores and removing them form the diet would lead to a marked improvement. Pineapples, tomatoes, lemons and walnuts are some of the foods that cause such allergic reactions. At the same time, avoid eating sugar, citrus fruits, coffee, nuts, fish or meat. Animal protein produces body acid, which can aggravate the ulcers.

• Orabase –B and Zilactin, both over-the-counter preparations, can be applied directly to the ulcers to stop pain and promote healing. Preparations used to promote healing should include benzocaine, menthol, eucalyptol or camphor.
• Zinc oxide can be directly applied to the sore as a protectant.
• Lobelia tincture can be painted over the sores several times a day.
• Hydrogen peroxide can be applied to the sores. At the same time, a hydrogen peroxide mouthwash made from ½ teaspoon of peroxide to eight ounces of water, can be used several times a day.
• Vitamin P can help heal mouth sores. As potatoes contain the vitamin, a raw potato can be kept on the sore to promote healing.
• A dab of alum on the sores can help prevent infection.
• Use one teaspoon of potassium chlorate in a cup of water as a mouth rinse.
• Rinsing the mouth with an antacid like mild of magnesia can coat the ulcers and provide some relief from pain. Do not use if the sores are infected.
• Sucking on ice can help decrease pain.
• Drinking fluids from a straw can be less painful, especially for children.
• Placing a wet teabag which contains tannins (an astringent and painkiller) directly on the sore can provide some relief.
• Making a paste of ground aspirin and water can serve to create a coating over the sore and promote healing.

Recurring canker sores can certainly signal a depressed immune system. By now, we are all too aware of how stress can precipitate illness. The bottom line is that all of us need to pay attention to the signals our bodies transmit in the guise of various symptoms or illnesses.

Canker Sores Begone and Canker Care+ Gel are herbal products that contain several herbs and other compounds like Echinacea, Golden Seal Root, Aloe Vera Gel, Lysine, vitamin B12 etc. Echinacea and Goldenseal have beneficial effects on immune health, gums health, soreness, and against harmful organisms. ^{1, 2, 3, 4, 5} Super Lysine Plus Cream contains lysine which exhibits its positive effects on harmful organisms. ^{1, 2, 3, 4, 6} Avamin Bio-Active B12 contains vitamin B12 which provides advantageous effects on soreness of tongue.¹

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, cure, mitigate, treat, or prevent any disease.