Ever woken up with a sore mouth which hurts so badly? And to find out that the cause of all the pain is maybe due to a small ulcer in the mouth? It appears out of the blue but stays at least for a week or two and causes us much pain. About 20% of the population (i.e. one in five people) suffer from this common condition. These gum boils are also called canker sores or apthous ulcers.
Canker sores are classified into 3 groups based on their size:
- Minor Sores: have a diameter of 1mm to 10mm. They are the most common and last around 7-10 days.
- Major Sores: have a diameter greater than 10mm and take longer to heal (10-30 days). They leave a scar after healing.
- Herptiform Ulcers: usually form in clusters and are less than 3mm. They heal within 7-10days.
Apthous ulcers ar commonly found on the movable parts of the mouth such as the tongue, inside lining of the lips and cheeks and at the base of the gums.
The following are some factors that seem to trigger outbreaks of ulcers:
- Lack of sleep; emotional stress
- Mechanical trauma (self inflicted bites)
- Nutritional deficiencies (vitamin B, iron, folic acid)
- Certain foods like chocolate
- Certain toothpastes
- Menstruation
Any remedies?
Presently there are no cures for apthous ulcers but there are remedies that help ease pain, discomfort and possibly speed the healing process.
The following are some at home treatments for minor apthous ulcers:
- Saltwater and Sodium Bicarbonate: mix 1tsp salt in a cup of warm water. Swish with the solution for around 30secs and spit. ½ tsp baking soda/ sodium bicarbonate may be added as well.
- You can also create thick mixes of baking soda and water and use them to cover these ulcers; this relieves pain. This can be done as often as possible.
- Hydrogen Peroxide: mix one part hydrogen peroxide with one part water and use a cotton swab to dab the solution onto the canker sore. The solution should not be swallowed.
- Milk of Magnesia: this is a liquid suspension of magnesium hydroxide. Dab milk of magnesia over the sores with a cotton swab three to four times a day. Recommended after using hydrogen peroxide.
- Diphenhydramine: also called Benadryl. This is a liquid antihistamine which can be used as an oral rinse by mixing one part of milk of magnesia and one part of Diphenhydramine together. Rinse for 1min then spit. Avoid swallowing.
- Over the Counter Products: antiseptic mouth rinses help heal the mouth sores by reducing the bacteria in the mouth. There are also oral products available to numb the painful ulcer. These are available as gels, pastes and rinses.
- Although the above mentioned remedies are said to be effective, it is always better to consult a dentist first. Major and Herptiform apthous ulcers require treatment from a dentist.
- Oral Medications: drugs are used in treating serious canker sores that have developed into secondary infections. Tetracycline suspensions may be used but is not given to children as it causes permanent discoloration of their teeth. Acyclovir is an antiviral drug that maybe prescribed for cases where there are multiple and very painful canker sores.
- Corticosteroids such as prednisone and dexamethasone may also be given, though rare.
Usually canker sores tend to heal on their own in spite of the pain but it’s always better to consult your dentist when the ulcers do not heal after 14 days and are accompanied by fever or appear to be infected.
