Aphthous Ulcers

Nearly 20% of Americans suffer from recurrent, painful mouth ulcers called aphthous ulcers or “canker sores”.    While the exact cause of aphthous ulcers is unknown, current theories suggest they may be an autoimmune reaction similar to Crohn’s disease. 

Increasing evidence illustrates a relationship between oral trauma and aphthous ulcers.  Simple things like biting the lip, brushing too hard, or scraping the inside of the mouth with certain foods, can initiate the formation of canker sores.   To reduce the occurrence of traumatic aphthous ulcers, we encourage people to **avoid** potato chips, tortilla chips, pretzels, apples, hard candy, or any other food that may damage the inside of the mouth.    Always use a soft toothbrush to gently cleanse the gums and oral cavity. 

Something as ordinary as food may be a potent trigger. Among the identified foods are whole wheat, rye, barley, chocolate, cinnamon, tomatoes, nuts, shellfish, mustard, strawberries, pineapples, and figs. We suggest sufferers unresponsive to other interventions systematically remove one of these foods from their diet one at a time while checking for a significant reduction in ulcers. 

Low levels of certain vitamins and minerals**,** specifically Vitamin Bs and iron, have been associated with an increase of aphthous ulcers.      We recommend that you take a   daily multivitamin with optimal levels of vitamins and iron to reduce your risk. 

Perhaps the most significant thing sufferers can do to prevent aphthous ulcers is to switch your toothpaste. Sometimes a simple switch to any other common toothpaste can reduce your symptoms significantly, but you may have to specifically seek out SLS -free (sodium lauryl sulfate and/or sodium laureth sulfate) toothpaste. Dental researchers in the US and Norway have shown that SLS is a prime contributor to aphthous ulcer formation. SLS creates the foaming action we associate with toothpastes as well as many soaps and detergents. Because alternatives to SLS are much more expensive, many toothpastes on the market contain SLS.  Some examples of brands that market an SLS-free toothpaste are Baby Bling, Tom’s of Maine Clean and Gentle, Rembrandt, JASON Sea Fresh, Sensodyne ProNamel Mint Essence Original, Biotene Fresh Mint Original. Please take the time to read the label carefully, looking for SLS (sodium lauryl sulfate and sodium laureth sulfate) as new formulations and new flavors are continually introduced. At times, we may also recommend treatment with laser therapy or systemic medications for very severe cases or very frequent recurrence rates.

To reduce your pain during an outbreak, we recommend avoiding spicy foods, carbonated beverages, and foods that are acidic like tomatoes and citrus fruits.  Dairy products can be soothing.  Drink lots of water to promote hydration and healing. Some products that can be soothing are: Glyoxide rinse (available in pharmacies and groceries), Zilactin-B canker sore gel (pharmacies and groceries), GUM brand Canker X (pharmacies and groceries), Cool Mint Listerine mouthwash, Tums chewable tablets every 3-4 hours, Use one Q-tip to clean with hydrogen peroxide , then another Q-tip to coat the lesion with Maalox , Tea tree oil placed on ulcer with a Q-tip, Deglycyrrhizinated licorice can be taken in pill form or use a powder mixed with your saliva to create a paste to place on the lesion.