General Description

Canker sores are painful, recurring ulcers (white spots) that appear inside the mouth on the cheeks or edge of the tongue. It is generally believed that certain factors, such as stress, poor dental hygiene, candidiasis, food allergies, and nutritional deficiencies are possible triggers for canker sores. Keep track of when you get canker sores so you can determine ways to avoid getting them.

Causes

Have you been under stress, or recently eaten certain foods, such as chocolate, strawberries, certain nuts, peanut butter or cinnamon? Citrus fruits and juices, especially orange, grapefruit and lemon, and tomatoes are often cited as possible causes. Eggs, wheat, pork, oranges, honey and brewer's yeast can also be culprits. Recent dental work, ill fitting dentures or braces can be causes. Do you suffer from allergies, have recently menstruated or had antibiotics? Even local injury to the mouth from brushing your teeth too hard, eating sharp or hard foods, or chewing can cause cankers. These possible causes may give you clues as to where the sores came from and how to avoid them.

It is suspected that food allergies are a major cause of many cankers. You may want to have allergy tests done or test yourself by eliminating the suspected foods from your diet for a few weeks, then reintroduce them one at a time and see which one triggers a canker. Cutting out sugar, coffee, and spicy or salty foods, may help as well. Individuals with celiac disease - the inability to digest the gluten in some grain (wheat, oats, rye and barley) foods - have a greater incidence of canker sores. Even without celiac disease, however, a person who is prone to canker sores may be more sensitive to gluten.

Having too much acidity in your stomach has been reported as a possible cause. If your body is too acidic and you have to take antacids regularly.

Nutritional deficiencies are another possible cause. Deficiencies in iron, zinc, B12, and folate (folic acid) can contribute to cankers. We suggest taking a good multi-vitamin and making sure you have a good diet as part of your program to overcome canker sores. Adding beta-carotene to your diet will speed the healing of the mucous membranes in your mouth.

Call your healthcare provider if the cankers develop after starting medication, last more than two weeks, or if white spots that are not canker sores appear in the mouth and are not improving in one or two weeks. Also see your doctor if you have a painless ulcer in your mouth that doesn't go away as it may be the symptom of a more serious underlying medical condition.

The main cornerstone of your Wellness Program will be to make dietary modifications. First, however, you need to find out what is triggering your canker sores, then you can implement a wellness program.

Modify Lifestyle

• If canker sores seem to be caused by stress, begin a relaxation program or do biofeedback.

• Have a thorough checkup by your dentist to eliminate dental problems as the cause.

• If you suspect you may have candidaisis (yeast infection) or celiac disease, check with your healthcare provider.

• Begin a dietary modification program as outlined below.

Dietary Changes

• Check to see if you have food allergies. Have a blood test done or do an elimination diet.

• Avoid sweets and citrus fruits, all refined and processed foods, and coffee and sugar.

• Reduce foods and beverages that create more acidity in the body. Sodas, for instance, are very acidic.

• Eliminate grain foods if you have determined that this is the cause of your cankers.

• Eliminate chewing gum, lozenges with sugar, and candy.

• Eat products containing acidophilus, such as yogurt, kefir, cottage cheese or buttermilk.

Supplements

B-complex vitamin If you are prone to canker sores, take a B-complex vitamin on a regular basis. B-2 (riboflavin) seems to be a great help. This prevents the sores from starting or reduces their duration.

Vitamin C in its various forms has proven successful. The citric acid will kill the bacteria in the sore and promote healing.

Zinc is also beneficial and should be used in combination with vitamin C for best results. Take 500 mg of vitamin C and 220 mg of zinc sulfate (with food, as it may upset an empty stomach) daily until the canker heals. If you get cankers frequently, take these supplements as a preventive measure, but cut down the zinc to 15 mg after two weeks of higher doses unless you have a doctor's permission. Higher doses of zinc may interfere with the absorption of other important minerals, especially copper. Try sucking on zinc lozenges (5-10 mg) four or five times a day.

Remedies

If you do get a canker, here are some remedies to clear it up and reduce the pain. In general, cankers go away in 7-10 days. One of these remedies may help you relieve the pain and get rid of cankers sooner.

Folk

Acidophilus Take 2-4 acidophilus capsules four times a day with milk. Make sure the tablets contain living organisms. The milk is an activating culture medium for the bacilli. This will reduce the pain and speed up healing. Eating plain yogurt (with acidophilus) with live cultures will add friendly bacteria to your mouth and help healing by competing with the bad bacteria. Yogurt seems to stimulates the immune system.

Aloe Use aloe juice as a mouth rinse several times a day.

Alum The preservative alum can be put on the canker. It will probably burn like crazy for a few minutes and make your mouth pucker, but it will relieve the pain and help clear the sore up quickly. Rinse with water after a few minutes. Repeat once or twice a day, as needed. Alum can be found in the spice section of your grocery store.

Antacids Antacid formulas, such as Mylanta and Milk of Magnesia, used as a mouth rinse for a few minutes have been reported to relieve the pain and speed healing.

Baking soda Baking soda is another time-honored remedy. It can either be used as a powder directly on the sore or made into a paste and applied. Use several times daily. It may sting a bit, but it works by reducing the amount of bacteria in the mouth. Another remedy using baking soda is to mix a teaspoon of baking soda with half a cup of warm water and use as a mouth wash several times a day, especially after meals and before bedtime. The pain should lessen in 24 hours and the sore should disappear within three days. Note: because baking soda contains a high level of sodium, those who must limit their intake of sodium should rinse their mouths out thoroughly after using it.

Copper sulfate (a/k/a bluestone) is an old remedy for canker sores that goes back at least to the 19th century. It is an astringent, and was also known as "lunar caustic." It stings upon application, but the canker sores should be gone in a day or two. This product may be ordered through chemical supply companies. Remedy courtesy of Becca Buzzell.

DMSO (dimethyl sulfoxide) Put it on sores with your fingers or a cotton ball. 

Grapefruit seed extract This extract is a powerful all-around antimicrobial product and is an excellent disinfectant. Use five or six drops in a glass of water and use as a mouthwash once daily. 

Hydrogen peroxide Found at your pharmacy, hydrogen peroxide may also be used as an effective mouthwash. Swish a capful around in your mouth twice a day and spit out. Another remedy says to use three parts water to one part hydrogen peroxide. Hydrogen peroxide is very good at killing bacteria, but use it sparingly when needed unless recommended by your dentist. It can kill too many good bacteria and cause other dental problems.

Lomatium (Lomatium dissectum) has a long history of use by Native Americans. Research suggests that it may be effective against viruses and is a prime infection fighter. Use an extract instead of a tincture to avoid getting a full-body rash.

• Combine equal parts of tinctures of echinacea, calendula, oats, burdock, and lomatium and take 1/2 teaspoon four or five times a day. This combination of herbs will boost the immune system, soothe inflamed tissues, remove toxins from the body, and kill viruses and bacteria.

Onion Apply raw onion to the sore.

Papaya Cankers can be cleared up by sucking on or chewing several papaya tablets a couple of times each day. Fresh papaya fruit would be good, too, if you can find it, and, if you live where there are fresh papaya leaves, chew on them.

Plum juice Take two tablespoons of fresh plum juice and use it as a mouth rinse for several minutes. For a bad sore soak a cotton ball in plum juice and use it as a compress for a few minutes.

Soda/salt At the first sign of a canker sore, gargle with a mixture of 1 teaspoon soda and a pinch of salt in 1 cup of warm water.

Sorrel Take a fresh piece of this bitter herb and place it on the sore until it becomes soggy; repeat. It should ease the pain quickly and speed healing. Sorrel has astringent and antiseptic properties and has long been used for various skin ailments.

Tea Try using a used tea bag on the canker. Press it on the sore like a wad of chewing tobacco and hold it there as long as you can. The tannic acid in the tea is an astringent and will relieve pain and aid healing.

Tea tree oil This oil is derived from the leaves of the native Australian Melaleuca alternifolia tree, and contains antiseptic compounds that are a very effective skin disinfectant. Depending on severity, use 5-15% solutions daily. 

Water, salt Salt water is another remedy you can use. Mix 2 tablespoons of salt in a 6 ounce glass of warm water and use as a mouth rinse 3-4 times a day. Both alum and salt help draw fluid from the canker and help it to heal.

Herbal

Burdock The herb burdock (Arctium lappa), taken as a tea or in capsules, may effectively treat cankers and other skin problems such as eczema, boils, acne, herpes and syphilitic sores, styes, carbuncles, and psoriasis. To make the tea, bring 1 quart of water to a boil, reduce to simmer, adding 4 teaspoons of cut, dried root. Cover and let simmer for 7 minutes, then remove from heat and let steep for 2 more hours. Drink a minimum of 2 cups a day on an empty stomach (more if a chronic problem exists). You may also use the tea as a skin wash.

Goldenseal Make a mouth rinse of 1/4 teaspoon salt, 1/2 teaspoon goldenseal powder, and 1 cup of warm water. Use several times a day. You can also apply a pinch of powdered goldenseal to the sore.

Lady's mantle Drink an infusion of lady's mantle to soothe the canker.

Myrrh Another herb, myrrh (Commiphora myrrah) helps cure canker sores. It can be made into a tea or the powder can be applied to the sore. To make the tea add 2 sprigs of coarsely chopped parsley, 3 whole spice cloves, 1 teaspoon of powdered myrrh, and 1/4 teaspoon powdered goldenseal to 1 pint of boiling water. Steep. Stir occasionally while cooling, then strain and use as a mouthwash. This tea will also help with bad breath and sore throats. To use the powder directly, empty two capsules onto a clean surface, moisten a cotton swab, dip it into the powder, and apply directly to the sore. Doing this twice a day should clear up the sore in less than a week. Another mouthwash can be made by using 1 teaspoon each of powdered myrrh, goldenseal and cayenne pepper blended in one quart of water.

Sage Sage (Salvia officinalis) made into a tea and used as a mouthwash is effective in healing cankers. It has astringent and drying properties and was used by Native Americans to heal sores and cleanse the mouth. You can also apply a pinch of powdered sage to the sore.

Homeopathic (gr. = granules)

Thuja 9: 5 gr. on waking, once a fortnight.

Cinnabaris 4: 2 gr. twice a day.

Arsenicum album 7 and Hydrastis 7: 2 gr. at about 6 PM. Each remedy on alternate days.