All About Canker Sores


           You will, at one time or another, gets what are ordinarily called "canker" sores in your mouth. They are an uncomfortable and annoying irritation that normally subside in a short period of time. The term canker sore though, is sometimes applied to conditions unrelated to what are the lesions that it is supposed to describe.


An example of a common canker.

           True canker sores are technically known as aphthous ulcers or, more generally, white lesions. Their exact mechanism of formation is not understood, but they are known to be brought on by irritants such as certain foods or mechanical irritation, cancer treatments and by stress, both physical and mental. It is thought that there may be some connection between these ulcers and decreased functioning of your immune system, although this has not been proven. They usually appear as yellowish white ulcers surrounded by an inflamed red border measuring a few millimeters in diameter. However, the ulceration can also be grayish white in color and become as large as 2 centimeters in diameter. They are mostly self-limiting and will resolve spontaneously in a week or two although rarely more severe cases will exhibit very large and numerous sores that can take up to 6 weeks to heal. The cankers will be apparent chiefly as separate ulcers on the slacker gum tissue that leads into the folds approaching your cheeks and lips and are hardly ever seen on the firmer gum tissue around your teeth and on the roof of your mouth. Occasionally, multiple cankers will be found in groups or clusters called herpetiform aphthous ulcers that may resemble cold sores and that recur frequently.  Individuals with a family history of these lesions are more predisposed to them and tobacco users are less likely to be affected than those who don't.  They usually are first seen before age 30 and oral contraceptive use or pregnancy may check their appearance in a small percentage of patients, suggesting hormonal factors may also be involved.

           The other affliction most commonly termed a canker is the common cold sore, technically known as herpes simplex. These ulcers are caused by the herpes type 1 virus. Approximately 90% of the U.S. population carries this virus although not nearly that many have outbreaks. The virus is most often transmitted from parent to child in infancy through kissing and flare-ups mainly occur during periods of high physical and psychological strain as may develop during illness or emotional distress. Cold sores present as angry looking red vesicles (blisters) that erupt in bunches most frequently on the lips, but can also be found on the palate and firmer gum tissue around your teeth. Your first bout with the herpes type 1 virus is almost always the worst with a high fever and numerous sores found inside your mouth that make eating and even swallowing very difficult. Herpes simplex is known to rage when your immune system has been depressed by the stressors noted above and will last on average about 10 days to 2 weeks. No medications currently available can eliminate the herpes type 1 virus, but there are those obtainable by prescription or over the counter that can shorten its course. If you would like to know more about these, ask Dr. McArdle.

           Less regularly, other ailments labeled as cankers of the mouth by the lay person may include tooth abscesses that eat their way through your jawbone and out of your gums called fistulas, the oral manifestations of venereal disease named chancres, localized contact allergies known as mucositis (that are often caused by cinnamon flavoring), autoimmune diseases in the pemphigus/pemphigoid family and a host of lesser emerging disorders. It is best to remember that the most common sores that can occur in your mouth, cankers and cold sores, do not form puss and will heal by themselves in a few weeks. Those with other characteristics need to be investigated further.


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Dr. Barry F. McArdle, D.M.D. ~ 118 Maplewood Avenue, The Captain Moses House, Suite B-7, Portsmouth, NH 03801

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