Apthous ulcers (“canker sores”) are the most common oral irritation in young adults. An apthous ulcer is a shallow erosion with a yellow-white center surrounded by a narrow, red ring. They are most often oval-shaped, with a diameter of 1/8 inch to one inch. Apthous ulcers have no blisters. They occur on the soft surfaces of the mouth such as the inner cheeks, inner lips, soft areas of the roof and floor of the mouth, tongue, gums, and pharynx (throat). There may be one or several apthous ulcers present.

Twenty to 60 percent of the population have had canker sores at some time in their lives. People most frequently get them between the ages of 10 and 40 and they are often recurrent. Tingling or burning may precede the lesions by 24 hours. The main “problem” caused by apthous ulcers is pain, which varies considerably among people from slight to severe. The acute painful phase lasts 3 to 4 days with complete healing in 7 to 10 days. Apthous ulcers heal without scarring.

No specific cause has been identified. Mouth trauma, braces, local immune response, hormonal changes, certain foods, allergies, vitamin deficiencies, physical and emotional stress are possible contributing factors. Apthous ulcers are not contagious or cancerous. They are not the same as “cold sores” which are caused by Herpes Simplex Virus.

Since the cause of canker sores has not been specifically identified, no cure has been found. Therapy is aimed at pain control. Avoid salty, spicy and citrus foods. Foods that cause the least pain are milk, Jello, ice cream, yogurt, and custard. Drinking through a straw may be helpful. You may try rinsing your mouth with salt water (1/2 teaspoon in 1 cup of water) or an antiseptic mouthwash 3 or more times a day, especially after eating. There are several treatment options for reducing the pain of these ulcers, such as taking ibuprofin or acetaminophen, applying ice, or using a protectorant such as Orabase.

Occasionally it may be necessary to seek medical treatment with topical anesthetics to reduce the pain or an antibiotic solution to prevent secondary infection. If ulcers persist longer than 10 days or are unusually large (1/2 inch or more), if you have a fever more than 100.4 degrees or unbearable pain, or none of the above helps, it may be necessary to seek evaluation from a health care provider


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