The first canker sore

If this is the first time you are dealing with a canker sore or think you may have a canker sore, it is wise to have it checked out by a physician. Yes, the mouth sore will probably go away in a few days. Yes, there is not too much that the doctor can do to cure the canker sore. But going to the physician for a first time canker sore is important for at least two reasons. First, you want to find out if what you are dealing with really is a canker sore. There are many mouth sores that can mimic a canker sore. While you can probably make the diagnosis yourself, you also do not want to miss a more serious diagnosis.

Second, the physician will rule out other diseases that might be causing the canker sores. For example, if you have a vitamin deficiency, that problem can be easily fixed through dietary changes and supplementation. Moreover, the vitamin deficiency may be causing other issues besides aphthous ulcers of which you were not aware.

Sometimes canker sores are the first indication that a person has celiac disease. A doctor can rule this out through blood tests. Likewise, inflammatory bowel disease and certain autoimmune diseases may first manifest as a mouth sore. There are a number of other tests that can be run during the diagnosis of canker sores that will exclude other diseases.

Major aphthous ulcers

If you think you may have a major aphthous ulcer, understand that this type of canker sore can scar the tissues of mouth. Major aphthous ulcers are bigger lesions than the minor form and fewer of them appear at once than the herpetiform type. These canker sores last about twice as long as minor canker sores and are very painful. Since inflammation in the mouth sore is mostly to blame for tissue scarring, a physician can prescribe canker sore treatments that can reduce or prevent this permanent deformity.

Immune system diseases

If you have a chronic disease that affects the immune system or are receiving immunosuppressant therapy, you should notify your doctor when you notice a canker sore. Once the aphthous ulcer takes hold, it can be very difficult to treat in the context of an immune system disease. Some diseases that place patients at increased risk for canker sores are:

• Behçet syndrome
• Cancers of the Oral Mucosa (mouth)
• Celiac disease
• Crohn’s Disease
• Histoplasmosis
• Human Immunodeficiency Virus Infection and AIDS
• Sweet syndrome
• Systemic Lupus Erythematosus

Also, patients that have had organ or tissue transplants and are on immunosuppressants may be at additional risk. To a lesser extent, people that take a daily dose of corticosteroids (relatively high dose) may also be more susceptible and should seek medical attention for canker sore treatment.

Reaching out to others

There is comfort in simply talking with someone else that is going through the same thing you are. While some say that the Internet makes us less social and more introverted, what other technology in the history of man has allowed us to meet so many people around the world? Online support groups do exist for canker sore sufferers. As with any online support group, the quality of the forum depends on the people that participate. Remember that most people frequenting a canker sore support group are lookig for answers or want to share canker sore remedies that worked for them.

Proceed with caution

While you are likely to get a number of suggestions from people in online support groups, be very careful with the treatments that you elect to try. While people that have gotten rid of aphthous ulcers are experts of their own bodies, there is no guarantee that the same canker sore remedy will work for you. Keep in mind that you may have certain allergies or underlying medical conditions that the helpful user that shared the treatment does not. Be wary of treatments that are overly painful or expensive. Ideally you would discuss the treatment with your physician before trying it. Remember that some home remedies for canker sores can also be powerful. Some can have their own side effects as well. It is best to learn the basics at CankerSoreTreatment.com so that you can make educated decisions.

Treatment Of Canker Sores At Home: how to get rid of canker sores

Resources

CankerSoreTreatment.com does not support or endorse any of these support groups, but they may be a good place to start. It is up to you to determine if an online support group is helpful for you and to make sure that any treatments discussed on these sites are safe.

Canker sores – The MedlinePlus website has a section on canker sores is particularly robust.

Recent updates on canker sore treatment

Quercetin

Researchers in Egypt examined the effects of topical quercetin on patients with recurrent aphthous ulcers. Quercetin is a plant product that gives many plants their color. It is also a flavonoid, which is a powerful antioxidant molecule. Egyptian researchers performed a randomized double-blind clinical trial showing that topical quercetin could speed up the healing process in people with canker sores.¹

Thai herbal remedies

Thai researchers looked at the antimicrobial and antioxidant properties of four traditional Thai herbal remedies. These canker sore remedies included Quercus infectoria, Kaempferia galanga, Coptis chinensis and Glycyrrhiza uralensis.² All remedies except Kaempferia galanga showed strong antioxidant properties.

Camel thorn distillate

Camel thorn distillate was compared to other canker sore remedies and performed just as well. Iranian researchers suggested that the compounds alhagitin and alhagidin found in camel thorn distillate might explain this effect.³

Low-level laser treatment

Low-level laser treatment was shown to reduce the time that canker sores were in the mouth when compared to corticosteroids. Also, patients reported less pain in the laser treated group. Canker sores lasted 6 days in the corticosteroid treated group and 4 days, on average, in the low-level laser treated group.⁴ Note that low-level laser treatment is different than the ablative laser treatment detailed in Medical treatment of canker sores.

Vitamin B12 and folate

Apparently people that get recurrent aphthous ulcers also eat less Vitamin B12 and folate than the rest of the population according to a group of American researchers. They examined 100 people with recurrent aphthous ulcers and found that their vitamin intake was lower than the Recommended Daily Allowance.⁵ This dietary deficiency provides both an explanation for the disease and a treatment for canker sores by starting vitamin supplementation.

Canker Sore Treatment For Mouth Sores: canker sore on tongue

Colchicine versus prednisone

While colchicine and prednisone are both medical treatments for canker sores some debate exists about which treatment is better for chronic, long-term aphthous ulcer care. In a head to head comparison, colchicine and prednisone performed equally well as canker sore remedies. However, colchicine caused side effects in over half of patients, while prednisone caused them in only about 10% of people tested.⁶ What was not mentioned in the study was the long term consequences of prednisone use, which may cause a separate and underappreciated set of side effects.

References

(1)     Hamdy AA, Ibrahem MA. Management of aphthous ulceration with topical quercetin: a randomized clinical trial. J Contemp Dent Pract 2010;11:E009-E016.

(2)     Mekseepralard C, Kamkaen N, Wilkinson JM. Antimicrobial and antioxidant activities of traditional Thai herbal remedies for aphthous ulcers. Phytother Res 2010;24:1514-1519.

(3)     Pourahmad M, Rahiminejad M, Fadaei S, Kashafi H. Effects of camel thorn distillate on recurrent oral aphthous lesions. J Dtsch Dermatol Ges 2010;8:348-352.

(4)     De Souza TO, Martins MA, Bussadori SK et al. Clinical evaluation of low-level laser treatment for recurring aphthous stomatitis. Photomed Laser Surg 2010;28 Suppl 2:S85-S88.

(5)     Kozlak ST, Walsh SJ, Lalla RV. Reduced dietary intake of vitamin B12 and folate in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2010;39:420-423.

Risk factors for developing canker sores

What is the one of the main risks for developing a canker sore? Having had a canker sore in the past. Most people that have had a canker sore will get more than one. Once they occur, they pop up from time to time. While it is not exactly clear what causes canker sores, there are a few things that increase the risk of getting one.

• Certain vitamin deficiencies such as iron, folic acid, or certain B vitamins increase the risk
• Deficiency in the immune system
• Exposure to sodium lauryl sulfate (a common detergent) in people that are sensitive
• Exposure to gluten (found in wheat, rye, barley) in people that are sensitive
• Exposure to certain drugs such as alendronate (Fosamax)
• Injury to the tongue or inside of the mouth often serves as a place for one of these mouth sores to show up
• Stopping cigarette smoking
• Stress seems to bring out aphthous ulcers

Preventing canker sores

Avoid injury

While there are few cures for canker sores, if any, there are ways of preventing canker sores that can improve a patient’s quality of life. No one intends to injure their mouth, but most mouth injuries occur when people are thoughtless or careless. If you are prone to developing aphthous ulcers, be cautious when eating sharp foods and avoid biting your tongue or inside of your cheek.

Avoid irritants

If your physician is discussing a new prescription with you, ask her if the drug increases the risk for canker sores. If it does, ask if there is an alternative medication. This same strategy of avoidance can be applied to other causes of canker sores. You might be surprised at how many household products contain sodium lauryl sulfate, yet people that have managed to reduce or eliminate the substance from their home notice a decrease in the number of canker sore flare-ups.

Check your diet

Some medical conditions predispose to canker sores. In people that cannot metabolize gluten (celiac disease), exposure to gluten in the diet is a well known cause of canker sores. Avoiding gluten can prevent canker sores in susceptible people. Likewise, vitamin deficiencies, when corrected, can lower recurrence rates. In fact, these dietary changes may be one of the few cures for canker sores (in select people).

Boost your immune system

People with diseases that depress or suppress the immune system are particularly prone to developing canker sores. Preventing canker sores in these cases is about keeping the immune system as healthy and vibrant as possible. If the immune deficiency is HIV/AIDS, staying on HAART therapy without fail and keeping T cell counts high is important. In Behçet’s syndrome, keeping inflammation to a minimum and the illness under control are reasonable approaches to preventing canker sores.

Manage and eliminate stress

Recent evidence is beginning to unlock some of the biological links between stress and the immune system. Prolonged or severe stress has a direct, negative effect on the immune system. Not surprisingly, periods of stress also bring on canker sore flare-ups. There is no shortage of effective stress management activities, but most people either fail to do them or do them properly. Applied relaxation, meditation, exercise (your choice), Tai chi, and yoga are excellent stress relievers. However if you do not do them routinely, they are of little benefit in preventing canker sores.

Immunosuppressants and Immunomodulators

It is perhaps easiest to start with a description of immunosuppressants because their function is straightforward: they suppress the immune system. Immunosuppressants are probably best known for their use in autoimmune diseases and as drugs that prevent the immune system from rejecting transplanted organs. However, immunosuppressants also have a place in the treatment of canker sores. While it is unclear why canker sores happen, the way in which they cause scars is understood. The immune system destroys the mucosal cells of the mouth (mucosal cells cover most of the area you can see in your mouth). Therefore blocking the immune system can reduce or prevent tissue damage and scarring.

Immunomodulators are slightly different from immunosuppressants in that they alter the immune system in some way (not necessarily suppress it). In fact, some immunomodulators may actually increase the effects of the immune system, though in a way that is favorable for the patient. In terms of canker sore treatment, there is little difference between immunomodulators and immunosuppressants.

Azathioprine

Azathioprine is a powerful medication that interferes with the synthesis (formation) of DNA and RNA. Since the cells of the immune system multiply rapidly, this canker sore treatment blocks new immune cells from being created. Azathioprine is usually given orally as a medicine for canker sores but may be given intravenously (IV) in some cases. This medication cannot be given during pregnancy or if the patient has an active infection. Blood tests need to be performed periodically to check for side effects.

Thalidomide

If people have heard of thalidomide, they have no doubt heard about the horrible birth defects that occurred when this drug was first prescribed several decades ago. After much testing and trepidation, thalidomide is now back on the market in very select patients for very select diseases. Thalidomide is the only canker sore treatment specifically approved by the FDA for the treatment of recurrent aphthous ulcers in people with HIV. The drug seems to inhibit immune system cells from coming together and causing inflammation.

Clofazimine

Clofazimine is a drug that is used to treat leprosy but has been shown to be helpful in some cases of canker sores. The way in which clofazimine works is not exactly known but it seems to suppress the immune system and reduce inflammation.

Amlexanox

Amlexanox is a paste that is placed directly on aphthous ulcers. While it is not clear how this topical drug works, it appears to inhibit the release of chemicals that stoke up inflammation. By limiting these chemicals around the lesion, inflammation is reduced locally. Limited clinical studies show that this canker sore treatment may actually speed up canker sore healing.

Colchicine

Colchicine is best known as a treatment for gout in which it suppresses the immune system’s response to uric acid in the joints. For reasons that are not entirely clear, colchicine also works as a medicine for canker sores. The main side effect of colchicine is diarrhea, which limits its use as a canker sore treatment.

Miscellaneous immune system modifiers

Other agents have been tried in difficult cases with limited success. Other drugs that may be used to treat refractory (difficult to treat) aphthous ulcers are

• Adalimumab
• Alefacept
• Cyclophosphamide
• Cyclosporine
• Dapsone
• Efalizumab
• Etanercept
• Infliximab
• Interferon
• Methotrexate
• Penoxifylline

Anesthetics

Simply put, pain is detected by pain receptors. These pain receptors generate pain signals that are transported through nerves to the brain. Once in the brain, the signals are registered as pain. An anesthetic is a drug that blocks this pathway, either at the pain receptor, the nerve, or both. Because canker sores can be very painful, anesthetics are sometimes used to control this pain and make patients more comfortable.

The two main anesthetics that are used as treatment for canker sores are benzocaine and lidocaine. Both medications come in a variety of preparations such as gels, ointments, sprays, pastes, and viscous (thick and sticky) suspensions. They are used topically (right on the canker sore) to stop pain signals from reaching the brain.

Anesthetics usually need to be applied with an applicator. If they are applied with a bare finger, the finger will become numb along with the treated area. While benzocaine and lidocaine could be injected under the skin, as canker sore treatments they are usually just placed topically. They may need to be reapplied four times a day or more (up to the maximum allowed).

Antiseptics

While it is not at all clear why they would help, certain antiseptic agents seem to reduce the symptoms of canker sores. This benefit is unexpected because canker sores are not contagious and do not seem to be caused by an infectious organism. Nevertheless, chlorhexidine gluconate and (dilute) hydrogen peroxide can shorten the duration that a person has an active canker sore and can also reduce pain. These antiseptics do not change whether the disease will recur, however.

Surgical care

The surgical treatment of canker sores is somewhat controversial. Directly removing the canker sore with a scalpel is not practical. This is because canker sores that are bad enough to warrant surgery would require too much tissue to be removed from the mouth. While some practitioners take a “biopsy” of the canker sore, essentially removing the whole lesion, this approach is not always favorable to patients. Instead, the main goal is to destroy (“burn”) the canker sore tissue rather than cutting it out.

Silver nitrate is one method for the surgical treatment of canker sores. The silver nitrate sticks are freely available. They are commonly used to cauterize mouth or nose bleeds that will not stop bleeding, but are less often used as a medicine for canker sores. Silver nitrate sticks work by causing a chemical burn when applied to mucous membranes (like the inside of the mouth). A physician that can see the aphthous ulcer could quickly treat it by touching the sore with the end of the stick. This converts the lesion from an ulcer into a burn. While this may make a less painful sore, the burn takes as long to heal as the aphthous ulcer.

Laser therapy may have a role in the surgical treatment of canker sores. Not only does laser treatment lessen patients’ pain and heal canker sores faster, some studies indicate that aphthous ulcers do not return as frequently with this treatment. Laser treatment for canker sores is not available everywhere. Moreover, not every physician that uses lasers in medical or surgical practice necessarily to uses it to heal canker sores.

Incidentally, cryotherapy (freezing the canker sore) does not appear to be an effective treatment for canker sores.

References

Arikan OK, Birol A, Tuncez F, Erkek E, Koc C. A prospective randomized controlled trial to determine if cryotherapy can reduce the pain of patients with minor form of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:e1-e5.

Tezel A, Kara C, Balkaya V, Orbak R. An evaluation of different treatments for recurrent aphthous stomatitis and patient perceptions: Nd:YAG laser versus medication. Photomed Laser Surg 2009;27:101-106.

Zand N, Ataie-Fashtami L, Djavid GE et al. Relieving pain in minor aphthous stomatitis by a single session of non-thermal carbon dioxide laser irradiation. Lasers Med Sci 2009;24:515-520.

Home remedies drawn from medical treatment

Some home remedies that divulge how to get rid of canker sores overlap with the medical treatment for the illness, such as corticosteroids and anesthetics. While a physician will prescribe highly concentrated corticosteroids, less concentrated ones are available without a prescription. Hydrocortisone creams such as Cortaid and Westcort are available over the counter and may be as effective as prescription treatments when used as directed. If your goal is simply pain relief, Anbesol contains up to 20% benzocaine and is an excellent, fast-acting topical anesthetic that does not require a prescription.

Canker sore home remedy: Mouth rinses

When considering how to get rid of a canker sore there are several mouth rinses that can be used to reduce the pain and irritation of aphthous ulcers. Perhaps the most well known canker sore home remedy is salt water. If you are going to use salt water as a canker sore remedy, remember that it may make the aphthous ulcer slightly more painful during the treatment. Mix between a teaspoon and a tablespoon of salt in eight ounces of warm water. The water should be almost hot to the touch but not so hot as to burn your mouth. Once the salt is dissolved, swish in your mouth for 30 to 60 seconds a spit (do not swallow).

Milk of magnesia and liquid antihistamines can be used as mouth rinses as well. While you may be able to swallow some of these medicines when used for other illnesses, as a home remedy for canker sores they should be spit out after use. They do their whole job right at the aphthous ulcer site.

There is some evidence that suggests that mouthwashes with triclosan might help prevent canker sores from recurring. Unfortunately triclosan is being investigated by the FDA and the EPA as a chemical that may interfere with the endocrine system (hormones). While it is not yet known to be dangerous, the results of ongoing investigations may conclude that this canker sore remedy is not worth the risk. On the other hand, avoiding mouth rinses that contain sodium lauryl sulfate may be beneficial. While no one knows why, sodium lauryl sulfate seems to make aphthous ulcers flare-up more frequently.

Diet and vitamins

For the most part, vitamin supplementation as a canker sore remedy is only helpful when there is a vitamin deficiency of some sort. Most Western diets are fortified with enough vitamins that additional supplementation is not usually necessary. That said, many people do have undiagnosed vitamin deficiencies and may benefit from B vitamin supplementation, zinc, and folate. One notable exception is vitamin B₁₂. This vitamin may actually be a canker sore remedy that works whether or not there is a deficiency.

Gluten may irritate aphthous ulcers and should be avoided in some people. It seems, though, that the people who benefit from gluten avoidance (as a home remedy for canker sores) are those that have an inability to digest gluten. Researchers are only recently beginning to realize, however, how many people have some degree of celiac disease that are not diagnosed. If you have recurrent aphthous ulcers, it may make sense to ask your doctor about testing for celiac disease. If positive, avoiding gluten will not only become a way of life, but will be a canker sore remedy as well.

References

Fridh G, Koch G. Effect of a mouth rinse containing amyloglucosidase and glucose oxidase on recurrent aphthous ulcers in children and adolescents. Swed Dent J 1999;23:49-57.

Gulcan E, Toker S, Hatipoglu H, Gulcan A, Toker A. Cyanocobalamin may be beneficial in the treatment of recurrent aphthous ulcers even when vitamin B12 levels are normal. Am J Med Sci 2008;336:379-382.

Hunter IP, Ferguson MM, Scully C, Galloway AR, Main AN, Russell RI. Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy. Oral Surg Oral Med Oral Pathol 1993;75:595-598.

Skaare AB, Herlofson BB, Barkvoll P. Mouthrinses containing triclosan reduce the incidence of recurrent aphthous ulcers (RAU). J Clin Periodontol 1996;23:778-781.

Volkov I, Rudoy I, Freud T et al. Effectiveness of vitamin B12 in treating recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled trial. J Am Board Fam Med 2009;22:9-16.

Corticosteroids

If your first inclination is to see a physician for canker sore treatment, you will likely be given some type of corticosteroid. Corticosteroids are rather powerful anti-inflammatory drugs that are administered in a variety of medical conditions. As a medicine for canker sores, corticosteroids are intended to reduce the canker sore symptoms such as pain, itching, and irritation. If this is your first case of aphthous ulcers, you will almost certainly be given a topical corticosteroid, that is, a cream or ointment that is placed directly on the canker sore. This should relieve symptoms and may shorten the duration of the disease. If successful, topical corticosteroids might be used for any flare-ups or recurrences. If ineffective, you may need oral corticosteroids or an injection of this canker sore treatment into the aphthous ulcer.

Immunomodulators

Immunomodulators and immunosuppressants are reserved for relatively severe cases of aphthous ulcers. These drugs modify or suppress the immune system—not only at the ulcer—but all over the body in some cases. That is why these medications are used more or less as a last resort. If your physician uses these medications, be aware that you may be monitored for side effects from time to time, because they can be severe.

Anesthetics

Since most canker sores will go away in several days, some people look to control the pain until the mouth sore is gone. In this case, topical anesthetics are used to treat canker sores. The anesthetic is placed on and around the aphthous ulcer and is absorbed into the tongue or gums. This medication numbs the mouth by blocking pain signals around the sore. Anesthetics will not speed up the rate in which the canker sore heals, but they can provide immediate and profound pain relief. Some preparations are available over the counter.

Surgical care

There are very few effective surgical treatments for canker sores. Cutting the lesion away is not always practical, especially if the mouth sore covers a large area of the mouth. Plus, cutting the canker sore out does not mean that it will be gone for good. In fact, the trauma done by the surgery may provoke other canker sores. Cryotherapy has the same poor success rate. One promising surgical treatment for canker sores is laser therapy. In this approach, a laser ablates the ulcer in layers instead of cutting it away.

Home remedies for canker sores

Traditional home remedies for canker sores abound; some are effective and some are not. Some of the best home remedies are those that are based on medical treatments, such as corticosteroids and anesthetics. However various mouth rinses and topical treatments gathered from commonly available substances can sooth and relieve canker sore pain. While it may take some trial and error, home remedies for canker sores generally have few side effects and are inexpensive.

Alternative and homeopathic canker sore treatment

As with natural home remedies, alternative canker sore treatment has a place among other medicines for canker sores. Since stress can bring on or exacerbate recurrent aphthous ulcers, methods to relieve stress such as mediation, yoga, and massage therapy can prevent them. In addition, there are a number of herbal remedies that may be helpful for some people with canker sores.

References

Arikan OK, Birol A, Tuncez F, Erkek E, Koc C. A prospective randomized controlled trial to determine if cryotherapy can reduce the pain of patients with minor form of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:e1-e5.

Eisen D, Lynch DP. Selecting topical and systemic agents for recurrent aphthous stomatitis. Cutis 2001;68:201-206.

Fridh G, Koch G. Effect of a mouth rinse containing amyloglucosidase and glucose oxidase on recurrent aphthous ulcers in children and adolescents. Swed Dent J 1999;23:49-57.

Quijano D, Rodriguez M. [Topical corticosteroids in recurrent aphthous stomatitis. Systematic review]. Acta Otorrinolaringol Esp 2008;59:298-307.

Schuyler W.Lininger, Jonathan Wright, Steve Austin, Donald J.Brown. The Natural Pharmacy. Prima Lifestyles, 1998.

Skaare AB, Herlofson BB, Barkvoll P. Mouthrinses containing triclosan reduce the incidence of recurrent aphthous ulcers (RAU). J Clin Periodontol 1996;23:778-781.

Tezel A, Kara C, Balkaya V, Orbak R. An evaluation of different treatments for recurrent aphthous stomatitis and patient perceptions: Nd:YAG laser versus medication. Photomed Laser Surg 2009;27:101-106.

Complications of major aphthous ulcers

Major aphthous ulcers are bigger than the more common minor ones. They are sometimes referred to as Sutton ulcers or periadenitis mucosa necrotica recurrens. Major aphthous ulcers are generally more painful, last longer, and recur more frequently as well. Unfortunately the main complication of major aphthous ulcers is tissue scarring.

Scientists believe that the reason this type of canker sore scars is because of the immune reaction that takes place at the site of the lesion. Remember that immune system cells are the killer cells of the body. They release toxic substances that are meant to destroy foreign invaders such as bacteria and viruses. When the immune system goes to work in a particular area of the body, these toxic substances sometimes land on the body’s own tissue. If this happens for a long period of time and/or the toxic substances accumulate in high concentrations, the tissues can become damaged. This tissue damage can result in scars.

There are certainly a number of canker sore treatments, including home remedies and alternative treatments. However, because major aphthous ulcers can result in tissue scarring in the mouth due to immune system activity, it might reasonable to discuss drugs that affect the immune system such as corticosteroids or even immunomodulators with your doctor. Other methods can be used to prevent recurrence between flare-ups.

Because these mouth sores are so painful, canker sores can interfere with eating and drinking. Patients may become dehydrated and malnourished because they refuse to eat. This is especially true in infants and small children. Young children often refuse to be fed but also dehydrate faster than older children and adults. In these cases, adequate pain control is essential. The goal should be to numb the mouth, perhaps through the use of anesthetics, so that eating and drinking can be restarted without pain.

Canker sore prognosis

Both minor aphthous ulcers and recurrent herpetiform ulcerations tend to heal without treatment. This assumes, however, that the patient’s immunes system is intact and healthy. Even minor lesions can last a very long time in people with weakened immune systems. HIV/AIDS patients are hard hit by canker sores. Cancer and various autoimmune diseases not only weaken the immune system directly, but the treatment for these illnesses may further weaken it. While prognosis is generally very good for most people, the disease can be quite severe in certain patient populations and recovery times are longer.

Herbal remedies for canker sores

Licorice root

Several herbs may be helpful as home remedies for canker sores. Licorice root may be soothing and promote canker sore healing. People with high blood pressure, congestive heart failure, and those who retain water may want to obtain the licorice root that has had the glycyrrhizic acid removed. Licorice root can be formed into a paste and placed directly on the aphthous ulcer.

Chamomile

Chamomile has a soothing effect and is one of the traditional herbal remedies for canker sores. Those that choose this home remedy may make a strong tea and allow it to remain in the mouth for a generous amount of time before swallowing. A moistened tea bag placed directly on the canker sore may help dry the ulcer and promote healing. In fact, virtually any tea that is used in this way may help.

Echinacea

Echinacea has wound healing properties and has been used as a home remedy for canker sores. While the capsule form may be effective, liquid Echinacea is likely to be of greater use since it can be held in the mouth and work directly on the canker sore.

Myrrh

Myrrh has been used for hundreds of years as a treatment for gum and mouth sores. As a canker sore remedy, the herbal extract or tincture is combined with enough water to allow it to be swished around the mouth.

Sage

As a home remedy for canker sores, sage is usually used in one of two ways. The leaves can be used to make a tea, of sorts, by steeping in hot water. Instead of drinking the sage extract as a tea, though, it is used as a “swish and spit” canker sore remedy. Alternatively, dried sage leaves can be placed directly on the canker sore.

Alternative canker sore remedies

Some patients with recurrent aphthous ulcers notice that the lesions tend to occur during periods of stress. Reflexively, people that can adequately manage and release stress from their lives have fewer flare-ups. There are a number of proven ways to relieve stress; however, it is generally best to find a method that works for you and that you enjoy enough to keep doing. Some stress-relieving activities that traditionally fall into the alternative category include:

• Acupuncture
• Aromatherapy
• Massage therapy
• Meditation
• Music therapy
• Tai chi
• Yoga

Homeopathic canker sore remedies

Little scientific evidence supports the use of homeopathy as a canker sore remedy. Nevertheless, those inclined to use homeopathic treatments for canker sores may find the following agents helpful. All of those listed are in the 6c concentration and should be used under the guidance of a homeopathic practitioner.

• Arsenicum album – Useful if stress is a key component of canker sore eruption; 3-4 times daily until symptoms improve then discontinued
• Borax – May be helpful when the canker sore is affected by acids and citrus; 3-4 times daily until symptoms improve then discontinued
• Mercurius sol – Used in cases where pain is greatest at night or when bad breath is apparent; 3-4 times daily until symptoms improve then discontinued
• Natrum muriaticum – A homeopathic treatment primarily used for cold sores but may also be used as a canker sore remedy; 3-4 times daily until symptoms improve then reduce frequency
• Rhus toxicodendron – Used in widespread or multiple aphthous ulcers; 3-4 times daily until symptoms improve then reduce frequency

Additional treatments, such as quercetin, may be found in Recent research and clinical trials on canker sore treatment.

Reference

Schuyler W.Lininger, Jonathan Wright, Steve Austin, Donald J.Brown. The Natural Pharmacy. Prima Lifestyles, 1998.