Dr. Urban on Today’s Dentistry: Canker Sores

Many of us have experienced canker sores. Where do they come from, what are they, and what do you do about them?
In a nutshell we do not know exactly what brings on a canker sore. They appear in young adults more often and frequently arise during periods of emotional or physical stress.
The sores typically occur on the cheek lining, under the tongue, around the uvula, bottom of the mouth and in front of the tonsils. It is not uncommon to have several sores appear near each other. They are very painful and can reoccur without any warning.
They appear first as tiny “bubbles” or red spots. The middle of the lesion becomes necrotic and a grayish-white covering or scab covers the wound. The nerve endings are exposed and the underlying tissue is very raw. Pain is the primary feature and will last for 5-7 days. These sores will typically run their course in 14 days. They can reappear with extreme and exasperating frequency.
Under the microscope scientists have noticed an intense infiltration of inflammatory cells leading to the theory that these sores are an immunologic defect in the cellular immune mechanism. In other words a small patch of cells cease performing the functions that maintain their life.
What can you do about them? Since we do not exactly know what will create a canker sore you really cannot prevent them from occurring. If one does pop up the pain can be relieved with Aphthasol or Kenalog ointments. These are prescription medications that your dentist can prescribe. They are anti-inflammatory and are locally applied to the wound. More severe sores can be treated with high potency steroids such as Decadron.
Otherwise, you can wait until they subside. In the meanwhile keep them clean with hydrogen peroxide and covered with Zilactin (an over the counter oral wound dressing). I like Zilactin with Benzocaine since it numbs the sore and seals it off from spicy and irritating foods. Keeping the wound free of secondary infection is important so your dentist may prescribe an oral antimicrobial rinse such as chlorhexidine.
Canker sores can be confused with herpes and traumatic ulcers. Although herpes is reoccurring it typically does not appear inside the mouth. Likewise, traumatic ulcers usually have a memorable start date and do not reoccur (unless you repeatedly bite the same area).
I advise people with troublesome canker sores to seek pain relief from their dentist.
For answers to your dental questions, contact Douglas Urban, D.D.S. Cerritos, CA 90703 562 924-1523 www.DrDouglasUrban.com