What Causes Canker Sores?

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Canker Sore Relief Is Possible!

Canker sores are very unpredictable and quite uncomfortable for many who suffer from them. Canker sores (apthous ulcers) are white sores, not blisters, that typically occur inside the cheeks, lips, and possibly on the gum tissues.

Most canker sores range in size from smallish dots to large coin-sized ulcerations. They can be pretty painful, make speaking, eating, or even a simple smile difficult, and may take 1-2 weeks to heal.

Researchers have studied canker sores for years, but the exact cause remains a mystery. There have been possible links to a patient’s genetic background, increased stress, or even minor oral trauma. 

Types Of Canker Sores

Minor canker sores

These are the most common type of canker sores and:

  • Are usually small
  • They are oval-shaped with a red edge
  • Typically heal without scarring in about one to two weeks

Major canker sores

Major canker sores are less common and:

  • Are more extensive and deeper than minor canker sores
  • They are usually round with defined borders but may have irregular edges when very large
  • It can be extremely painful
  • These can take about 4-6 weeks to heal. This type can leave extensive scarring.

Herpetiform canker sores

Herpetiform canker sores are quite uncommon and usually develop as the patient ages, but they are not caused by the herpes virus. This type of canker sores include:

  • Are pinpoint in size
  • Herpetiform occur in clusters of 10 to 100 sores but can often merge into one large ulcer
  • Edges are irregular
  • Typically heal without scarring in about two weeks

Common canker sore symptoms include:

  • A burning, tingling, or prickling sensation, up to 24 hours before the sore appears
  • Crater-like ulcers that are white, gray, or yellow in color, with a red border
  • Canker sores are usually painful
  • Difficulty speaking, eating, or swallowing

Less common symptoms of canker sores can also indicate a more serious underlying infection include:

  • Fever
  • Swollen lymph nodes
  • Sluggishness
  • Weight loss
  • Presence of thrush infection in your mouth or throat

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Are cold sores the same as canker sores?

No. Although these sores are often confused with one another, they are definitely not the same.

Cold sores

  • Are a group of painful, fluid-filled blisters caused by the herpes simplex virus.
  • Caused by a virus.
  • Tingling or Burning Sensation.
  • Highly contagious.
  • Typically appear outside the mouth. Common areas for cold sores include around the lips, under the nose, or under the chin.

Canker sores

  • Caused by an infection
  • Not contagious.
  • Occur inside the mouth.
  • Tingling or burning sensation.

What should you do to stay canker sore-free?

Tips To Avoid Canker Sores

Maintain Proper Nutrition.

It is essential to maintain proper nutrition. This is to ensure you are consuming the right mix of vitamins and minerals to keep your body healthy. Research has shown nutritional deficiencies can cause mouth ulcers. Researchers have shown that zinc, B12, iron, l-lysine, and folic acid can all be very helpful in preventing the development of canker sores.

Avoid Certain Foods.

If you are experiencing a canker sore outbreak, you should watch what you eat. Acidic foods and drinks (such as lemonade or orange juice) can inflame and irritate the painful canker sores and prolong healing. Consuming chocolate is a known trigger for apthous ulcers.

Change Dental Hygiene Products.

The bubbling agent used in toothpaste can be an irritant to some patients’ oral tissues. If you notice sloughing tissues, red or irritated tissue, and experience frequent canker sores, you may want to remove regular toothpaste from your dental hygiene routine.

You may want to experiment with some new dental hygiene products that are gentler in your mouth. There are specialized canker sore toothpaste specially formulated not to irritate the mouth. These kinds of toothpaste are sodium lauryl sulfate-free (SLS).

Sodium lauryl sulfate is generally used in toothpaste to produce that foaming action when brushing. It is believed that changing to an SLS-free toothpaste will reduce the incidence of canker sores.


Rises in hormones during the menstrual cycle, menopause, pregnancy can also trigger a patient to develop canker sores.


Certain medications can trigger apthous ulcers. These medications include Nicorandil, a medicine used in patients with angina, antihypertensives, sulfa drugs, and immunosuppressants.

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What To Do If The Canker Sores Persist


DeBacterol is a topical canker sore medicine that chemically cauterizes mouth sores. The relief is virtually instantaneous, and the healing will be completed within days instead of the normal weeks—this is a top medicine to treat canker sores and relieve pain from the canker sore.

Drinking milk

The milk is supposed to decrease the number of canker sore outbreaks. Drinking milk is supposed to help decrease canker sore outbreaks.

Supplement with a multivitamin 

The multivitamin will help to ensure you are getting everything your body needs. Nutrition has been proven to play a role in the recurrence of canker sores.

If you are experiencing persistent sores in the mouth, call your dentist. You should make an appointment to get the surrounding teeth and gums checked.

Call your dentist about canker sore outbreaks if you have the following symptoms of canker sores:

  • Unusually large sores.
  • Sores that are spreading.
  • A canker sore or ulcer that lasts three weeks or even longer.
  • Intolerable pain. This pain is despite avoiding trigger foods and taking over-the-counter pain medication.
  • Difficulty staying hydrated.
  • A high fever in combination with the appearance of canker sores.

What To Do If You Get Recurring Sores?

  • If a patient suffers from frequent canker sores, there may be an underlying medical reason or illness present. See your medical doctor or dentist if there are any concerns that canker sores are frequent.
  • Predisposition to most canker sores may have a genetic cause. However, some diseases that affect the immune system may cause frequent or recurrent canker sores. These canker sore causing diseases include lupus, Crohn’s disease, celiac disease, or HIV/AIDS.
  • A medical doctor can order testing to determine a possible underlying medical reason for a patients’ frequent canker sores.


Canker or mouth sores can be uncomfortable and often debilitating, but your dentist can take treatment steps to relieve them when they appear. In some cases, even avoid them altogether. The frequency with which you develop sores, their size, and how long they last are important. Discuss all of the symptoms with your dentist so that they may assess whether they are your typical canker sores or possibly a more serious issue that may require further treatment and examination.

Regain confidence in your smile with the help of Marielaina Perrone DDS!

Our goal is to help our patients give them their best smile yet. Dr. Perrone and her cosmetic dental team are proud to offer comprehensive dental care, including routine dental cleanings as well as the cosmetic and restorative procedures mentioned above.

If you are ready for a smile makeover, contact Marielaina Perrone DDS at (702) 458-2929 to schedule a no cost cosmetic consultation appointment. We cannot wait to help you with your state of the art smile makeover to create the smile of your dreams in Summerlin, Henderson, and Las Vegas, NV.