Aphthous ulcers (or canker sores) are common and affect people of all ages. Did you know that they can be prevented and relieved?

What are aphthous ulcers?

Aphthous ulcers are what is commonly called canker sores. For the most part, they are round or oval-shaped with a red border covered by a white, yellow or sometimes grayish membrane. They can appear in different areas of the mouth—tongue, inside of the cheek, roof of the mouth or gums. They are often painful and cause a burning sensation. They can hamper nutrition and hydration.

The size of canker sores can vary greatly. While some will only be a few millimeters in diameter, others will be larger than a centimeter. Depending on the type of canker sore, they may appear alone or in clusters. Most of the time, minor aphthous ulcers heal on their own after 7 to 14 days, without leaving a scar. Major canker sores (which are generally bigger) can take up to 6 weeks to heal and can leave scars.

What are the risk factors?

Canker sores can affect anyone, but some people are more at risk than others. Women are more likely to have them than men. People under the age of 40, particularly children and adolescents, are also more at risk.

Canker sores can appear without any apparent reason. In some cases, some triggering factors may be identified. Here are some examples:

• a local trauma
• stress and anxiety
• hormonal changes
• certain additives or food preservatives
• certain medications
• certain health problems
• certain vitamin and mineral deficiencies

Pharmacists can inform you about the medications that are likely to cause the appearance of canker sores. They can tell you if certain products put you at risk by reviewing your list of medications. The medications that can cause canker sores are often prescribed to treat cancer, inflammation, hypertension, and heart disease.

How can canker sores be prevented?

If you are aware of the factors that cause your canker sores, do your best to avoid them. Moreover, there are certain measures you can take to prevent canker sores. Here are a few examples:

• Maintain excellent oral hygiene. Use a toothbrush with soft bristles and a gentle toothpaste.
• If you wear dentures or braces, make sure they are well-adjusted.
• Take the time to adequately chew your food and avoid talking while you eat, as this will help prevent inadvertently biting the inside of your mouth.
• Be careful when you eat food that is likely to cause mouth lesions, such as sunflower seeds or peanuts.
• Avoid chewing the inside of your cheeks. It is a bad habit that can lead canker sores.
• Reduce stress and anxiety.
• Get plenty of sleep.
• Limit your alcohol consumption.

How can canker sores be treated?

Most of the time, canker sores can be treated easily and quickly. Above all, continue to brush your teeth and use dental floss.

Moreover, there are several measures you can take to help relieve and heal canker sores. Here are some examples:

• Let an ice cube melt on the canker sore.
• Apply orthodontic wax to limit traumas caused by poorly adjusted braces.
• Rinse your mouth with salt water (one teaspoon of salt for one cup of water).
• Avoid applying salt directly on the sore.
• Avoid alcohol-based mouth wash.
• Avoid eating foods that are spicy, acidic, hard or sharp.

There are several over-the-counter products available in-pharmacy that are designed to treat canker sores—gargle, gels, pastes, and patches. Some of them contain anesthetic agents, others help to prevent infection, while some are used to cover and protect canker sores. There are also prescription medications available to treat canker sores.

When a canker sore causes pain, you can use an acetaminophen or ibuprofen-based analgesic. Ask your pharmacist to recommend the product that best suits your needs based on your situation, age, health, and the medication you are already taking.

You should see a doctor if:

• you frequently have canker sores (more than six times a year)
• your canker sores are long to heal (no improvement after seven days)
• the appearance of canker sores is accompanied by other symptoms (diarrhea, red eyes, fever, etc.)
• you have significant difficulty eating or hydrating

Speak to your pharmacist for additional information about canker sores.