Definition

Canker sores, also known as aphthous ulcers or aphthous stomatitis, are non-contagious erosive lesions resulting from the rupture of the epithelial tissue (one of the layers of the mouth’s skin) and exposure of the connective tissue.

Incidence

About 20% of the population suffers from recurrent canker sores. And although they are very uncomfortable, they usually do not cause serious problems.

Causes

The exact reasons for their appearance are not fully understood, but they seem to be associated with an imbalance in the individual's immune system.

There are also some factors that appear to contribute to the development of the lesions, such as: local trauma, stress, short sleep periods, gastroesophageal reflux, hormonal changes during the menstrual cycle, allergies to certain foods, and deficiencies in vitamins B12 and C, zinc, iron, and folic acid.

Characteristics

A canker sore appears as a round ulcerated lesion, covered by a white-yellowish membrane and surrounded by a red halo. It can occur anywhere in the oral cavity, be single or multiple, and vary in size. With an average duration of 7 to 10 days, the lesions do not leave scars, and are identified by their appearance, the pain they cause, and how long they last.

All age groups can be affected. However, the lesions are more common in children, adolescents, and young adults—due to the high incidence of trauma (accidental bites, use of orthodontic appliances), but mainly because of diets rich in acidic foods (sodas, juices, acidic fruits).

Proper oral hygiene can help reduce mouth acidity. It is important for parents to avoid offering children large amounts of acidic foods and to monitor the duration of the sore. If the discomfort is intense, a dentist should be consulted.

Although treatment is not effective for all patients, it aims to speed up the healing process and reduce pain. Antiseptics, anti-inflammatories, anesthetics, or mucosal protectors may be used, but only under a dentist’s guidance. Home remedies should be avoided, as they can further irritate the area, potentially causing burns and increased pain.

Canker sores are not dangerous, but attention should be paid to lesions that do not heal within 15 days. In such cases, a dentist should evaluate the area to rule out squamous cell carcinoma, a cause of oral cancer that often begins as an ulcerated lesion. Some systemic diseases, such as lupus or herpes, can also manifest in the oral cavity and may resemble canker sores at certain stages of their development.

Prevention

People prone to canker sores should avoid consuming acidic fruits and condiments. A diet rich in iron, folic acid, and vitamin B12—found in red meats and dark green leafy vegetables—helps with prevention. Additionally, managing stress is also a strong ally.

By Einstein Editorial board