Wednesday, November 17, 2010

The Battle Against Canker Sores


If you've ever suffered from canker sores (aphthous ulcers) then you know just how irritating those little monsters can be.  They pack a big punch and have made many people's day miserable in doing so.

When in full force they dictate what you eat and even how you speak.  Ketchup and mustard anyone?  I think not!  How about your favorite citrus fruits?  Not a chance!  And there's nothing worse then having one land right on the inside of your lip making it sound like you missed out on Hooked On Phonics as you try to pronounce simple letters such as 'f', 'b', and 'v'.

But don't give up hope just yet because although science may not have found a definitive cause or a cure there is some great information out there to try and keep these mouth ulcers at bay.  Let's take a closer look at this:

1)  Boost Your Immune System  - There has been some preliminary evidence that certain bacteria (H. pylori)[1] and even the AIDS virus[2] could be linked to canker sores.  It is important to keep a healthy immune system to fight off these microorganism's effects as best as possible.  This can be done by eating a nutrient dense, plant-based diet, exercising regularly, reducing stress, and forming good sleeping habits.

2)  Use SLS-Free Toothpastes & Mouthwashes - Sodium lauryl sulfate (SLS) is a surfactant used to remove oily stains and residues and is included in various products such as engine degreasers, floor cleaners, and car wash soaps.  Smaller amounts of SLS are included in toothpastes, mouthwashes, and shaving foams.  It actually works as a thickening agent to help form a lather in these products.  However, it has been link in several studies to frequently increasing the occurrence of canker sores[3,4,5].  To find a list of SLS-free toothpastes go here.

3)  Chew Carefully & Brush Easily - Oral trauma has been shown to cause canker sores.  I've personally experienced this several times after accidentally biting my lip or cheek.  Dentures, burning your mouth with hot food, or brushing too hard can all cause tissue damage and lead to mouth ulcers.  It's a good idea to brush lightly and you may want to buy a soft bristled toothbrush instead of one with medium or hard bristles to avoid injury as well.

4)  Maintain Adequate B12, Iron, & Folate Levels - These nutritional deficiencies have all been linked to recurrent canker sores[6].  If you eat a vegetarian or vegan diet make sure you are supplementing with vitamin B12 as these diets are often found to be deficient in this vitamin.  Also make sure you're eating plenty of dark leafy greens, nuts (if not allergic), seeds, and a variety of beans to get plenty of iron and folate.

5)  Avoid Food Allergies & Sensitivities - Your body doesn't always agree with certain foods and they could very well be the guilty party in causing your canker sores.  Acidic fruits such as tomatoes, pineapples, and other citrus fruits can be the cause of your problems.  They can also exacerbate aphthous ulcers.  Canker sores have also been linked to allergies to shellfish, nuts, eggs, soy, chocolate, cow's milk[7], and gluten containing foods (wheat products)[8].

6)  Chronic Diseases -  Certain chronic diseases have been linked to recurrent canker sores including Behçet's disease and Crohn's disease[9].  Find out more about these diseases and what you can do for them by clicking on their link.


I hope this has given you a good rundown of what might be causing your canker sores and how to try and alleviate them.  There's no magic bullet as of yet to cure these irritating little guys but you've got some starting points to go by now in your quest to maintain a healthy, pain free mouth.









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by Dustin Rudolph, PharmD
Clinical Pharmacist

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References:
Karaca SSeyhan MSenol MHarputluoglu MMOzcan A. The effect of gastric Helicobacter pylori eradication on recurrent aphthous stomatitis. Int J Dermatol. 2008 Jun;47(6):615-7.
Miziara IDAraujo Filho BCWeber R. AIDS and Recurrent Aphthous Stomatitis. Braz J Otorhinolaryngol. 2005 Jul-Aug;71(4):517-20.
Herlofson BBBarkvoll P. The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand. 1996 Jun;54(3):150-3.
Chahine LSempson NWagoner C. The effect of sodium lauryl sulfate on recurrent aphthous ulcers: a clinical study. Compend Contin Educ Dent. 1997 Dec;18(12):1238-40.
Herlofson BBBarkvoll P. Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study. Acta Odontol Scand. 1994 Oct;52(5):257-9.
Wray DFerguson MMHutcheon WADagg JH. Nutritional deficiencies in recurrent aphthae. J Oral Pathol. 1978;7(6):418-23.
Besu IJankovic LMagdu IUKonic-Ristic ARaskovic SJuranic Z. Humoral immunity to cow's milk proteins and gliadin within the etiology of recurrent aphthous ulcers? Oral Dis. 2009 Nov;15(8):560-4. Epub 2009 Jun 29.
Bucci PCarile FSangianantoni AD'Angiò FSantarelli ALo Muzio L. Oral aphthous ulcers and dental enamel defects in children with coeliac disease. Acta Paediatr. 2006 Feb;95(2):203-7.
Vavricka SRBrun LBallabeni PPittet VPrinz Vavricka BMZeitz JRogler GSchoepfer AM. Frequency and Risk Factors for Extraintestinal Manifestations in the Swiss Inflammatory Bowel Disease Cohort. Am J Gastroenterol. 2010 Aug 31. [Epub ahead of print]

2 comments:

  1. I do have canker sores. I have had them about six months. I had the swine flu last winter and had to take antibotics, the first time in my life. (age 68) It did a number on me, I got a yeast infection, in my mouth and when that went away, I had the canker sores. The EN&T specilist told me to take LLysine. He stated there is not a set amount of miligram recommended. So, I take one 500mg tablet, twice a day. Plus I take Acidophillus tablets, as I go to bed, in case, acid comes up into my mouth, while I am sleeping. I have not had any sores now for almost 4 weeks, so I think I might have a handle on it. The main thing, boost your immune system.

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  2. I discovered at an early age that I get canker sores from eating food with any type of hot, red pepper in it. Unfortunately, I have to limit the amount of curry that I eat. Only recently (two or three years) I began to get canker sores after eating tomatoes, even organic ones. Once in a while though I put up with the canker sores to enjoy a plump, ripe tomato. It would be interesting to find out what caused the tomato problem.

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