Canker Sore

Overview:

A canker sore is a destructive condition related to the oral cavity of humans, also called as aphthous or mouth ulcers. Aphthous is marked by the repeated generation of the non-spreading and less harmful wound in the mouth. These are tiny, superficial bruises on the soft tissues of the mouth or at the base of gums present in the mouth. They are not occurring on the base of your lips or other exterior surfaces. Canker sores are painful, having stress on your psychological condition as you are unable to eat or talk comfortably. Most canker sore heals on their own in one to two weeks, but if there is a large or painful canker sore, you may need a consultation with your dentist or physician.

Types:

There are few kinds of canker sore, including herpetiform sores, minor sores, and major sores.

1. Herpetiform canker Sores: They are rare, and usually develop in later stages of life, they are of pinpoint size occurs in a cluster and may form one large ulcer, having irregular sides and heal itself within two weeks without scarring.

2. Minor canker sores: These are the most common type of sores, small in size, having oval-shaped with red sides. It heals within one to two weeks.

3. Major canker sores: They are less common and are round with definite edges, can be very painful, present as large and deeper sore, may take 4 to 6 weeks to heals, and may cause scarring.

Causes:

Most probably, canker sores are idiopathic, having no possible cause or mechanism from an origin, Following possible causes of canker sore may be considerable.

• Simple canker sore may be caused due to some minor injuries like vigorous tooth brushing, dental work, or any sports freak.
• Citrus fruits like strawberries, lemon may be triggered, or worsen the canker sore.
• Deficiency of vitamin B12, folic acid or iron
• Hormonal imbalance and autoimmune diseases
• Prolonged use of NSAIDs (non-steroidal anti-inflammatory drugs)
• By using sodium lauryl sulfates containing toothpaste.

Cardinal signs and symptoms:

• The commonly expose symptoms are sores of white, yellow, or grey color with a distinctive red boundary in your mouth.
• Pain depending upon the size and deepness of sore.
• A sensation of prickling, burning, and stinging before the sore appears.
• Trouble in eating, swallowing, and speaking.

Prevention:

By following good oral hygiene habits, you can be easily prevented from a canker sore. Oral hygiene habits include regular brushing of your teeth after meal and flossing can help you to clean your mouth from food debris that might be the cause of the sore. Avoid abrasive food items that may be stuck into your teeth. Do not use kinds of toothpaste and mouthwashes having sodium lauryl sulphate.

Treatment:

A number of the causes of canker sores do not need any treatment, and nothing specific you need to get rid of it, because in most cases, it heals on its own. But home remedies can be beneficial to relieve pain and other symptomatic conditions.

Home remedies:

 Home remedies can be helpful to the speed healing process, relieves irritation, and pain caused by a canker sore.

• Dissolve a piece of ice slowly in your mouth. It can be beneficial to relieve pain.
• Use a soft bristle brush, and gently brush your teeth.
• Prepare a solution of salt and water or baking soda and rinse thoroughly.
• Echinacea herb helps to speed up the healing process.
• Vitamin B complex and vitamin C have taken orally to prevent further progress in the lesion.
• Zinc lozenges can be used to speed the healing process.
• Milk of magnesia with Benadryl extract can be used as a rinse, or you can directly apply the solution to the affected area.
• The use of aloe vera gel can soothe the area.
• If sore may be due to nutritional deficiency, take vitamin supplements as OTC or by the guidance of your health care provider.

Clinical treatment plans and procedure:

If you have a high-grade fever with canker sores and feel difficulty while eating and drinking, you should consult the physician. You may experience deep and large canker sores’ pain. It is challenging to bear, and you are unable to control with self-care medications.

Over-the-counter (OTC) prescription and topical treatment:  

Over-the-counter treatment for cancer sore falls into the following categories.

• Occlusive or emollient:

       That forms a protective sheath that blocks irritation of the sore. These protective materials are pharmacologically inert and nonreactive. Products used as emollient purposes are Southern-Seal, Orabase.

• Anaesthetics:

These drugs are usually combined with other agents to provide symptomatic relief: Benzocaine 5-20% and lidocaine. Many OTC anaesthetic gels are available in the market.

• Antiseptics and cleaning agents:

       These agents help to maintain oral hygiene by cleanse the area and decrease the number of microbial growths. 3% aqueous solution of hydrogen peroxide in diluted form can be used as a mouth rinse. Paste or solution of sodium bicarbonate having efficacy to cleanse wounds.

• Topical anti-inflammatory:

      Fluocinodine, triamcinolone acetone, and other steroids can be used topically to reduce inflammation caused by the canker sore.

• Topical antibiotics:

These drugs are used with the prescription of the physician or dentist if the patient experiences symptoms of microbial infection such as fever, pus discharge, redness, and inflammation.

• Mouthwashes solutions:

      Suspension of diphenhydramine is used as a mouth rinse due to its oral anaesthetic effect. Suspension should be swished for about 30- 60 sec, and it should not be swallowed. Anti-inflammatory mouthwashes can be prescribed to decrease inflammation of sore.

Antibiotics like tetracycline or another rinse can be prescribed to relieve pain and promote the healing process. Don’t use this type of rinse in children or pregnant women.

• Pain medications:

       Over the counter pain management, medicine like NSAIDs include Naproxen, ibuprofen, and paracetamol can be used to relieve mild to moderate pain and reduce inflammation.

• Lozenges and multivitamins: 

       Zinc-containing lozenges or vitamin supplements as Surbex, polybion, can be helpful to relieve symptoms of canker sores.

References:

• Journal

CANKER SORES

In-text: (Canker sores, 2004)

Your Bibliography: Postgraduate Medicine, 2004. Canker sores. 116(1), pp.67-67.

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• "New research comes to terms with old ideas about canker sores." ScienceDaily. ScienceDaily, 29 March 2017.

• Tezel A, Kara C, Balkaya V, Orbak R. An evaluation of different treatments for recurrent aphthous stomatitis and patient perceptions. 2009;27(1):101-106. doi: 10.1089/pho.2008.2274.

• https://www.medicinenet.com/canker_sores/article.htm#what_are_canker_sores.