General Illness Information
Common Name:	CANKER SORES
Medical Term:	Aphthous Ulcers
Description:	Painful non-cancerous ulcers or sores occurring in the lining of the mouth (oral mucosa). Minor ulcers (less than 1cm in diameter) are common, last over 14 days. Major ulcers (over 1cm in diameter) are much less common, last over 14 days and heal with scarring. Recurrent attacks are common. Women are affected more than men.
Causes:	Unknown, but the following are the most likely causes: Virus infection; Irritation from foods, such as chocolate, citrus, acidic foods (vinegar, pickles), etc; Injury to the mouth lining caused by rough dentures, hot food, or other local trauma; Emotional or physical stress.
Prevention:	Avoid intimate contact with infected persons. If canker sores develop after eating specific foods; then avoid these foods. Avoid stress if possible. Brush teeth at least twice a day and floss regularly to keep mouth clean and healthy. Eat a nutritious diet
Signs & Symptoms
Begins as shallow small ulcer, slightly raised yellowish border, with small outer reddish zone. Sometimes proceeded by burning or tingling. Soon covered with yellowish, gray tissue, causing acute pain. Painful period lasts 2-4 days.
Risk Factors
Recent dental work. Iron and vitamin deficiency states.
Diagnosis & Treatment
General Measures: Laboratory examination of the sores may be recommended to distinguish from herpes infection or detect other bacterial infection. Rinse the mouth 3 or more times a day with a salt solution (1/2-teaspoon salt to 6 oz. of warm water) if this isn't painful. Clean sores frequently with 2% hydrogen peroxide on a cotton applicator. If a canker sore is caused by a rough tooth, braces or dentures, consult your dentist. The sore won't heal until the cause is eliminated.
Medications: Topical anesthetics to relieve pain e.g. viscous lidocaine can be applied with a swab or used as a mouth rinse. The lidocaine helps relieve pain for several minutes and can make eating less painful. Protective coating of carboxy-methylcellulose applied to the ulcer may relieve the pain. Protective dental paste with a steroid derivative, such as Orabase with triamcinolone acetonide. If applied as soon as the ulcer begins, this prevents pain. Keep medicine prescribed for the first attack. Use it immediately at the sign of a recurrent attack. The sooner treatment starts the milder the attack. For multiple, very painful lesions tetracycline (only adults) mouth wash, may be prescribed by your doctor. For severe canker sores a dexamethasone mouth rinse or prednisone tablets can be prescribed.
Activity: No restrictions.
Diet: No restrictions, except to avoid food that aggravate ulcers. Drink as many fluids and eat as well balanced a diet as possible while the ulcer is healing. To minimize pain, sip liquids through straws. Foods that cause the least pain are milk, Jell-O, yogurt, ice cream and custard.
Possible Complications : Dehydration in severe cases where eating and drinking are limited.
Prognosis
Most ulcers heal without scarring in 2 weeks. Recurrent attacks are common.