Canker sores remain problematic, poorly understood and recur frequently. Also know as recurrent aphthous stomatitis or recurrent aphthous ulcers, canker sores affect approximately 1 in 4 individuals. After peaking in incidence during childhood, canker sores tend to become less frequent with increasing age.
Regularly associated by the general public with recurrent herpes simplex, canker sores bear no relationship to the common cold sore. The underlying mechanism responsible for canker sores remains a mystery. Neither viral nor bacterial, canker sores may represent a reaction to local tissue injury in a genetically susceptible individual. Trauma may originate from irritation with a tooth brush or the sharp edges of crackers, potato chips or pretzels.
With pain disproportionate to their size, canker sores generally appear as small round to ovoid ulcers covered by whitish-gray debris and surrounded by a red halo. After the first several days the pain resolves with total healing of the canker sore in about 1 week.
Canker sores target the mucous membranes lining the inside of the cheek, undersurface of the tongue and the gutter between the lips and jawbone. Most canker sores remain less than four tenths of an inch in diameter and occur either singly or in groups of up to 10.
For the overwhelming majority of people experiencing canker sores, medical investigations are unnecessary and unhelpful. Treatment generally consists of ignoring the lesions or applying some over-the-counter protective topical adhesive paste. For some Orabase, Bendaryl elixir, viscous xylocaine or even a topically applied antacid suspension might provide relief. Vitamin supplements fail to reduce recurrences.
