Tips and Techniques for Preventing Canker Sores

Canker sores (mouth ulcers) plague millions. Just how does one prevent these terrible mouth sores? We have spent countless hours researching this question.

  Below we discuss factors related to canker sores (mouth ulcers) and how these factors may influence the number of canker sores you experience. This information is based on review of research literature, experience with our patients, and feedback we have received from you the viewer. We hope this helps to bring some relief.

(canker sores = Recurrent Aphthous Stomatitis = RAS = aphthous ulcers = oral ulcers = mouth ulcers)

Watch What You Eat

It appears that what we eat may influence whether or not we come down with an episode of canker sores. Some people have allergies to certain foods.  Consumption of these foods can lead to canker sores. Studies show that elimination of these offending foods can sometimes dramatically reduce the number of canker sore

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 episodes a person experiences.

Drs. Wray, Vlagopoulos, and Siraganian (1) , for example, illustrated a relationship between the following foods and canker sores :

buckwheat, whole wheat, rye, barley, chocolate, nuts, shellfish, soy, tomatoes, apples, and cheese.

figs, cheese, tomatoes, lemon, vinegar, French mustard, pineapples, apples, milk, wheat, and flour.

Many of our viewers have e-mailed to share their experiences with foods and canker sores as well. Chocolate, in particular, is a problem for some people. For these people, eating chocolate often leads to canker sores.

Another common culprit seems to be oranges and other citric fruits with many people experiencing canker sores after eating these fruits or after drinking orange juice.

Keeping a Canker Sore Notebook in which you keep track of foods you eat and canker sore incidence can help you identify foods which may be contributing to your canker sores.

Check Your Toothpaste

Outside of reducing stress and avoiding trauma to your oral tissue, the latest information on a new causative factor in canker sore formation provides us with hope that the incidence and severity of canker sores can be reduced, perhaps dramatically. It appears that an ingredient in toothpaste called SLS, Sodium Lauryl Sulfate, may cause canker sores in some people. SLS free toothpaste has provided so much relief to our patients that we have devoted an entire article to this subject.

Eliminate Stress

We all feel stress at one time or another. Stress is simply the body's reaction to perceived threats or harmful stimuli. In response, the body increases heart rate, increases blood pressure, and releases a host of cytokines and other chemicals. While stress is meant to be a protective mechanism, in today's society, we often experience so much stress that it can become dangerous to our health.

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Uncontrolled stress can cause severe medical problems including migraines, high blood pressure, heart disease, and gastric/intestinal disorders. Not surprisingly, stress has been implicated as a factor contributing to canker sores.

Several studies have shown an increased incidence of canker sores among highly stressed populations. Medical students and dental students, for example, lead an extremely demanding and stressful life and have been shown to suffer with canker sores to a greater extent than the rest of the population.

We have seen stress as a factor in causing canker sores in our patient population as well. Many of our patients experience canker sores during extremely stressful periods of their lives. Viewers of our website have also e-mailed us pointing out the role that stress plays in causing their canker sore outbreaks as well.

We advise those patients susceptible to canker sores to try to reduce the stress in their lives. In today's society this is often easier said than done. It's well worth the effort, however, since reducing stress has other health benefits as well. We have provided the following links which may help:

• Wellmedia Stress Page
• Mind Tools - How to Master Stress
• UT Austin Learning Skills Center - Stress Relief Information
• Rose Medical Center Stress Page

Take Your Vitamins

The relationship between vitamin / mineral deficiencies and canker sores amongst visitors to the website is also unclear. While many e-mail to say that they believe vitamin and mineral supplements have decreased the incidence or severity of their canker sores, others see no effect.

A good place to start is by seeing your doctor and having him or her take blood tests to measure the levels of B vitamins, folate, and other minerals. If you are deficient in any of these, your doctor can suggest appropriate supplements.

It is not a good idea to take an excess of vitamins or minerals as toxicities can occur when you take too many.

Be Kind To Your Mouth, Eliminate Oral Trauma

There is evidence that trauma to the inside of the mouth may initiate canker sores. In many cases, this trauma can be caused by such simple things as biting the inside of the mouth or eating hard candy which scrapes or nicks the inside of the mouth. In our office, we advise patients to look for things that may cause trauma to their mouth. These include:

• Ill-fitting dentures or braces Often dentures which do not fit properly can irritate and injure adjacent oral tissue leading to the formation of canker sores. If you have dentures and suspect that this may be a culprit, have your dentist take a look to see if your dentures are properly fitted to your mouth.

  A similar problem is often experienced by people wearing braces. The metal can rub into and damage the inside of the mouth. As with ill-fitting dentures, if you suspect that this is a problem, contact your dentist.

• Toothbrushing Trauma Your very own toothbrush could be damaging your teeth and oral tissue. This is because nearly 2 out of 3 people brush too hard applying excessive and damaging force to teeth, gums, and other oral tissues.

  Although we advise our patients to brush with less pressure, often they can not do this. This is because toothbrushing is a habit which has been ingrained since childhood. We encourage them to use the Alert Toothbrush which lights when you brush too hard protecting your teeth, gums, and oral tissue.

• Food Trauma Unfortunately, many of the foods we eat can nick, scrape, or otherwise injure oral tissue and lead to canker sores. We encourage our patients to avoid or cut down on foods like potato chips, hard pretzels or pre-cut apples. Especially damaging can be hard candies which after being partially eaten or crunched can form sharp edges. These sharp edges can nick and injure the soft tissue of the mouth.

• Dental Procedures Sometimes dental procedures can irritate the soft tissue of the mouth leading to canker sores. One viewer e-mailed telling us that the needle used for novacaine injection would result in canker sores the next day. If you suspect that you may form canker sores after dental visits, warn your dentist so that he or she can be extra gentle during procedures.

• Biting the Inside of Your Mouth Many people cause oral damage by biting their lips and inside of their mouth. Often this can be an unconscious habit or occur during sleep. For these people, we often suggest a mouthguard. Worn over the bottom set of teeth, mouthguards prevent biting damage to lips and the inside of the mouth. Mouthguards can be custom made by your dentist or standard mouthguards can be purchased at the local drug or sports store.