Dr. Alan Greene on Canker Sores

What can I do to prevent them and help them heal quickly?


My 7-year-old daughter has painful canker sores inside her lips and on her gums, and sometimes on the roof of her mouth. What can I do to prevent them and help them heal quickly? What causes them, and will they recur throughout her life? Her dad gets canker sores and he rubs salt on them, and although it stings he swears it helps heal them faster. Would vitamins help?


There are two very different kinds of common mouth sores. One kind is called cold sores, or herpetic stomatitis. The other is called canker sores, or aphthous stomatitis. Cold sores are caused by the herpes virus, and canker sores are not, but sometimes they can be difficult to tell apart. With herpes sores, even though the first ones can be on the lips or in the mouth, the recurrent ones tend to be only on the lips. So if the recurrent ones also occur inside, on the gums and on the roof of the mouth, then canker sores are generally the problem.

Canker sores are not spread like a virus or by contact. They tend to run in families -- about one-third of people with canker sores have someone else in the family with the same tendency. It's an inherited tendency for the T cells in the immune system to get overactive sometimes. This overactivity can be brought on by anemia, iron deficiency, B-vitamin deficiency, stress, physical trauma, food allergies, celiac, drug reactions, and autoimmune diseases, or with the menstrual cycle.

When someone gets a canker sore, it will usually heal on its own in seven to 10 days, although bigger ones can take longer -- sometimes even a month. In the meantime they can be quite uncomfortable. Once a sore has appeared, the treatment is aimed at dealing with the discomfort. There are several ways to do this, such as with topical forms of anesthetics like lidocaine or Benadryl. Some kids like a mouthwash of Benadryl mixed with Maalox or Mylanta to swish and spit. Both salt and antiseptic mouthwashes can help canker sores heal faster, they but don't help the pain in the meantime. Topical steroid creams mixed with a teething gel (like Orabase) can give pain relief and speed healing.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

Healthy Kid


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