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Canker Sores - Quick links to information about mouth ulcers on Animated-Teeth.com |
Canker sores (recurrent minor aphthous ulcers): What causes these mouth ulcers? Risk factors.
| ⇓ Here's a brief overview of our topic - Canker Sores / Aphthous Ulcers! Canker sores, or more specifically in scientific terms "recurrent minor aphthous ulcers," are one of the most frequently occurring types of oral lesions. Outbreaks of canker sores can range from being a simple annoyance to, at the other extreme, intensely painful lesions that interfere with normal oral activities. The following pages will help you understand what triggers canker sores as well as ways to differentiate them from other types of mouth sores. Additionally, our pages include a discussion about the various products and medications that can be useful in the treatment of canker sores, including home remedies and also over-the-counter products and prescription medications. |
What are canker sores?
Canker sores are a type of mouth ulcer. In fact, they are the most common type of recurring mouth ulceration.
| Some of the medical terms that are used to refer to canker sores are "recurrent minor aphthous ulcers" and "recurrent minor aphthous stomatitis.." [ Thus differentiating the term 'canker sore' from other forms of aphthous ulcers or aphthous stomatitis. ] |
What causes canker sores to form?
The cause of canker sores is not well understood. Their formation, however, is thought to be related to an abnormal response by the sufferer's immune system.
Canker sores form when a person's immune system becomes mobilized by the detection of what it interprets to be foreign molecules. This activation triggers an assault upon these molecules by lymphocytes (a type of white blood cell); somewhat similar as when a person's immune system attacks a transplanted organ. The carnage created by this attack results in the formation of ulceration. It is these ulcerations that are termed canker sores.
What triggers canker sore outbreaks? - The risk factors.
There are a number of factors that can play a role in triggering canker sore outbreaks. One (or a combination) of the following risk factors may play a role in the formation of canker sores for any one individual:
- Toothpastes and mouthwashes that contain sodium lauryl sulfate (SLS).
- Research has suggested that the use of products that contain sodium lauryl sulfate ("SLS"), a foaming agent found in most toothpaste and mouthwash formulations, can be associated with an increased risk for canker sore outbreaks. This may be due to a drying effect SLS has on the protective surface of oral tissues. Once this protective layer has been compromised the tissue underneath is more vulnerable to irritants such as acidic foods.
Several studies have reported that participants who brushed using SLS free toothpaste found that they experienced a reduction in the total number of canker sores that they had form. This reduction in mouth sores was found to be as high as 81% in one study. In this same study also reported that some of its participants stated that the canker sores that did form were less painful than those that developed during those time periods when they had been using a toothpaste that did contain SLS. - Mechanical trauma to oral tissues.
- People state that they often recall some sort of physical trauma preceding the formation of their canker sores. This trauma might take the form of a self-inflicted bite, irritation from a sharp tooth edge, or possibly trauma from some type of food such as a crisp chip. 38% of the participants of one study felt that their canker sores were precipitated by trauma.
- Emotional stress / Psychic stress.
- Psychological stress has been shown to adversely affect the health of people in a number of ways. Many people who suffer from canker sores report that the appearances of their ulcers coincide with periods of stress. Higher incidences of canker sore breakouts have been identified among patients who suffer from psychological disorders. Researchers have also found that patients with genetic defects linked to increased anxiety traits experience higher rates of aphthous ulcer outbreaks.
- Diet: Nutritional deficiencies.
- Researchers have found that some people who suffer from canker sore outbreaks have poor diets and therefore an accompanying nutritional deficiency. Some of the nutritional deficiencies that have been correlated with the presence of canker sores are:
- Vitamin deficiencies: B1, B2, B6, B12, C
- Other nutrients: zinc, folic acid, iron, selenium, calcium
- Diet: Allergies and sensitivities.
- Allergies to foods and other substances have been postulated as being triggers for canker sore breakouts. Any substance that comes into contact with the person's oral tissues must be considered to be a potential causative agent. If an allergy is suspected the individual might choose to maintain a diary so to help them (and their dentist) identify the most likely candidates associated with the causation of their sores. In some cases allergy testing might be considered.
Some of the dietary substances identified by researchers as being potential triggers for canker sore outbreaks are:- Cereal grains: buckwheat, wheat, oats, rye, barley, the gluten protein found in grains
- Fruits and vegetables: lemons, oranges, pineapples, apples, figs, tomatoes, strawberries
- Dairy: milk, cheeses
- Other foods: nuts (walnuts), chocolate, shellfish, soy, vinegar, French mustard
- Additives: cinnamonaldehyde (a flavoring agent), benzoic acid (a preservative)
- Other substances: toothpastes, mints, gums, dental materials, metals, medications
- Hormonal changes.
- Some women have reported that they find a relationship between the presence of canker sores and certain phases of their menstrual period. It has also been reported that a woman may notice a remission of canker sores during pregnancy. Neither of these observations has been adequately documented nor explained by research.
- Genetics.
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Some researchers have felt that they have identified a genetic predisposition for canker sores. One study found that 35% of those persons who experience canker sores have at least one parent who also suffers from these ulcers. Another study found that 91% of identical twins both suffered from canker sores whereas only 57% of fraternal twins did. People who have a positive family history for canker sores typically experience them at an earlier age and with a greater level of symptoms.
- Infectious agents - Bacterial.
- The fact that chemical compounds typically associated with bacterial infections have been isolated from canker sores suggests that some strains could be causative agents in their formation. In one research study 95 different bacterial species were found to be associated with the study group's canker sores. Only 3 of these bacterial species were common to both the study group and the control group.
- Infectious agents - Viral.
- Viruses may play a role in canker sore formation by way of causing an immune response. Some of the strains of viruses whose presence has been associated with aphthous ulcers are: cytomegalovirus (CMV), human papilloma virus (HPV), human herpes virus-8 (HHV-8), Epstein-Barr virus (EBV), human immunodeficiency virus (HIV) and herpes simplex virus (HSV-1).
- Medical conditions.
- Several different medical conditions can be associated with the presence of canker sores (and other forms of aphthous ulcers as well). For those patients who experience persistent difficulties with canker sores consideration must be given to the presence of an underlying undiagnosed systemic disease and the need for an evaluation and testing by a physician.
A few of the medical conditions that have been associated with the presence of mouth ulcers are: Behcet's disease, neutrophil dysfunction diseases, inflammatory bowel diseases (celiac and Crohn's), HIV-AIDS, MAGIC disease, and Sweet's syndrome. - Medications.
- The use of nonsteroidal anti-inflammatory drugs (NSAIDs), beta blockers, chemotherapeutic agents, and nicorandil have each been suggested as possibly placing a person at greater risk for outbreaks of canker sores.
