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Chronic Canker Sores

By - Bad Breath Expert

Medically referred to as recurrent aphthous stomatitis (RAS), chronic canker sores are open sores occurring under the tongue, on the gums, inside the mouth on the cheek area and sometimes at the back of the throat. Sometimes called aphthous ulcers, canker sores develop when an area of the mouth's mucous membrane is broken, resulting in a painful cut. Research has still not determined the exact cause of these lesions but they do know that canker lesions are not contagious. Further, canker sores are not related to fever blisters or cold sores produced by HSV-1, the herpes simplex virus, and are always found inside the mouth rather than on the outside of the lip. Click here to learn more about the difference between a canker sore vs cold sore.

Appearing as small (less than one centimeter), yellow or whitish sores often surrounded by an inflamed, red circle, chronic canker sores may be triggered by one or more different medical conditions that include:

  • Problems with the immune system
  • Viral infections
  • Obsessive cheek and/or tongue biting
  • Lack of vitamin B12, folic acid and/or iron
  • Emotional stress
  • Hormonal fluctuations
  • Food allergies

Canker Sore Development

canker sore in the mouth Prior to the appearance of a canker sore, individuals may feel an itching or burning sensation in the area where the sore eventually emerges. Several days later, the person will feel a small bump in the burning spot, which gradually becomes painful and easily irritated by eating or drinking certain foods. Suffering from chronic dry mouth will also worsen the pain of a canker sore.

Although anyone can develop a canker sore, women are more likely to suffer from RAS than men, especially women in their 20s. Additionally, scientists are investigating the possibility that chronic cancer sores may contain a genetic component due to the observed tendency for generational family members to experience RAS. An article titled "Mucosal disease series. Number VI. Recurrent aphthous stomatitis" published in a 2006 edition of Oral Disease (12 (1): 1?21) states that nearly 30 percent of individuals suffering from RAS have reported a family history of canker sores.

Once a canker sore has emerged inside the mouth, it may take up to ten days before the pain subsides and another two weeks for the sore to heal. Cankers sores generally heal by themselves, unless an accompanying illness is inhibiting the healing process. The larger the ulcer, the longer it takes it to disappear. A canker sore outbreak in which three or more sores appear may cause fever, swollen lymph nodes and other nonspecific signs of illness.

When a canker sore starts to develop a whitish-gray cast, this indicates that coagulants and healing proteins are attempting to repair the lesion.

Treatment for Chronic Canker Sores

To help treat canker sores and reduce the discomfort and pain caused by canker sores, individuals can try a variety of countermeasures involving diet, home remedies and medication:

  • Avoiding spicy or hot foods
  • Dabbing the canker sore with Orajel or hydrogen peroxide will temporarily relieve pain and facilitate healing
  • Rinsing the mouth with salt water
  • Applying milk of magnesia to the lesion
  • Increasing intake of iron, B12 and folic acid

Serious flare-ups of canker sores may require anti-inflammatory prescription medications such as a fluocinonide gel, chlorhexidine gluconate mouthwash or sometimes a corticosteroid to alleviate symptom severity. Click here to learn more about canker sore treatment.

Research Regarding Chronic Canker Sores

In trying to find the exact cause of RAS, a team of oral pathologists conducted an experiment using subjects who had experienced three or more episodes of recurrent ahpthous stomatitis. Results were published in an article called "Reduced dietary intake of vitamin B12 and folate in patients with RAS" for the February 2010 edition of the Journal of Oral Pathological Medicine. According to the researchers, patients with RAS showed a statistically significant lowered dietary intake of folate and B12 than the control group, indicating a viable correlation between folate and B12 deficiency and the appearance of chronic canker sores.

When to See a Physician about Chronic Canker Sores

Because most canker sores heal without treatment within two weeks, few people visit their physician for help. However, there are times when someone with cankers sore should make an appointment with a doctor, since abnormally behaving canker lesions may be an indication of a more serious illness:

  • If the canker lesion is unbearably painful, bigger than a dime and/or is irregularly shaped
  • If the canker sore has not healed on its own in four weeks
  • If cankers sores begin spreading from the inside of the mouth to the outside of the lips
  • If a particularly large cluster of lesions affect only one area of the mouth
  • If a fever develops during each outbreak

Preventing Chronic Canker Sores

While practicing good oral hygiene, consuming sufficient amounts of B12, iron and folate and reducing stress may all contribute to preventing canker sores from appearing, using toothpaste that does not contain sodium lauryl sulfate (SLS) will dramatically inhibit canker sore development.

Sodium lauryl sulfate (SLS) is essentially a detergent included in soap and shampoo that exacerbates early canker sores and may even promote canker lesion growth in people who have RAS. SLS does not promote oral hygiene and is used only to give consumers the impression that the foaming action it produces is actually performing an important task.

TheraBreath Toothpaste to prevent Canker Sores

When using TheraBreath's SLS-free toothpaste as part of your daily oral hygiene regimen, you know for certain that the toothpaste applied to your teeth and gums does not harbor the caustic foaming agent sodium lauryl sulfate. In addition, TheraBreath toothpaste is sugar-free, vegan-friendly and contains no unnecessary dyes, flavorings or abrasive detergents that may exacerbate canker sores. It is also completely safe for children to use and effectively prevents them from suffering the discomfort and pain of chronic canker sores.


TheraBreath products are used by millions of people worldwide. Click here to read some of their success stories.