Mr CAPT Gregory D. Naylor

"What is That Sore in my Mouth" CAPT Gregory D. Naylor, DC, USN Recurrent "canker sores" affect approximately 20 to 25% of the United States population. The proper terminology for a canker sore is recurrent aphthous stomatitis. The sores or ulcers are most commonly located on the moveable tissues of the mouth, like the tongue, the inside of the lips and cheeks, the floor of the mouth, or the soft palate. Generally, the sores begin as small, red, oval swellings that become a shallow ulcer that has a whitish-yellow center surrounded by a red halo. The ulcers normally heal within a seven to ten day period. Canker sores can range in size from a half a centimeter to two centimeters or greater in the most severe cases. In the severe cases, the ulcer may leave a scar after healing is complete. Fever is not associated with the sores, but regional lymph nodes may be sore and tender in response to the ulcer. Patients may have one or more ulcers at the same time. The frequency of recurrences of ulcers varies considerably between patients. Some patients will have only one or two ulcers per year, while others may suffer from ulcers on a continuous basis. The cause of canker sores is not fully understood, in fact there may be a number of causes. There does not appear to be a virus or bacteria responsible. Allergic reactions to certain foods have been implicated. Patients with stomach and intestinal ulcers may also be susceptible to oral ulcers. Female sex hormones may play a role in causing canker sores, since the ulcers occur in certain phases of the menstrual cycle. Most women experience improvement or remission of the ulcers during pregnancy. It is interesting that patients who smoke or use smokeless tobacco are not affected by canker sores. This, however, is not an indication to use tobacco products. Women seem to be affected more often then men, and studies show that the susceptibility to recurrences may be inherited. Patients who have frequent recurrences of the ulcers should have blood and allergy tests to determine if there are nutritional deficiencies, allergies, or some other cause. Vitamins and other nutritional supplements may prevent or reduce the recurrences. Patients with food allergies can reduce recurrences by avoiding those foods that have been proven to cause the ulcers. There are several treatments for reducing the pain and duration of canker sores for patients whose recurre