The canker sores are small ulcers superficial which most often form on the mucous membranes inside the stuffy : on the inside of the cheeks, the tongue, the inside of the lips, the palate or the gums. Canker sores can also appear on the genitals, but rarely. This will only deal with canker sores in the mouth.

When canker sores occur repeatedly, it is called aphthosis. The word stomatitis means that there is an inflammation of the mucous membranes inside the mouth.

The mouth ulcers are common: around 17% of the population has it at some point in their life. Often the first outbreak of canker sores appears duringchildhood. Then, the symptoms return at certain times, and then disappear permanently during the thirties.

Canker sores can manifest themselves in a number of ways.

• Minor form : 1 to 5 oval ulcers (2 mm to 1 cm in diameter) that heal naturally in 7 to 14 days without leaving a scar. Canker sores appear in this form in 80% of cases.
• Major or troublesome form : Larger ulcers (more than 1 cm in diameter), with irregular edges, which can take 6 weeks to heal and often leave scars.
• Herpetiform or miliary form : 10 to 100 tiny ulcers (less than 3 mm in diameter) with irregular contours which gradually regroup, then form an ulcerative area, which persists for 1 to 2 weeks without leaving a scar.

Evolution

The pain usually lasts 2 to 5 days. However, ulcers may take 1 to 3 weeks to heal.

Diagnostic

Canker sores are round or oval sores that are painful and occur in flare-ups.

To make the diagnosis of canker sore, the doctor relies on several characteristics:

• the yellowish (“fresh butter”) or greyish background,
• the infiltrated base (we can take the canker sore between the fingers and we feel that the whole area is discreetly indurated),
• edges sharp and surrounded by a bright red halo.

When symptoms similar to those of mouth ulcers occur recurrent, the vaut mieux see a doctor. He will carry out a complete medical examination, which will allow him to make a diagnosis.

If, in addition to canker sores, redness of the eyes, joint pain, persistent diarrhea, or abdominal pain are present, it is important to consult without delay.

Canker-like ulcers can be caused by chronic disease, such as inflammatory bowel disease (Crohn’s disease or ulcerative colitis), celiac disease, or Behçet’s disease.

In addition, canker sores can look like a mucosite : an inflammation of the lining of the mouth which sometimes creates small lesions. Individuals with weakened immune systems (due to HIV infection or cancer treatment, for example) are more likely to have ulcers which could be mistaken for canker sores.

Causes

The causes of aphthous stomatitis are not yet well established. Canker sores are not of infectious origin, so not contagious. Several factors, including heredity, could be contributing to this.

However, scientists have noted factors that tend to trigger symptoms in people with.

• A small wound inside the mouth. It can be caused by a bad fit of a dental prosthesis, by oral surgery, by too forceful use of the toothbrush, by biting the cheek, etc.
• Physical fatigue and stress. These often precede the onset of canker sores.
• Food allergies or sensitivities. Recurrence of canker sores and food allergies or sensitivities (for example, to coffee, chocolate, eggs, nuts, cheese, highly acidic foods and preservatives, etc.) has been reported in the scientific literature. such as benzoic acid and cinnamaldehyde)^1-4 .
• A dietary deficiency in vitamin B12, zinc, folic acid or iron.
• Smoking cessation. Canker sores can occur during smoking cessation.
• Infection with the bacteria Helicobacter pylori, the same bacteria that can cause an ulcer in the stomach or small intestine.
• Some drugs. Nonsteroidal anti-inflammatory drugs (ibuprofen and others), beta blockers (propranolol and others) and alendronate (against osteoporosis) can cause canker sores.
• Hormonal changes related to the menstrual cycle, possibly. Canker sores tend to appear during menstruation, but this link is uncertain.

Note. The use of a toothpaste containing sodium dodecyl sulfate (called sodium lauryl sulfate, in English), an ingredient in most toothpaste, could increase the risk of getting canker sores. It would make the inside of the mouth more vulnerable to injury by removing the protective layer that lines it. However, this hypothesis remains to be verified. A few small clinical trials suggest that the use of toothpaste without sodium dodecyl sulfate reduces the frequency of canker sores^5-7 . However, a more recent clinical trial concluded that the type of toothpaste used did not influence canker sores.⁸.