EN Investigates How to Calm Cantankerous Canker Sores

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Q. I get recurrent canker sores. Can supplements or a change in diet help?

A. Perhaps, if you detect and correct an underlying cause, such as a food allergy or nutrient deficiency. However, canker culprits are often elusive. Natural remedies offer palliative relief at best.

Canker sores (aphthous ulcers in medical terms) are benign but painful small ulcers that typically occur on the inner surface of the cheeks and lips, but can appear anywhere in the mouth, even on the tongue, gums and soft palate.

About 20% of the population suffers from occasional canker sores; women are more prone to them than men. The sores typically last five to 14 days. Canker sores are not the same as cold sores (fever blisters). Cold sores, caused by the Herpes simplex virus, form contagious blisters on the outside of lips.

Canker Causes? Triggers for canker sores are hotly debated, but most often they can be attributed to mouth trauma, such as dental work, a hard toothbrush or accidentally biting the inside of the cheek. Food allergies, nutrient deficiencies (iron, folic acid, B12, zinc), hormonal changes and immune impairment are also sometimes blamed, as is an ingredient called sodium lauryl sulfate (SLS), found in most toothpastes. Some people seem to inherit a predisposition to canker sores and get them frequently, often during times of stress or fatigue.

According to Alan Gaby, M.D., nutrition professor at the alternative Bastyr University in Seattle and author of The Patient's Book of Natural Healing (Prima Publishing, 1999), eliminating suspect foods (citrus and chocolate are often cited), taking a multivitamin and switching to an SLS-free toothpaste (check health food stores) may help. Most mainstream doctors, however, are likely to suggest there is nothing you can do to help prevent them.

Canker Cure? No cure exists--canker sores must simply run their course--but the sores can be soothed somewhat. Over-the-counter topical salves like Anbesol can numb the area temporarily and allow you to eat relatively free of pain.

For pain relief, vitamin E is touted to help both canker and cold sores by forming a protective barrier. Squeeze an E capsule onto a cotton swab and apply to the sore for 10 minutes, as needed, to make eating more comfortable. Licorice is another remedy to try applying directly to the sore. Look for a tincture, powder or tablet of deglycyrrhizinated (DGL) licorice, which is free of a substance that can elevate blood pressure. Other proposed natural remedies--zinc gluconate lozenges, B complex vitamins, vitamin C, bioflavonoids, bee propolis and echinacea--have little or no research to back them. Lysine may help cold sores, but not canker sores.

Other Canker Tips. If you have active sores, avoid spicy, acidic and abrasive foods, rinse with salt water and don't forego good hygiene even if pain makes it uncomfortable. In most cases, canker sores heal on their own. If healing is too slow or you experience fever or rash, see your doctor or dentist to rule out a more serious condition.

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