People use lots of different names to describe recurring aphthous ulcers (canker sores, recurring aphthous stomatitis, oral ulcers etc.), but they all describe the same condition.
Although a small minority of people may be predisposed to aphthous ulcers because of systemic diseases (diseases affecting multiple areas of the body), canker sores are typically a localized problem resulting from a local activation of immune cells where the ulcer or ulcers appear.
There likely is a significant genetic basis for this condition, since people often report a history of ulcers in their family, and there are numerous different factors that can cause ulcers to appear. Rather than have me read them all off one by one on video I thought it would be easier to write them out below.
Trauma – Trauma, such as bumping your gums with your toothbrush, is a frequent cause of canker sores.
Stress – Periods of high stress can provoke episodes of aphthous ulcers, but this association is highly variable
Foods – As we talked about last week, there are numerous different foods that cause canker sores. In addition to the food products we discussed it is worth looking into whether sodium lauryl sulfate a common surfactant in toothpastes might be causing your ulcerations. Try using an SLS free toothpaste with fluoride, they are hard to find, but if it helps then the search is worth it.
Hormonal Imbalances – Normal hormonal cycles associated with menstruation have been shown to provoke oral ulcers in women. On the other hand, outbreaks have been seen to decrease during pregnancy and with the use of oral contraceptives.
Tobacco Smoking – Ironically patients suffering from recurring aphthous ulcers are usually nonsmokers, and there is a lower prevalence and severity of aphthous ulcers among heavy smokers compared to moderate smokers. Some patients have also reported the onset of oral ulcers after they stop smoking, and a decrease in ulcers when they begin smoking again. The use of smokeless tobacco has also been associated with a significantly lower prevalence of canker sores. Nicotine-contianing tablets also appear to help control the frequency of canker sores (e-cigarettes would likely produce the same effect). An exact mechanism hasn’t been identified for these observations, but at any rate this doesn’t make using cigarettes or nicotine a good idea for your health.
Oral Exposure to Certain Drugs – Nicorandil (a potassium channel blocker used in cardiac disease) and nonsteroidal anti-inflmammtory drugs (aspirin, ibuprofen, etc.) may produce ulcers similar to canker sores. Talk with your doctor about changing medications first.
Immune System Disturbances – Ulcers have been seen in HIV positive patients, immunodeficient individuals, myelodysplastic syndromes, and forms of neutropenia. If you have one of these conditions you will likely already be aware of it; the ulcers are not a sign of these diseases.
Hematinic Deficiencies – Deficiencies of Vitamins B1, B2, B6, B12, Folic Acid, or Iron have been found with increased incidence in people experiencing aphthous ulcers. A simple blood test administered by your physician will identify if you have any of these vitamin or mineral deficiencies.
Gastrointestinal Diseases – Celiac disease (gluten intolerance) is seen more frequently in people with recurring aphthous stomatitis. Crohn’s disease and ulcerative colitis may also be accompanied by oral ulcers. Treatment of these conditions will help the ulcers.
Other Systemic Conditions – Behcet’s syndrome and Sweet’s syndrome are more complex disorders that produce oral ulcers along with lesions and sores on other parts of the body. If you are noticing ulcers simultaneously in areas other than just the mouth see your doctor.
Knowing which factors might be a problem for you can help you make changes to avoid frequent oral ulcers. Most people also experience a localized burning or pain for 24 to 48 hours prior to the ulcers appearing, which will allow you to treating ulcers early and help them heal faster. I will go over different treatments for ulcers next week.
That wraps up this guide on what you should know about mouth ulcers. Contact us today for more information or additional questions!
"We recently moved to the Chesapeake area and needed an orthodontist that could continue treatment for our two kiddos. Hatcher & Frey Orthodontics made our transition seamless and even provided an Invisalign option. The staff is amazing and the facilities are top notch!"
"This is an OUTSTANDING team of dental professionals. We are greeted with smiles every time and wait less than 5 minutes to be called back for our appointment. This is EXCEPTIONAL when compared to the usual, long waiting room wait in MANY practices. The changing seasonal themes is always surprising and enjoyable. THIS IS NOT THE USUAL MEDICAL FACILITY OFTEN VISITED. Doctors Frey and Hatcher are personable, very friendly and HAPPY to work with their patients. Theirs is the most pleasant office to visit and this team is competent and approachable all the time. I'd GIVE THEM A 10 if I could!"
"We absolutely LOVE Hatcher & Frey Orthodontics. I have 3 daughters who went through braces for about ten years (2002-2012). Now, I am wearing Invisalign. They have been consistently professional and offer the very best care. I highly recommend them."
"We love Dr. Hatcher and Dr. Frey! They are super thorough when you go in for an evaluation, and give you pricing up front. I visited a different local orthodontist, who wouldn’t give a price until after we started... they are detailed in the plan and the outcome is terrific! It is a wonderful practice with an amazing team! I highly recommend them!!"
"I can't tell you how astonished I was with the customer service, everyone here is affectionate, and kind. I feel respected and important here. I am a current patient with crowding problems; Invisalign was what I went with because It doesn't seem too much of a chore to keep up with rather than braces. Thanks Dr. Hatcher for your stunning care; I know I'm in good hands and can't wait to see a different smile in the near future. I hope if you've read this far you choose to come here even if you live far away; it's definitely worth the drive. I would recommend this to anyone who is in need of an orthodontist."
"Got my braces off today after 29 months of wearing them. When I came to Dr. Hatcher back in June 2017, my teeth looked like they were beat by Negan's bat, Lucille, from TWD. Today, I am a brand new person that has been cured of my zombie teeth apocalypse! Thank you Dr Hatcher, Shawna, and the rest of the staff! Your hard work has paid off and will not be forgotten. I will think of you every time I smile."
"Five stars I scheduled a consult after seeing photos of Dr Frey’s cases with early development utilizing Invisalign. I also felt orthodontics should start early not late and I wanted the best for my 5yr old twins. I was blown away with Dr Frey’s clinical skills, understanding of sleep apnea in children, his updated technology and ability to do digital scans instead of impressions totally shows his education and expertise, but my biggest compliment was how well they treated my family. It’s care that is surpasses any practice I’ve seen. Thank you for educating us and giving us a sound treatment plan."
"Dr. Hatcher is wonderful and the staff is exceptional! We have had a very positive experience here with both of our daughters. They go above and beyond and I recommend them to anyone who is looking for an orthodontist. They make you feel like family and the kids love going to their appointments. State of the art technology is used to transform smiles from good to great!"
"Dr. Scott Frey is an amazing Orthodontist and very caring. The most important thing which many people don't understand is it's not just straightening your teeth but knowing your bite is right for the lifetime of functioning. It's well worth the investment and time to do it right, so it won't cost you even more down the road. I give him 5 stars!"
"What a great experience! We were referred to Hatcher & Frey Orthodontics by our pediatric dentist’s office and they are very helpful and professional. Couldn't have had a better team to help my now 13-year-old achieve her perfect smile."