What Causes Canker Sores?

Mar 16, 2018 · 188 comments
Emily Booth (Chicago, IL )
I did not have canker sores until age 59 when I came down with burning mouth syndrome. BMS has over 30 causes. My internist was unable to help. The oral surgeon found no neuropathy. It was thru OSU's Center for Integrated Health that I found relief. Their director prescribed a vitamin - mineral regiment that cured it. It was basically B12 and magnesium that I was lacking. However, I still had a bit of a dry mouth which was much better but never really went away. Four years later, I have many canker sores, a swollen tongue and a very dry mouth. It started with toothpaste. Acidic and spicey foods made it worse. A very bad cold where I was taking Mucinex really made it bad. It is healing very slowly. My DDS referred me to an ENT.
Merrill Lewen (USA)
It may be as simple as avoiding toothpaste with sodium laurel sulphate.
anonymouse (Seattle)
I now only get them after I eat something I'm allergic to or when I eat too much. But in my youth, I had no idea. Although doctors said it wasn't possible to cure them, I once went to a dentist in St Louis who gave me a solution to swish around in my mouth and in less than 48 hours they were gone.
Elliot (New York)
I was plagued by painful canker sores in my 20s and 30s and rarely get them now that I'm in my sixties. I do remember a doctor prescribing gargling with tetracycline dissolved in water, and recall that treatment being very effective.
Anne (PA)
As others have mentioned here, I was also helped by switching to SLS-free toothpaste. There have been several scientific studies that have looked at the effects of SLS on canker sores (you can find them in PubMed) and while the results have varied, enough studies have shown a correlation that it is certainly worth a try for anyone who has this problem. I switched about 20 years ago and have had only a few canker sores since then, and of shorter duration. I used to get such bad ones that the swelling was visible to others when my mouth was closed-- I would get them on my lip and they could get as large as a dime. I've found a few brands that are SLS-free and still have fluoride-- Jason Sea Fresh, Hello Fresh, and Verve Ultra (available from Amazon) are some.
Betsy Hood (Memphis)
I tend to get canker sores when I have eaten too many sweets...and my age old remedy which always works is baking soda applied directly to the sore (I get them on my cheek--this would be tough on a tongue). A swish of baking soda and water a few times a day would probably have same effect. I'm sure there's some pH balance thing involved.
Kally (Kettering)
I’ve had canker sores since I was a small child, bad enough that my parents even took me to a doctor for it (which is not something they did often). I had this weird yellow liquid I was supposed to swish in my mouth (I don’t recall it working—this would have been in the 50’s so heaven knows what that stuff was). I had a very severe outbreak years ago when I had been sick and thought eating a couple oranges a day would be a healthy thing to do—wrong! I got so many I could hardly talk. So, an interesting thing happened recently. My oldest brother was extremely ill and was diagnosed with Chron’s. One of the clues that it was Chron’s rather than ulcerative colitis was that he also had mouth ulcers. The GI doctor said that in some people, Chron’s manifests as mouth sores only. Whaaaa? I had never heard of that and it made me wonder—as there’s a genetic component to Chron’s, does this have some connections to my canker sores? I’m very curious, but not enough to talk to a doctor about it. Overall, I’m extremely healthy and figure I ought to leave well enough alone! As another commenter mentioned, Triamcinolone dental paste works very well to shorten the duration of a canker sore. Your dentist or doctor can prescribe it. I’ll also try SLS-free toothpaste as a prevention—thanks for that commenters!
Kally (Kettering)
Oops—something they did NOT do often!
Liz (Boston)
For some reason this still mystifies some, but canker sores do in fact have a relationship to Herpes simplex virus. Some people who have HSV1 only get canker sores, not cold sores. Thankfully, there are simple antiviral pills with little side effects that can be taken that resolve the sores within 24/48 hours.
Kally (Kettering)
How do you know this or what exaclty do you mean? I believe you are wrong and apparently the doctor and studies cited in this article also think so.
Ann Michel (seattle)
Mine almost completely disappeared when I stopped using toothpaste that contain laurel sulphate about a year ago. And they worsened during the month that I was using extra laurel sulphate toothpaste during brushings. My dentist has also heard of this connection.
Mark (Los Angeles)
I used to get canker sores a fair amount of time and it drove me nuts. A few years ago I started taking 2,000MG of L-Lysine (an amino acid) per day to boost my immune system and I get them maybe only once or twice a year at most.
DIANE KILPACK (UTAH)
I do that exact same regime. If for some reason I start to get one, even after taking 2,000mg/day, I up it to 3000mg for a couple of days and it goes away.
IRS (Lansing, MI)
I, too, had a continual problem with canker sores until I switched to a toothpaste withour sodium lauryl sulfate. I the last eight years after I switched, I have not had even one canker sore.
Wilks (Canada)
My canker sore appeared due to poor diet one day. Found spraying organic thyme oil diluted with water worked beautifully. Disappeared within a day.
DG (San Francisco)
I'm another reader who suffered from canker sores for many, many years until I tired brushing with SLS-free toothpaste (and other products) ten years ago. Since then, no more canker sores, except when I bite my lip every once in a while. The author of the article, Roni Caryn Rabin, could do a lot of other Times readers a huge service by updating her article to mention SLS as a causal factor for many people.
DM (New York, NY)
My husband also got very painful canker sores regularly until he started using toothpastes without SLS (sodium laurel sulfate). Hasn't had one since -- and that was 10 years ago. Need to read the labels.
janeway452 (Milford, OH)
DM, you beat me to it. Years ago after getting one painful canker sore after another, I did some research. Found a reference to sodium laurel sulfate (SLS) a "natural" (derived for coconut oil or something) sudsing agent in toothpaste, causing canker sores in some people. I immediately found a toothpaste that didn't have SLS. When that brand disappeared it took awhile to find another. So far, Trader Joe's toothpaste is the only one I can find. For me it really works. I very, very rarely get one. SLS is a sudsing agent found in many products, such as shampoo, but these don't bother me. I'm also sensitive to Sorbitol (in gum and suger free candies).
DM (New York, NY)
Many -- not all -- Sensodyne toothpastes don't have SLS, nor do most Bioetene products, although those are $$$. Good luck!
Bobby Wallace (New York, NY)
I suffered monthly from canker sores for years until I was in my late thirties. I had a hunch that mine were caused by tea or cranberries. Now that I stopped drinking any tea products I no longer get them. If I do have tea or cranberry, I consistently get a canker sore within 7 days. The interesting thing is that a tea bag on the sore is a home remedy. And crams berry is infused in dental floss to heal gums.
Mike B (Oakland, CA)
Best temporary solution I found is to grind down an aspirin tablet until powder. Then dab some on the sore. The pain then goes away.
E Holland (Jupiter FL)
I find that when I have a breakout of a lot of canker sores that taking Lysine helps clear them up in a couple of days and taking Lysine when I get one or two prevents so many from appearing. I seem to get cluster canker sores over a period of time when I get them.
John (Los Osos, CA 93402)
I also was a long long time sufferer. Then an NPR radio program gave the solution for me: sodium laurel sulfate (SLS) in toothpaste. My canker sores stopped the instant I got rid of SLS. Some dentists know about this, most don't. You'll have to search to find a toothpaste without SLS. Just for fun you should know SLS is a suspected carcinogen.
Naomi (Monterey Bay Area, Calif)
I've had mild-to-moderate frequency canker sores all my life. (Triggered by mouth injury, excess sugar, or excess acidity (lemon drops, e.g.). About 30 years ago, I read that L-Lysine supplements could make them heal more quickly. I tried it, and it worked. A few months ago I had to get full-mouth braces, and the constant abrasions prompted constant canker sores. I finally started taking the L-Lysine every day (instead of waiting for a sore to develop), and the sores have only recurred once. I'm going to try the SLS-free toothpaste, too.
David Krigbaum,DDS (Wausau, Wisconsin)
Frequent and large canker sores need to be evaluated by an Oral & Maxillofacial Surgeon. There are conditions that can be treated, usually with steroids topical or systemic.
DM (New York, NY)
And recommending the use of toothpastes that do not contain SLS!
M. Herman (La Quinta, Ca)
Under the advice of a dental pathologist, I have been applying pin-head size amounts of .05% Clobet or Lidex in Orabase to the lesions in my mouth. I have used this method for decades. I find that it usually clears up the sore within a few days rather than weeks. Applying it at the first sign of soreness is vital.
j.broclawik (Warsaw)
For me sage tea used as a mouthwash (used when already cold) was always very helpful.
Fanelli (Martha)
I had experienced constant lesions from my preteens to my early thirties. Finally, a doctor put me on 25 mg of Nortriptyline and I have been lesion free ever since. It changed my life!
Les Le Gear (New Jersey)
I've been getting them all my life. It was more frequent and lasted longer as a child. I still get them, but not as often, and they go away in a day or two.
Sean Belt (St. Louis)
My family's old tried and true recipe for canker sores is to drink buttermilk. I drink about a quart through the course of a day and the sore is gone by the next morning. Fortunately, I like buttermilk!
MoA (Bethesda, MD)
Triamcinolone .01% in dental paste clears mine right up. I am thinking of having this and a few other essential things tattooed on my chest for the nursing home staff.
RW (Tucson, AZ)
This really works well, use it 2 nights in a row and it clears right up instead of enduring for a week-just don’t expect instant relief as it’s a steroid, not an anesthetic. ask your dentist for a prescription. Dry the spot with one end of a cotton bud, and apply the paste with the other end.
Kally (Kettering)
Yes, was going to post this as well. For anyone who has problems with canker sores, this stuff works great. I’ll give the non-SLS toothpaste a try as well as a preventative measure. I know that eating too much acidic foods (late summer and fall when tomatoes are so good it a bad time for me) and rough food (toast, baguette bread) will cause problems for me.
Brighteyed (MA)
1) My mother used to paint the chancre sores in us kids' mouths with gentian violet ( gentian root is the same stuff that gives Moxie soda its terrible taste). It worked for us. 2) FYI. There are cross reactive allergies amongst certain fruits like banana and kiwi and latex allergy. Google it.
Catherine Sicilian (Portland OR)
As a teen ager I got canker sores monthly. I voluntered in a hospital where they used Gentian Violet on newborns umbilical cords. I would take home a leftover bottle and use it. It worked very fast. I never understood why this is not a recommended cure.
Eric Longo (New York)
Tea tree oil worked well for me.
Jojo (CT)
I use tea tree oil for exterior cold sores, never internally
Marsha (San Francisco)
Changing to a toothpaste that does not contain SLS (e.g., Pronamel) has almost entirely eliminated my cancer sores (I'd been a frequent, life-long sufferer). A type of foaming agent, SLS acts to "slough" the outside layer of the membrane in the mouth and increases the incidence of cancer sores, or causes them to persist once they begin to appear. This one simple step has been life-changing!
Pdxtran (Minneapolis)
Yes, this has been my experience, too!
MoA (Bethesda, MD)
Aha! No connection to my aphthous ulcers that I'm aware of, but I always wondered what caused the webs on the mouth after using certain toothpastes. TMI, I know, but I sort of enjoy that.
LA (San Anselmo CA)
The plague of painful canker sores stopped when a friend brought me a tube of Zendium toothpaste from Europe. Sores stopped. It was a miracle. Developed in the Netherlands in the 70's it contains no laurel sulfate, the foaming agent that strips the mucus lining of your mouth. Whatever it has ....or doesn't worked for me. I LOVE it.
Momoka (Georgia)
Mouthwash and sugar reduction. Saved my life. I used to have multiple canker sores in my mouth at any given time. Cut back heavily on sugars and began using regular old, alcohol-based off-brand mouthwash. Besides accidentally cutting my mouth on a particularly vicious chip now and then, I haven't had a canker sore in years. If you're concerned about what might be in your mouthwash, good ol' hard liquor works fine too as a mouthwash.
JFC (Havertown, PA)
I'm a senior in his mid sixties and I've suffer canker sores since my teen years. I have in the past noticed an occasional association with trauma (biting the inside of the lip) but one powerful association I couldn't escape was drinking tea. I used to love it, drank iced tea by the gallon in the summer, hot tea the rest of the year. Finally, about 20 years ago I said enough. I hit bottom as the 12 steppers like to say. I stopped drinking tea, cold turkey. I've probably only had 3 or 4 canker sores since then.
Sutter (Sacramento)
In the spice section of the grocery store you can find Alum: https://www.mccormick.com/spices-and-flavors/herbs-and-spices/spices/alum It is used for to prepare pickles made from vegetables and watermelon rind. Wash your hands first. With a damp finger touch the Alum (it will stick to it.) Now place the powder on the canker sore. The sore will go away soon. This helps with one canker sore. If you have many, see a doctor.
MadelineConant (Midwest)
Yes, I can testify that Alum was the home remedy for canker sores that my mother used when we were children, and it does help. It causes the sore to shrivel up. Doesn't taste bad, just a little sour.
Julia (NYC)
boric acid dabbed on
Bruce Miller (Seattle)
Like many commentators I suffered from canker sores (aphthous ulcers) for years. I tried many things without relief. About 12 or 15 years an endocrinologist diagnosed me celiac disease, which in my ease lead to an unrecognized vitamin deficiency. Canker sores are a known complication of celiac disease and my case, after removing gluten containing products from my diet, my aphthous ulcers stopped completely and have not returned. I am not suggesting that all canker sore sufferers have celiac disease. However because there is a blood test for celiac disease it may be worth ruling out celiac disease in cases of persistent canker sores. I have found that many physicians are not aware that celiac disease can result canker sores so you may have to be persistent in dealing with health care providers.
Sarah L (NWFlorida)
During my 20's, I had canker sores all the time, particularly after my period. My pharmacist told me it was due to the absence of lysine, an amino acid, that quits producing during my monthly. She said to take it a week before and during it....she was right. Eating plenty of tomatoes also helps, since lysine is found in them. No problems after following her advice!
Janissa (Idaho)
I had the exact same experience. I had frequent bouts with numerous large canker sores that took weeks to heal. After 15 years of suffering through that and other symptoms, including severe malnutrition despite eating a healthy diet, and receiving multiple misdiagnoses, I was finally correctly diagnosed with celiac sprue. Celiac sprue causes an auto-immune reaction whenever gluten (such as wheat) is eaten. As soon as I went on a gluten-free diet, the canker sores went away, and I haven't had any since. My doctor at the time knew little about celiac sprue. It's definitely worth asking your doctor about celiac sprue and whether it is a possible cause of your canker sores. But don't just go on a gluten-free diet without getting a diagnosis. Despite what many believe, a gluten-free diet is not healthier for you if you don't have celiac sprue.
jnandi (MA)
Lysine also works for cold sores. If you start taking it high dose when you start feeling that tingle that precedes a cold sore, it will retreat without ever emerging.
evancuster (california)
After 50 years, I finally realized that whenever I took aspirin or IBprofen or any other NSAID (non-steroidal anti inflammatory drug), I would get a canker sore. Now that I avoid the NSAID's, I have had decreased number of canker sores unless I bite my cheek. As to treatment, my dentist said he used to get them, but his doctor would give him one dose of prednisone (a steroid) of 50 mg and the canker sore would disappear over night. I myself have never tried it, so I cannot personally vouch for its effectiveness.
Jane (northern California coast)
My husband suffered from terrible canker sores all his life until he consulted a Chinese medicine acupuncturist who prescribed two chinese herbal meds: Nine Flavor Tea, and Coptis Purge Fire. He hasn't had a canker sore since, it's been 25 years. His sores were so bad before he had to burn them with silver nitrate sticks. It's all about the gut. Cool the fire, no more sores.
Chris (UK)
TOOTHPASTE!!! (I had to shout it for emphasis) I think many non-dentists would agree that standard toothpaste is a real cause of this ailment. Lauryl sulphate is a particular nasty, absent from some brands like Sensodyne, but even better is "natural" toothpaste like those from Weleda. Research and personal experience confirms the deleterious effects of standard toothpaste.
HCS (Canada)
That worked for my son. He had terrible canker sores until we removed SLS from his toothpaste. Now he's fine.
Colleen (WA)
My husband and 2 kids get canker sores. I never have. If they use toothpaste with SLS, they get one. I can use SLS toothpaste, and never have a problem.
Tim Prendergast (Palm Springs)
Anbesol provides tremendous relief, especially if applied with a q-tip multiple times in a few minutes. Apply, let dry, re-apply...let dry...re-apply. This provides a significant barrier to irritants and shrinks the canker dramatically in a short time. Also Canker Cover can have dramatic results. Put it on...let it adhere and dry and leave it alone. It can reduce the pain and longevity from 10 days to 2 days. At least for me.
Leslie Durr (Charlottesville, VA)
This reminded me that I had many episodes of canker sores as a teen but never since. For those who have "found" the reason in toothpaste, i would say that back then, toothpaste didn't contain that ingredient so the fact that the canker sores went away was probably 1. they do go away in a few days, and 2. they do go away after the teen/young adult years. Total coincidence not cause.
Petey Tonei (MA)
When we were young my mom physician would give us B complex tablets twice a day, these are water soluble so any excess simply washes out. For some reason the canker sores would disappear. Same with 500 mg Vit C which would seem counterintuitive to take something so acidic but that would help as well. Nowadays sachets like EmergenC have those B complex plus vit C plus essential minerals that help disappear these sores within a day...
Scamp (Toronto)
I've suffered from canker sores on the inside of my mouth since I could remember. The ones that appear on the tongue are not the same and the cause of those is usually from eating something too acidic for me. One year (about 20 years ago) I started noticing that I would get them really bad once October or November came around every year. I looked at what changed around that time and it was my consumption of fruit because the ones I liked goes out of season around then. From trial and error I narrowed it down to Oranges. If I eat an orange or two a day I don't get sores. If I stop they come right back with a vengeance. It isn't the vitamin C because for a long time while I was suffering from canker sores I was taking vitamin C pills. Don't know what it is in oranges but I've eaten one almost every day for 20 years and haven't had canker sores since.
Kally (Kettering)
Oranges give me canker sores—go figure.
LT (Boston)
Canker sores run in my family and I began getting them as a child. As a college student in the '80s, I'd get so many at exam time that I could only eat mushy cereal for a week. At my first job after college, secretary in an ad agency, I was reprimanded for not being smiley enough — I was unable to smile for a few days due to canker sores. A few years later, my dentist told me to take a vitamin with B-complex and C. I bought some and never suffered again. If I start to get a sore, I take a stress-formula vitamin and the sore heals by the next day.
Kaydea (Chicago)
I eliminated canker sores by using SLS (Sodium Lauryl Sulfate) Free toothpaste, about 10 years ago. I'd tried L-Lysine w some degree of success, but it didn't eliminate the canker sores. I also use a tongue scraper which was recommended by my dentist. Please always read the info that comes w your medications. I used triamcinolone cream on my hands for a fungal infection years ago. I just checked medicinenet https://www.medicinenet.com/triamcinolone-dental/article.htm# Re the triamcinolone toothpaste. Like the cream I used, the triamcinolone toothpaste is to be used only for a short duration. I also noticed pregnant women should not use it. If this medication is to be used only for a short duration of time & pregnant women should not use it, what harm can it cause?
Nancy Kruse (Long Island, NY)
I was plagued with canker sores throughout my life. I began taking 1000 mg. of Vitamin C daily over 30 years ago and can count on my two hands the number of canker sore outbreaks I've suffered since then. To be specific, I take 1000 mg. of Solgar Vitamin C. The simplest form. Other "fancier" vitamins failed.
EB (Seattle)
Swishing with chlorhexidine can help heal canker sores quickly, in a few days rather than weeks. Dentist can write a prescription. Swishing an oral dexamethasone solution can help too, but it is a steroid.
Bernie W (NYC)
I used a dexamethasone liquid swish for already established sores and it shortens duration of it but doesn't prevent them. Removing SLS almost immediately eliminated their occurance. I remember that most other toothpastes would give me a slimy residue after brushing; SLS free toothpaste does not. If you need flouride then you have to investigate SLS free flouride toothpastes or use a flouride swish in addition to brushing with SLS free toothpaste
Lisa (London)
I concur on the wonders of SLS-free toothpaste—although many of them do not contain fluoride. Lately I alternate between “regular” toothpaste and SLS-free and have been ok.
Alexa Fleckenstein M.D. (Boston)
Think about gluten and allergy problems ...
Lydia (Portland, OR)
I only get them after I eat too much sugar.
PM (New York)
If you have recurrent canker sores, you may have Behcet's Disease. I had this for years and no one knew why I would frequently get them. I tried everything to treat them and nothing worked. Once I started medications for Behcet's, they went away. If you think you have Behcet's, you should see a rheumatologist.
Allen Bagwell (Oakland, CA)
I've been prone to bad canker sore outbreaks since grade school. Like others, however, I have found that using SLS-free toothpaste drastically reduced the occurences. Sodium lauryl sulfate is the foaming agent that produces sudsy bubbles in hand soap. It's also used in most toothpastes and mouthwashes. Unfortunately SLS-free toothpaste is almost always flouride-free as well, so options are extremely limited for those like myself who aren't fluoride dental health deniers. I found Sensodyne to be a good alternative. SLS-free mouthwash is a bit easier to find. With regard to the article stating frequent canker sore sufferers should get checked for HIV infection, that's just silly and irresponsible as the problem existed throughout the general population long before was HIV discovered.
Petey Tonei (MA)
Yay to sensodyne!
Jeremy Bounce Rumblethud (West Coast)
I am hardly an alternative medicine enthusiast but I discovered years ago that honey cures canker sores almost overnight. Just hold a teaspoon of it against the sore with your tongue a few times (it dissolves quickly, of course). For me, it works like magic.
Gary Davis (Austin, Texas)
40 years ago, a dentist prescribed a steroid dental paste, Triamcinolone Acetonide Dental Paste, USP. 0.1%. I have kept a tube of it on hand ever since. The stuff is miraculous: relieves pain immediately by protecting the sore, then reduces inflammation, so it goes away quickly. If I catch a canker sore early with it, the sore usually never becomes serious. Also, another dentist recommended that I avoid toothpaste with sodium laurel sulfate. That seemed to reduce my frequency of canker sores significantly.. Finally, while I had many of them in my youth, they have become quite rare as I have grown older.
rhrjruk (virginia)
Ditto. As a lifelong canker sore sufferer, this steroid cream changed my life when it was first prescribed for me 10 years ago. Most doctors and dentists are unaware of it as a treatment for canker sores. The trick is to apply the cream at the first sign of trouble.
K. R. (Seattle)
My dentist gave me a prescription for Magic Swizzle. Has lidocaine. Definitely helped numb the pain but did not heal. I have also read that canker sores may be an autoimmune disease. Regardless, I am now on a supplement for folic acid (I have a mutated MFTHR gene and my body wasn't processing folic acid, etc. ) and the B vitamins. So far, so good.
T.W. Hughes (Norfolk, CT)
What has worked very well for me is L-Lysine everyday. When I take it regularly--daily, no canker sores. If I miss and do get one, then taking Lysine with each meal seems to minimize the pain as well as the duration of the sore,
Jon (VA)
I been using Lysine for years and I can't remember the last time I had a canker sore. It has worked like a champ for me.
Leanne (Coos Bay, OR)
I've only rarely had canker sores but got one recently. I remembered that they had been attributed to a lack of lysine, took a supplement of vitamin C, lysine & proline and it was gone the next morning.
Diane Pedersen (Germany)
Here in Germany my dentist suggested applying a small amount of the gel, "Urgo" (Ingredients: alcohol, cellulose derivative, carboxylic acids, inorganic acid, Water, Flavour, Sucralose.) which seems to do the trick for me every time. It burns a bit at first, but then the sores go away quite quickly.
Martha (Brooklyn)
Only because I haven't seen this explanation cited other than indirectly by one commentor, I will offer this: on my mother's side, the women in my family appear to have a predisposition to canker sores. Many of us also had/have rheumatoid arthritis. I suffered with canker sores starting in my teens to the point of not being able to eat anything for days, and found relief (but not a cure) when my dentist gave me a triamcinolone liquid paste. But since menopause, the only canker sores I've had have been the result of biting my tongue. As far as I'm concerned, QED.
Hope Springs (Michigan)
My family has a genetic predisposition to canker sores, and I have had so many I can’t count them. Every ding or nick inside my mouth turned into one, and as I aged, they have become more intense - my glands swell and I feel like I have the flu. All of that came to a crashing halt the day I read about SLS-free toothpaste. It seemed too easy to work, but I had nothing to lose by trying. It’s been like a miracle for me. I occasionally get one, but very, very rarely. Rembrandt is the brand I’ve been using. What a change!
Ohana (Bellevue, WA)
A thousand times yes. I finally decided to get serious about canker sores after I had a terrible outbreak of maybe 10 or 12 canker sores for no reason I could guess. It was BRUTAL. I switched to Tom's natural toothpaste, and I've had maybe one or two canker sores a YEAR since then. Who knows if that's really what fixed it for me, but if you're suffering, it's worth a try. That was a few years ago, and my dental health has not changed otherwise.
Patricia (Cleveland)
I have also suffered for many years with horribly painful outbreaks of canker sores, sometimes 7 or 8 in my mouth at the same time, and so painful I literally could not talk. I have also found SLS free toothpaste have changed all that - Trader Joe's makes a pleasant tasting and fairly inexpensive SLS free toothpaste that I've used for a few years now and have not experienced an outbreak since then.
EB (Seattle)
Yes, avoid toothpaste with sodium laurel sulfate. I do get occasional does, but much less often.
Alan Green (Boulder, Colorado)
For 30 years I have been recommending 3 things to do with canker and cold sores. 1)Licorice root extract (not deglycyrrhized (DGL) licorice) directly on the sore. 2)Magnesium supplements, either 500mg before bed or if taking a calcium/magnesium supplement already enough Mg for a 1:1 ratio with Ca. 3)Not to eat peanuts or chocolate, which is high in arginine, while a sore is present. This has been very successful protocol for most patients.
Roger Harris (Boulder, CO)
As a lifetime suffer, I concur that there is a link to SLS toothpaste. I have been virtually canker free since I switch to an SLS-free toothpaste like Natural Dentist. Yet if I bite my cheek, or am in a lot of stress, I do occasionally still get a canker. One application of Debactrol (50% sulfonated phenolics and 30% sulfuric acid) with almost instantly stop the pain, cauterize the site, and after that, healing is rapid. My dentist will give me a treatment on short notice, as he is a canker sore suffer himself.
VirginiaValley (Atlanta)
As a life long sufferer, I too found that switching to SLS-free toothpaste has been a miracle. I highly suspect that there is a genetic predisposition to canker sores. On my mother's side, four out of five siblings suffered through them, as well as six of my first cousins out of 10. We are not aware of anyone on my dad's side that had canker sores. (Nothing like a couple of family reunions with salty shrimp boils to figure out who has them).
amy (vermont)
Could have lived without the photograph.
Sharon in DC (DC)
Why? It's not a big deal, and could give guidance to those who need it. Just look away, Amy, and may you never be so afflicted. . .
Petey Tonei (MA)
Amy, thanks for mentioning. We don’t have cable TV so we watch mostly prime Network channels aired locally. You will not believe it but every evening the nation is exposed to graphic violent shows in the name of entertainment. From law and order to blindspit to deception to marvel to CSI to NCIS to bones to what not. We are rendered numb by these visuals of places blowing up, gun violence, rape and bludgeonings and such. For some reason Americans love violence and gross body parts, it sells on TV and Hollywood. These are ramped up a notch close to Halloween when horror shows become fashionable. It appears as though Americans are unaware of real life tragedy poverty refugees all over the world, so they watch it on TV as fictional entertainment.
Margaret (Fl)
While the writer seems to be leaving no stone overturned in theories researched and backed up by medical authorities as to what causes canker sores, the answer seems to be in the ubiquitious ingredient sodium lauryl sulfate that is in virtually every single brand of toothpaste known to man. It's hard not to feel cynical about the level-headedness of some of these columnists. I'm pretty sure the writer never had a canker sore - if she had, you can bet she would have googled it and this column would have been written differently.
Chris (UK)
I have to agree.
V. McD. (Seattle)
I've suffered from awful - truly awful canker sores the cause of which is uncertain. They would form on my tongue or cheek and for 10 days prevent me from eating anything with salt or acid (OJ). It was debilitating. I've learned to adjust my diet and their occurrence has diminished. The best response -truly, the best treatment, once they show up, is to load up on the amino acid, L-Lysine. Seriously, it's like kryptonite to these sores. I've shared this many a time and hope that those of you who suffer from these terrible sore give it a try. Good luck.
Johnny K. (CT)
Agreed! L-Lysine works quite reliably and I have shared this with others who reported back success. To clarify, this is a supplement and a bottle of 100 tablets or so should run under $10.
Faith (Ventura, CA)
Fifteen years ago I developed a terrible canker sore while backpacking through Malaysia. Since I didn't pack any medicine I went to a local pharmacy where through a combination of English, Malay and gestures I was able to describe the problem. The pharmacist gave me something called "watermelon frost". It was a dark powder, tasted like dirt and cured my canker sore faster than anything I had ever experience in America. Simply amazing! I took it home with me and used it sparingly. Always with great and rapid success. I recently ran out and in desperation went to Amazon. Success! They now sell it. Look for Watermelon frost compound in the squirt bottle. Squirt the compound on the sore and wait 15 minutes before rinsing.
Binne (New Paltz)
Try folic acid. Cleared mine up in a day.
Nelle Engoron (SF Bay Area)
Used to get them regularly but almost never since I stopped drinking orange juice. (Acidic foods and beverages can trigger them.) After getting a very painful canker sore that seemed to become infected, I tried an herbal rinse that healed things up within hours: Brew a cup of tea of goldenseal herb (which you can buy loose or in tea bags) along with 1/2 tsp of salt and a dash of cayenne. Let it all steep several minutes, until no longer too hot for your mouth but still warm. Swish a mouthful thoroughly a few times and then spit it out. Repeat every few hours for as long as needed.
Steve (Florida)
You have to be your own doctor and figure out what causes yours. I get them from minor scratches or injuries in the mouth. Triamcinolone ointment works really well for me. But I know other people who get similar-looking sores for no apparent reason, and the triamcinolone does not help them at all.
WWD (Boston)
The women in my family have always gotten them, both as part of PMS and just generally. Probiotics, a B-complex vitamin, and lysine are good preventatives and promote rapid healing. For real prevention, giving up wheat (since we all develop celiac by the time we're 40) and significantly cutting sugar intake have been the best bets. The alleviation of arthritis symptoms is a nice bonus.
vicky (baltimore, md)
I used to get them with sodium bicarb toothpaste (baking soda), it is too irritating to the mucosa tissue of the mouth. Basically anything that's too harsh, including some medications, can irritate the mucosa.
Steel (Florida)
1) try to get more sleep; 2) listerine once a day after brushing to fizzle out those sores (it works); 3) STOP EATING SUGAR; 4) use a toothpaste without SLS Canker sores / aphthous ulcers = gone.
JK (IL)
Agreed: sugar is a trigger
uxf (CA)
As can be seen from the comments, this devilish condition (which is not as trivial as non-sufferers might think) has an array of triggers and possible remedies. I've had them for as long as I can remember. Huge, painful ones, or clusters of little ones, that made it torture to eat, slurred my speech, and actually affected my personality! Every accidental bite to the inside of my mouth will result in one that lasts for 2 weeks. Stress and sleep deprivation too. I tried every remedy ever suggested, and nothing worked reliably, or at all. Then a new dentist recommended fluocinonide (brand name Lidex). I'm not exaggerating to say that it changed my life. Ask your doctor.
Sheila (Santa Rosa, CA)
I'll echo other comments: eliminating sodium lauryl sulfate from my toothpaste made a HUGE difference in canker sore occurrences for me. The other culprit is chocolate -- any kind (but white). Whenever I get a canker sore it's because I've eaten chocolate. (Though not every exposure to chocolate causes a sore.) I have no incidence of canker sores when I avoid SLS and chocolate.
Olive52 (Philly)
I’m 65 and have had canker sores since my teenage years My culprits are walnuts, some aged cheeses, and citrus juices. If the orange or walnuts are just a little old, I break out in a very visible and sore spot on the side of my tongue. It takes days to heal. I’m glad for this column and the home remedies suggested
iulia (Denver, Colorado)
Nearly fifty years ago, my dentist noted a canker sore during a routine appointment and asked, "Does that [sore] bother you?" I grunted affirmatively with mouth pried wide open. "Black olives," he continued, "cut one in half and place it where it hurts. Heals almost immediately." Though he was a savvy dentist, I was skeptical of such swift results from a homespun remedy. Just the same, I tried it and—lo, it worked for me—and has every time since. He went to his reward long ago but I think fondly of him to this day.
A.D. (Alabama)
I had canker sores for years, many times several sores at a time and sometimes huge and lasting for weeks. I switched to toothpaste without sodium lauryl sulfate and had fewer sores, but still got them regularly. Then, a little over a year ago, after other health issues, I was diagnosed with Celiac Disease. After going gluten-free and ensuring my toothpaste was not only SLS free but also gluten-free, I have maybe had one in the last year, and it healed much quicker than normal.
Pika (Oregon)
Went gluten free after finding out I had celiac disease. Canker sores have disappeared, except when I get accidentally "glutened." Had frequent canker sores as a kid. Now I know why. For a small number of us, an underlying condition causes canker sores.
Tim T (Nova Scotia)
Something that works for me and I haven't seen mentioned in the comments yet is simply applying ice or even just cold water if ice is not readily available. I discovered this after years of suffering but have had no trouble for decades now.
Steel (Florida)
That soothes them for me, but doesn't make them go away.
Frank Crisler (Arlington, SD)
It was cinnamon-flavored toothpaste that gave me canker sores. I had them frequently for a few years, before my dental hygienist suggested it might be the cinnamon toothpaste. I discontinued that, and haven’t had one since. Not a big deal, and never all that painful for me, but I prefer not having them.
Sharon Fratepietro (South Carolina)
I had multiple painful canker sores for years, and no doctor or dentist could tell me why or how to stop them. I also have dry eyes, and several years ago I participated in the drug trial for Restasis, a drug that treats dry eyes. After six months on Restasis, I still had dry eyes, but the canker sores had stopped completely. A doctor speculated that the cyclosporine in Restasis had changed my immune system to resist the canker sores.
greenlady (boston)
Have had them all my 71 years, eating too much refined carbohydrates (white flour and sugar) is the culprit, usually and too much dried fruit. Gave vinegar years ago. My theory is that a fungus (possible thrush) is the culprit.
Jess (Los Angeles)
Triamcinolone Acetonide Dental Paste was a miracle cure for me. Nothing worked until an infectious disease specialist wrote me a prescription for it. Almost immediately previously completely resistant sores healed within days. If you dry the area with a paper towel, dab a bit on, rub it lightly with a fingertip the try to keep your mouth open and the area as saliva free as possible for a few seconds, the ointment sticks better and remains on the sore longer.
Nancy F. Sudik (Bethel, CT)
I second that. Suffered from my teenage years until I was about 65 years old when my new dentist prescribed Triamcinolone Acetonide Dental Paste. It was like a miracle. I went from having 5 or 6 at a time to one or two a year. And all through the many years' plague of mouth sores I played french horn in various orchestras. The pain at times was unbearable.
LN (Chicago)
When I feel one coming on, I pop a B-12 daily, and that usually helps.
MA (Overland Park, KS)
Most toothpastes contain sodium lauryl sulfate/SLS which is a chemical used in toothpaste to create foaming action. I had frequent canker sores all my life until someone mentioned sensitivity to SLS. I switched to SLS free toothpaste and haven't had a canker sore in years.
Kristine (Illinois)
Is there a brand of SLS-free toothpaste you use?
MA (Overland Park, KS)
I use Jason's sea fresh with fluoride.
Kirby (Minneapolis)
I rarely get them any more now that I'm older (61), but when I did a quick (but painful) remedy was to brush the ulcer with my toothbrush. It would be gone the next day.
Lee (Illinois)
I find these comments from canker sore sufferers to be of far greater value than the Q and A that induced them. My personal triggers are of two types mentioned: mouth trauma (everything from the irritation of braces as a kid to the occasional inadvertent biting my lip or inner cheek), and food allergies. My mother always got canker sores from eating fresh pineapple, and though I share most of her food allergies, pineapple is not one of mine. My specific and absolute triggers are dextrin and maltodextrin (increasingly popular food additive or source of complex carbohydrates in everything from energy drinks to baked goods, and used in many processed foods to attach flavors, such as to potato chips). It requires me to read every ingredient on every container of food I buy or consume. For everything I can't read, it requires me to make mental notes on what restaurants I need to avoid. Hydrogen peroxide generally works for me, but upon reading the comments here, I am eager to find a source of the Triamcinolone Acetonide Dental Paste and try it on my next outbreak. Thanks.
Gigi (Kentucky)
Triamcinolone paste is by prescription. My dentist ordered mine. Really helps. Helps even more if you start using as soon as you feel symptomatic. I, too, avoid SLS-free toothpaste. I use Biotene instead, which is expensive, but worth every penny.
Janeal Thompson (Lamar, Colorado)
My doctor prescribed Triamcinolone Acetonide Dental Paste .1%, for me years ago. My present dentist said I was his first patient to ever request a prescription. Believe me, this works and is easy to use. My canker sores are allergy related, night shade plants such as tomatoes, potatoes, peppers, etc., and the dental paste is the only thing that helps. My toothpastes are SLS-free. Ask your dentist/doctor for a prescription, you won't be sorry. Good luck.
MamaBear (Massachusetts)
My now teen daughter used to get canker sores for reasons her dentist couldn't explain, but they seemed to increase with the use of a particular big-brand toothpaste. I switched her to a natural brand that's free of sodium lauryl sulfate, and the sores disappeared. If she runs out and needs to use a regular toothpaste for a day or two, they reappear. Needless to say, we are now well stocked with her SLS-free paste.
Abby (Illinois)
It appears every time following a minor trauma on my lips. (biting inside the lips or inside the cheeks, instrument pressure by dentist) and predictably disappears on an application of prednisone pills on the ulcer. It is caused probably by non-pathogenic bacteria of our oral cavity, through the breakage of barrier - mucous membrane. This is very different from herpes of the lips.
R (NYC)
This is anecdotal, but I always get canker sores when I'm regularly drinking soda or diet soda, and never get canker sores when I'm not. Sometimes just one soda a week will be enough to trigger a couple of canker sores.
Nancy S (West Kelowna)
Like many others here, I have found this: Cause: too much acidic food (tomatoes, sugar) Treatment: swish with hydrogen peroxide (first aid grade). Stops pain, ulcer gone the next day. Sometimes the medical establishment doesn't look at the easy solutions.
Roger (seattle)
I've tried most of the things described in this discussion, mostly without success. 400mg of folic acid supplement for a couple of days has without exception healed sores that exist or prevents them if I sense one forming. This works for my children as well.
mrhodes (Fullerton CA)
It took me years to discover that walnuts were the culprit, as well as toothpaste with SLS.
AK (SF Bay)
Walnuts and pecans for me
lxnd (Baltimore, MD)
I get one or two sores a couple times a year. They can last up to two weeks. Like other respondents, I also switched to SLS-free toothpaste, which helped enormously. Trader Joe's has one with fluoride. My other reliable source of relief is B-12 patches made by OraHealth. I've found that I develop a tolerance to numbing gels after awhile, but the B-12 patches help with pain and healing.
Will (Florida)
I used to get canker sores all the time when I was an older teenager and young adult. The only thing that made them go away was warm salt water rinsing (after brushing) several times a day. I stopped getting them all together around age 30. I'm not sure if this caused the end of my problem or not, but I recall that around age 30 I had switched my toothpaste to Arm & Hammer Banking Soda Toothpaste and my mouthwash to Cepacol, which I've been using ever since. I've also had healther gums even though my flossing frequency hasn't improved.
Still Waiting for a NBA Title (SL, UT)
Sour Patch kids' specific combination of citric acid, tartaric acid plus what ever else in them give me canker sours on the inside of my checks. I can eat other sour foods all I want and it doesn't happen. But if I eat a couple handsful of those I get them without fail. I haven't had them in a over a decade and haven't had one since.
Adi (Los Angeles)
I never comment on these things, but I suffered from canker sores chronically for years, and when I complained to doctor's they were never much help. Changing my toothpaste to a sodium lauryl sulfate free one (I use Sensodyne), completely solved the problem! It took way longer to figure this out than it should have. I also was using Tom's toothpaste for awhile because I thought they were all SLS free and was confused why I was still getting canker sores, but only certain flavors of Tom's are SLS free so make sure to always check the ingredient list!
Bala (St. Louis)
For one, avoiding dairy or gluten appears to help for those who are sensitive. https://nutritionfacts.org/video/the-role-of-dairy-and-gluten-in-canker-...
Marilyn Sue Michel (Los Angeles, CA)
Excessive consumption of sugar can cause an outbreak.
rls (nyc)
Canker sores for me have always been related to my menstrual cycle. I get them less frequently now that I'm older, but as a teen and in my 20s I had them monthly.
PDuff (Palm Springs, CA)
I used to get these a lot when I was younger (and more stressed). Taking lysine tablets regularly helped to ward them off, as did lysine gels during an outbreak, which would greatly help to minimize the pain.
WWD (Boston)
Second the lysine-- taking it regularly prevented them from happening as much, and rapidly decreased healing time.
a goldstein (pdx)
Anything that weakens the already delicate tissues of the oral cavity can produce a canker sore. Not mentioned in the article are reactions to any one of several natural constituents of foods. There's eating a lot of sour dill pickles with its high acidity and spices. And things like ketchup and spicy sauces.
judy1234 (Philadelphia, PA)
Interesting. Mine seemed to always follow excessive consumption of Vitamin C.
Cindy (DC Metro area)
I got canker sores frequently as a teenager & young adult - I'm now in my 40s & get them less frequently, but *every* time I accidentally bite my check I develop a canker sore in that exact spot. So, add me to the "mouth trauma" cause camp! The tingle you get combined w/ the reoccurrence makes me think that the underlying cause is a virus (that's in a latent state between whatever triggers the outbreak), but as the article says that hasn't been proven.
cheryl (yorktown)
Noticed that I also get canker sores if i bite my cheek ( not the only time), but I wonder if there was already a small swelling that made a piece of the cheek collide with teeth -- maybe the beginning of the sore comes first.
tom (denver)
stopped using sodium lauryl sulfate toothpaste - reduced canker sore occurrence by probably 90%
Mark Stewart (St. Paul, MN)
Absolutely agree. As others have mentioned avoiding SLS worked wonders for me. I had canker sores frequently for 30+ years until I stopped using SLS toothpaste and now I rarely (maybe once a year) have one. Again as others have noted, stress, other food irritants and/or mouth trauma led to canker sores before I stopped using SLS toothpaste, but now a bite will heal overnight without becoming infected.
NYCSandi (NYC)
I have heard this as well...
Sharon (Miami Beach)
My mom gets them from eating pineapple
mkt42 (Portland, OR)
I can't eat fresh pineapple because the acid burns my mouth. But I don't get canker sores from it, just inflamed areas if I eat pineapple for more than 5 or 10 minutes.
Petey Tonei (MA)
For some people kiwi fruits as well.
Jim (Hunt Bch Ca)
I had the problem for many years until a doctor prescribed " Dental Paste " ( Triamcinolone Acetonide ) . Now if I feel the tingle in my mouth that one is starting to form I smear a little Dental Paste on it right away and it never develops. After years of using it I rarely get a tingle in my mouth any longer. Everyone I've told about it it's worked for them too.
dk (oregon)
This stuff is a life saver, it can squash a canker sore overnight if applied early on. Very few drs and dentists seem to know about it.
GreaterMetropolitanArea (just far enough from the big city)
I was surprised to read this because I recognized the drug name right away: triamcinolone acetonide 0.1%, which I use for a skin condition. Interestingly, the patient information sheet from the pharmacy says "Do not take this drug by mouth." What you use must be triamcinolone acetonide--dental, a thicker paste; mine is a thin cream. But the drug is apparently identical. There are contraindications for people who have infections or are pregnant or breastfeeding.
John Douglas (Charleston, SC)
Same with me. It has worked magic. Not sure why a steroid would do it, given the lack of understanding on the underlying cause, but it does work. At least for me.
Jenny Guitar (Oakland)
I used to get canker sores almost constantly. I probably had a very painful canker sore about 50% of the time from childhood through my mid-twenties, until a dentist suggested switching to a toothpaste that doesn't contain sodium lauryl sulfate (SLS). Since I made that switch, I've had only one canker sore! It can be hard to find toothpaste without SLS that also has fluoride, but JASON brand has a couple. (It can feel a little weird when you first switch, because SLS is a foaming agent, which makes the toothpaste feel kind of fluffy. But I got used to it quickly.)
P Rogers (Sag Harbor)
There IS a cure for canker sores that has worked for myself and everyone to whom I have recommended the treatement! As a child and youth, probably due to Behçet's disease, I had awful canker sores. In retrospect, allergies and an adverse reaction to chocolate, also played significant roles. Treatment in those days was to cauterize the wounds with silver nitrate, a caustic pencil, painful indeed! Thankfully I encountered some competent medical advice over the years. Today-for isolated sores on the inner lips, cheeks and tongue- I apply Triamcinolone Acetonide Dental Paste .1%. For more generalized ulcers in the mouth and throat I use Dexamethasone Oral Solution 0.5Mg for one minute 3-4 times a day. I have gone for continuous attacks every few days, sometimes lining my entire throat, to one or two mild ulcers per year. Hope this helps!
P Rogers (Sag Harbor)
An addendum, as other commentors have noted, absolutely no SLS in your toothpaste! I love Xyli-White. You might consider removing it from your body soap as well.
John Douglas (Charleston, SC)
Triamcinolone Acetonide Dental Paste also works for me and my wife. Perhaps not a solution for everyone, but worth a try for everyone.
j (Arlington Virginia)
I find that applying peroxide using a cotton swab directly onto the sore will provide immediate relief and facilitate healing.
Barbara (Minnesota)
Switching to an SLS-free toothpaste resolved my severe canker sore problem.
NYCSandi (NYC)
30 years ago it was suggested to me by a colleague RN to take L-lysine supplements, available at the chain drug stores. I started with one 500 mg pill daily for a year; now I take two such pills once a week. The incidence of a canker sore is sooo much less, and when I do get one it is smaller and lasts only 24 hours. Sometimes I only get the "tingle" but no actual sore. It may not work for everyone but it has worked for me and other family members.
InOrlando (Orlando, FL)
I never had much of a history of canker sores, until I started working in a high stress job. While in that position, I had canker sores pop up once or twice a month. After the first couple I read some information about stress and canker sores. Since leaving that job almost 2 years ago, I’ve only had one canker sore. There is, in my opinion, validity to the stress-canker sore correlation.
Paul (Brooklyn)
We can put a man on the moon, develop robots that act like humans but can't find a cure for cancer or canker sores. It almost turns a rational man like me into reading up on conspiracy theories.
Susan Steen (Lawrenceville, NJ)
While not one specific "cure" may exist, it seems quite possible that simple life-style changes bring dramatic relief from this problem. My daughter has remained nearly sore-free after eliminating SLS and fresh pineapple. Always explore life-style changes before seeking treatment with drugs which may have undesirable side-effects. No conspiracy here, just a common annoyance which can be decreased or avoided by changing your choices.
Sarah (Massachusetts)
H.I.V. is a virus that targets the immune system. Simply being ill or having a chronic disease does not weaken the immune system. Ironically in the case of autoimmune disease, like type 1 diabetes, which many people seem to confuse with an under functioning immune system, the opposite is true. The malfunction is that the immune system is mistakenly targeting an organ, in this case the pancreas, and attacking it.
Bill (Hoboken)
I've found stress to be a major trigger for me. Acidic foods/drinks may exacerbate them as well.
Alex (Washington, DC)
I was plagued with canker sores from the age to 4 to my early 20s. I had them monthly, and often endured multiple large sores throughout my mouth. I spoke to numerous doctors and dentists without receiving any helpful guidance. When I was 22, I did some online research and discovered a British study suggesting that a vitamin deficiency might be to blame for canker sores. The next day, I bought a jar of multi-vitamins at the grocery store. Their efficacy in preventing sores was amazing. I am now almost 45, and I get perhaps one small canker sore a year that lasts only a couple of days. No more clusters of large sores, no more monthly mouth pain. I still take a daily multi-vitamin to keep the canker sores away.
Jim Muncy (& Tessa)
Weird, but true: Once upon a time, my dentist cauterized a painful canker sore that I had. I asked my doctor about doing said treatment years later when I happened to have an appointment with her. She had never heard of it. Years later, same story: I asked another dentist to cauterize a canker sore, but she had never heard of such a thing either. Are these guys messing with me? Or am I sliding from one dimension or universe to another?
P Rogers (Sag Harbor)
Your canker sore was cauterized with a "caustic pencil" or silver nitrate. Many dentists still have them. For a simpler solution please use Dexamethasone wash for generalized outbreaks and Triamcinolone Acetonide Dental Paste for single sores. Also, avoid SLS in toothpaste. Hope this helps.
Jim Muncy (& Tessa)
Yes, in fact, when you wrote silver nitrate, I remembered him saying that: Funny how the memory works like that, i.e., if you say someone's name, I remember it fully well. Thank you. This scientific knowledge can help somebody with a painful canker sore; prayer won't. Magic dancing might, though.
AndreaK (Toronto, Canada)
In my case, a simple blood test determined that I had a pretty serious B12 deficiency that explained a lot of odd symptoms. Within a week of taking good quality supplements, I could think again, had more energy, and the sores in my mouth disappeared. Ah - how wonderful. For two years, I had ask my dentist and his assistant if they had any ideas on what caused them and they always said they had no clue. Anyway -- give B12 a try.
Blake (New York, NY)
I know this is anecdotal, but there might be an underlying genetic basis for some people. Both my brother and I consistently developed canker sores. Since switching to SLS-free toothpaste ~8 years ago I went from having 2-3 a month to 0 per year. I'm sure it won't work for everyone, but it's definitely something to consider. The one caution would be to make sure your SLS-free toothpaste still has fluoride.
Lois Manning (Los Gatos, California)
I tend to get one if I've eaten too much acidic food such as grapefruit or oranges.
Samantha Cocco-Klein (Brooklyn)
Me too. Had them for years and realized was most commonly caused by acidic fruit, particularly pineapples and Tuscan melons.
Nancy G (MA)
I can no longer eat anything that has cooked tomato...no tomato sauce of any kind; no oranges and no chocolate. : (
DL (NH)
I get canker sores on my tongue off and on for most of my life. I have found simple remedy that usually works overnight. Bad ones take 2 nights to heal. There is a special dental paste that adheres to the tongue most of the night. The active ingredient is Triamcinolone, a cortico-steroid. This can be obtained by asking your dentist for Triamcinolone in dental paste or requesting it from you primary care physician. Dry your tongue with a tissue just before you go to sleep. Apply a small dab of the paste on top of the canker sore and rub it in so that it adheres well. Close your mouth, don't move your tongue about so that the dental past is not disturbed. You can't talk after applying it to avoid disturbing it. Go to sleep. You will have no pain by the next morning and the canker sore will have subsided significantly. Apply one more time before bedtime if it is still bothering you. It is indeed a powerful cortico-sterioid so do not overuse it or abuse it. One very tiny tube lasts me about 5 years although it usually expires prior to that.
Mary (New England)
Triamcinalone dental paste, which requires a prescription, has been a miracle drug for me. It cuts the duration from 10-14 days down to just a single day or 2. Not sure why it is not more widely used. It is a steroid, but the amount absorbed by using just a small dab on the sore, at most just 2 times, can't be much.
Susan Steen (Lawrenceville, NJ)
Thirty plus years working in pharmaceutical development suggests that you might want to try some of these excellent life-style changes to prevent your sores before treating them with a drug. My daughter eliminated her canker sores by avoiding SLS and fresh pineapple. Always avoid the use of drugs if you can.
Rachel (Los Alamos)
I (Rachel's husband) regularly had canker sores all my life until I was in my early 30's. These were very painful, very frequent, and would last months. At some point a pharmacist recommended acidophilus which, for me, worked miracles. I'm in my 60's now and from the time I first took acidophilus (and other similar probiotics), I've almost never had canker sores. I guess there are multiple causes for canker sores and perhaps what works for one won't work for all but acidophilus did the job for me. We keep some in the refrigerator in case either of us feel a sore coming on, but I need it less than once a year.
Susan Callihan (Peterborough, NH)
I am a 70 year old woman and have been plagued with canker sores my whole adult life. At times I have had two or three of them at once, and could never figure out the cause. Then six years ago I had an attack of diverticulitis and decided to change my diet. I cut out gluten, sugar and most dairy. I eat small amounts of goat cheese. I had been eating bread every day and yogurt most days. Over the last six years I have had no further occurrences of diverticulitis. A huge side benefit to changing my diet is that I have had no canker sores. I can only assume that the major trigger for me was gluten. When I saw a naturopathic doctor a couple of years ago for a check up and told her of my delight and surprise at having no more canker sores since changing my diet, she said "Well it makes sense -- the mouth is the other end of the digestive system". That's as good as any explanation I have heard.
Allison Sealy (Raleigh, NC)
I have suffered from almost constant cankers throughout my childhood and early adult life. After a conversation with my dentist about a year ago though, that changed. She told me that many people unknowingly have a sensitivity (or full-blown allergy) to a foaming agent found in many items, including toothpaste, called sodium lauryl sulfate. After replacing my toothpaste with one of the few brands that offer toothpaste without this foaming agent, my canker sores have reduced by 75%. Total game changer.
Steve (NC)
I suffered from painful canker sores for many years and finally determined that the culprit was my toothpaste, which contained sodium lauryl sulfate. There are only a few that don't contain this sudsing agent, but since I switched 10 years ago, I have had very few canker sores. I actually confirmed this cause by unknowingly starting to use a toothpaste with this sudsing agent again. The canker sores came back inside of a week. I threw the toothpaste out.
Jeff Morse (Virginia)
I had very bad outbreaks of cancer sores every year over the last 30 years ... until last year. My doc suggested propranolol (second line blood pressure med that may cause dizziness 40mg a day. The only outbreak I had last year was when I switched docs and did not have this for a couple weeks. My experience may be unique but ask you doc for try if nothing else worked (I tried a bunch of home remedies). If this post makes life better for even a few folks please spread the word, these outbreaks really limited what I could do with my work life.
wmferree (deland, fl)
For some of us, switching away from popular brands of toothpaste goes a long way in eliminating these nasty things.
P Rogers (Sag Harbor)
Specifically, switching to a brand of toothpaste completely free of SLS, Sodium Laureth Sulfate, will eliminate most outbreaks. I like Xyli-White.
cheryl (yorktown)
From childhood into my 20's, I used to get many - I also used to get repeat tonsillitis/strep infections, and always wondered if there might be some correlation. As an older adult I started to get them again -not sure at what age, probably 50's - and experimented with various "home remedy" approaches: one seems to help heal existing ones, and prevent breakouts - taking regular additional vitamin B12. ( I have no clue as to the 'right' amount, tho')
M (Levy)
The only preventative technique I've found is flossing consistently. For them to form, they need slightly inflamed or swollen gums. If your gums are always healthy, pink, etc., they won't generally form. This is from experience; I am not a medical professional. But I used to get these all the time and now I never do.
Bob Epstein (Berkeley, CA)
I have had a significant reduction in the frequency of canker sores by switching to a toothpaste that does not contain sodium laurel sulfate.