Canker Sores vs Cold Sores – Treatment, Pictures, Contagious, in Throat, on Tonsils, on Roof of Mouth

Key Facts

Canker Sores are small, shallow, painful lesions that develop in the mouth

Common areas affected are the base of the gums, inside of the lips, cheeks, and sometimes on or under the tongue

Appearance is round or oval with a white or yellowish center and a red border

Cankes sores are common affecting about 20% of the population

Canker sores duration is usually 1 to 2 weeks

Causes are various, including minor injuries, food sensitivities, certain toothpastes, vitamin deficiencies, stress, or underlying health conditions

Treatment is often not necessary as canker sores usually heal on their own. Pain relief and antimicrobial mouth rinses may be recommended

Prevention is avoiding known triggers, maintaining oral hygiene, and ensuring a balanced diet

What are Canker Sores?

Canker sores, medically termed aphthous ulcers, are small, shallow ulcers that can appear inside the mouth, usually at the base of the gums, inside lips, inside cheeks, or under the tongue. They are not contagious and are different from cold sores, which are caused by the herpes simplex virus and typically appear outside the mouth. Canker sores can be extremely painful, especially when eating, drinking, or talking, and are among the most common oral health issues.

What are the Symptoms of Canker Sores?

The primary symptom of a canker sore is a small, painful sore or ulcer in the mouth. Here are some canker sore symptoms detailed characteristics:

Size and Shape: Typically round or oval, and usually less than one centimeter in diameter
Color: A white or yellowish center with a defined red border
Pain: They can be very painful, particularly when eating or drinking. The pain usually decreases after the first few days, and the sore often heals up within two weeks
Multiple Sores: Sometimes, several canker sores can occur in the mouth at the same time
General Symptoms: In severe cases, canker sores can be associated with fever, sluggishness, and swollen lymph nodes

Canker Sore Causes: What Causes Canker Sores? How do you develop canker sores?

The exact cause of canker sores is not clearly understood, but they seem to be the result of a combination of factors.
If you develop canker sores these triggers and contributing factors may have contributed:

Minor Injuries: Canker sores can be triggered by minor oral injuries from aggressive brushing, dental work, sports injuries, or accidental bites.
Sensitivities to Certain Foods: Citrus fruits, tomatoes, strawberries, chocolate, coffee, nuts, and spicy or acidic foods can trigger canker sores in some people.
Toothpaste Ingredients: Some toothpastes contain sodium lauryl sulfate (SLS), which can contribute to the development of canker sores.
Vitamin Deficiencies: Deficiencies in vitamin B12, iron, and folate can be linked to the development of canker sores.
Stress: Emotional stress is considered one of the common triggers.
Hormonal Fluctuations: Changes in hormonal levels, such as during menstruation, can lead to canker sores in some individuals.
Underlying Health Conditions: Diseases such as Celiac disease, inflammatory bowel diseases, Behcet’s disease, and HIV/AIDS can cause canker sores.

It’s important to note that while canker sores can be annoying and painful, they are not generally a serious health concern and often resolve on their own. However, understanding and managing the triggers of canker sores may help in preventing their occurrence and experiencing pain canker sores.

Are Canker Sores an STI (STD)?

No, canker sores are not sexually transmitted infections (STIs) or Sexually transmitted diseases (STDs). They are benign ulcers that occur in the mouth and are not caused by any sexually transmitted virus or bacteria.

Canker Sore vs. Cold Sore: Are They the Same Thing?

These are two completly different conditions:

Canker Sores are small ulcers that occur inside the mouth. Unlike cold sores, they are not caused by a virus and are not contagious. They usually have a white or yellow center with a red border.
Cold Sores, also known as fever blisters, and unlike canker sores are caused by the herpes simplex virus and are contagious. They usually appear outside the mouth, often under the nose, around the lips, or under the chin, and are filled with fluid.

Who Gets Canker Sores?

Canker sores can affect people of all ages, but they are more common in children and young adults. Women are also more likely to get canker sores than men. People with a family history of canker sores are more likely to develop them.

How Common is This Condition?

Canker sores are quite common. It is estimated that around 20% of the population will get canker sores at some point in their life. They can occur occasionally or frequently, depending on various factors such as stress, diet, and individual predisposition.

Are Canker Sores Contagious?

Even major canker sores are not contagious. They cannot be spread through kissing, sharing utensils, or any other form of contact. This is in contrast to cold sores, which are highly contagious and can be easily spread through close personal contact.

How are Canker Sores Diagnosed?

Canker sores are usually diagnosed through a clinical examination. A healthcare provider or dentist will examine the inside of your mouth to check for the characteristic appearance of canker sores (look for the common symptoms). Typically, no further testing is necessary as they are easily recognizable. However, if there is an unusual presentation or frequent recurrence, the healthcare provider may take a small sample for biopsy to rule out other conditions, or may inquire further into your medical history and lifestyle.

How Do You Heal a Canker Sore Fast?

While most canker sores usually heal on their own within one to two weeks, there are ways to alleviate pain and possibly speed up the healing process:

Avoid Irritating Foods: Spicy, salty, or acidic foods can aggravate a canker sore. It’s best to avoid these when you have an active sore.
Use a Soft Toothbrush: This can prevent further irritation of the sore.
Rinse with a Saltwater Solution: Mix 1/4 to 1/2 teaspoon of salt in 8 ounces of warm water. Rinse your mouth with this solution for 15-30 seconds before spitting it out. This can be repeated every few hours.
Apply a Topical Product: Over-the-counter products such as creams, ointments, or mouthwashes designed for canker sore treatment can be helpful. Some products form a protective barrier over the sore to shield it from irritants.
Take Pain Relievers: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help relieve pain.

How Long Do Most Canker Sores Last?

Canker sores usually last for about one to two weeks. The pain of painful canker sores often decreases after the first few days and then gradually subsides as the sore heals. If a canker sore lasts longer than two weeks or is unusually painful or large, it is important to diagnose canker sores by visiting a healthcare provider.

Can I Prevent Canker Sores?

While it may not be possible to completely prevent canker sores, especially if they are caused by factors such as genetics, there are steps that can be taken to reduce their frequency and severity:

Maintain Good Oral Hygiene: Regularly brush and floss your teeth to keep your mouth clean.
Avoid Known Triggers: If certain foods or toothpastes seem to cause canker sores for you, try to avoid them.
Manage Stress: Since stress can be a trigger, finding ways to manage stress through relaxation techniques can be beneficial.
Watch Your Diet: Ensuring that your diet is balanced and provides all the necessary nutrients, especially vitamins B and C and iron, can also be helpful.

By recognizing the signs of canker sores and taking steps to manage and prevent them, you can treat canker sores and reduce their impact on your quality of life. If canker sores become a recurrent issue or are particularly severe, seeking the advice of a healthcare provider is advisable.

What Can I Expect If I Have a Canker Sore?

If you have a canker sore, you can expect to experience some discomfort, especially when eating or drinking acidic or spicy foods. The canker sore appears itself as a usually small, round or oval, with a white or yellowish center and a red border. They often develop on the inside of the lips, cheeks, or under the tongue. During the first few days, the pain might be more pronounced but typically starts to diminish thereafter. Most canker sores heal on their own without scarring within one to two weeks.

Stages of canker sores

Canker sores, also known as aphthous ulcers, typically go through several stages in their development and healing process:

Tingling or Burning Sensation: Before the canker sore becomes visible, canker sore starts with a tingling, itching, or burning sensation in the area where it’s about to form. This usually occurs 12-24 hours before the sore appears.
Formation: This is when the sore actually appears. It usually takes the form of a small, round or oval-shaped ulcer. It typically has a white or yellowish center with a red border. This stage is often accompanied by pain or discomfort, especially when eating or drinking acidic, spicy, or salty foods.
Inflammation and Pain Peak: Over the next few days, the canker sore may become more inflamed and painful. Some individuals might experience swollen lymph nodes and a general feeling of being unwell during this stage.
Healing Begins: After several days, the pain and inflammation should start to subside. The sore will begin the healing process. The edges of the ulcer may appear less defined, and the white or yellowish center begins to disappear.
Complete Healing: Canker sores usually heal without leaving a scar. This final stage is when the ulcer is completely gone. Healing usually occurs within one to two weeks of the sore first appearing, though larger sores can take longer to heal.

Remember, it is important to avoid irritating the canker sore during the healing process, and to maintain good oral hygiene. If you notice that your canker sores are unusually large, lasting more than two weeks, or are accompanied by severe pain or a high fever, it is advisable to consult a healthcare provider.

When Should I See My Healthcare Provider?

While minor canker sores are generally not a cause for concern, major canker sores may need to be consulted by a healthcare provider:

If your canker sores are unusually large
If the sores are spreading
If they last longer than two weeks
If you experience an unusually high level of pain that is not relieved by over-the-counter painkillers
If you develop a fever or feel unwell alongside the presence of canker sores
If you have difficulty eating and drinking because of the sores

What Questions Should I Ask My Healthcare Provider?

When you visit your healthcare provider regarding canker sores, you might want to ask the following questions:

What could be causing my recurrent canker sores?
Are there any specific treatments you would recommend for my canker sores?
Could my canker sores be a sign of an underlying health issue?
What steps can I take to prevent future canker sores?
Are there any dietary changes that could help?
Are there any oral care products that you recommend to avoid or to use to reduce the occurrence of canker sores?

What are herpetiform canker sores?

Herpetiform canker sores, also known as herpetiform ulcers, are a type of aphthous stomatitis. Unlike what their name might suggest, they are not caused by the herpes virus. These sores typically appear as a cluster of multiple small ulcers. They can be as small as 1 to 2 millimeters in diameter (minor canker sores), but because they often group together, they can form larger areas of ulceration. They can occur anywhere inside the mouth, including on the inside of the lips, cheeks, tongue, gum, or soft palate. The ulcers are usually very painful and can cause discomfort while eating, speaking, or swallowing. They may also be accompanied by a burning or tingling sensation before the sores appear. The exact cause of herpetiform canker sores is unknown, but factors like stress, nutritional deficiencies, hormonal changes, and immune system problems may contribute to their development. Treatment is aimed at reducing pain and speeding up healing. This may include topical medications, oral medications, mouth rinses, and avoiding spicy or acidic foods that can irritate the ulcers. These sores usually heal within one to four weeks without scarring. Some people may experience herpetiform ulcers only once, while others have recurrent episodes.

Bottom Line

Canker sores are a common oral condition and usually not a cause for concern. They are characterized by small, painful ulcers inside the mouth that can be uncomfortable, but they generally heal on their own within a couple of weeks. Maintaining good oral hygiene and avoiding foods that irritate the mouth can help in managing the symptoms. Canker sores are not contagious and are not the same as cold sores. However, if you experience severe, recurrent, or unusually long-lasting canker sores, it’s important to consult a healthcare provider to rule out any underlying health issues. Be proactive in your health by asking questions and following any advice or treatment recommended by your healthcare provider.

This article is complete and was published on July 11, 2023, and last updated on November 22, 2023.

Key Facts