Why Can Canker Sores Form in The Mouth? How Can It Be Prevented?

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What Are Canker Sores?

Aphthae are painful sores on the oral mucosa, usually round or oval in shape and covered with a thin yellowish or gray membrane. Aphthous ulcers, medically known as “aphthous ulcers”, are most commonly found on the lips, cheek mucosa, tongue or palate. Small aphthae are a few millimeters in diameter and tend to heal on their own; in some cases, larger and painful lesions may develop.

The appearance of aphthae can reduce quality of life by causing discomfort during eating and speaking.

How Can Canker Sores Form in the Mouth?

Although the mechanism of canker sores is not fully understood, the immune system, hormones, nutrient deficiencies and stress play an important role. Minor injuries or imbalances in the oral mucosa trigger cells that are mistakenly targeted by the immune system, leading to canker sores. Aphthae are not caused by a virus, although in some cases they can be confused with sores caused by the first type of herpes simplex virus. The onset of canker sores is usually characterized by a slight burning or tingling sensation and soon turns into an open sore.

What Precautions Can Be Taken to Prevent Aphthae?

Although it is not always possible to completely prevent aphthae formation, it is possible to reduce their frequency and severity with some simple but effective measures:

Eat a balanced and adequate diet: Vitamin B12, folic acid, iron and zinc deficiency can cause canker sores. Therefore, a diet rich in vegetables, fruits, whole grains and protein is important.
Pay Attention to Oral Hygiene: Brush your teeth daily with a soft-bristled brush and use products that do not irritate the inside of the mouth. Cleaning between teeth with dental floss also reduces the risk of infection.
Choose SLS-Free Toothpaste: Sodium lauryl sulfate (SLS) can trigger aphthae in some people. SLS-free toothpastes provide a more gentle cleaning.
Try to Avoid Stress: Excessive stress can affect the immune system and trigger aphthae formation. Relaxation techniques such as meditation, walking and quality sleep can be helpful.
Beware of Allergies and Irritation: Acidic, spicy or very hot foods can irritate the oral mucosa. Avoiding such foods is beneficial.
Prevent Oral Trauma: Hard-shelled foods, braces or dentures can injure the inside of the mouth. In such cases, you can use protective balms or special gels.
Have Regular Medical Checkups: People with frequent aphthae may have vitamin deficiency or systemic diseases. For this reason, doctor checks should not be disrupted.

Which Diseases Can Frequent Aphthae be a Sign of?

People who suffer from persistent or frequent canker sores may be deficient in iron, folic acid or vitamin B12; deficiencies in these nutrients have a negative impact on the health of the blood structure and mucous membranes. Systemic inflammatory conditions such as Behcet’s disease, celiac disease or Crohn’s disease can also be associated with canker sores. As a side effect of autoimmune conditions, such as lupus, the immune system can develop reactions against the oral mucosa. Therefore, frequent canker sores in the mouth require a thorough examination for underlying health problems.

What is the Role of Oral Hygiene in Aphthae Outbreak?

Proper oral hygiene is one of the main factors that reduce the risk of canker sores. Regular brushing and flossing reduces the risk of microbial infection by preventing bacterial accumulation. Acidic and sugary foods can disrupt the pH balance in the mouth and cause damage to the mucosa; therefore, it is beneficial to rinse the mouth with water after eating. However, soft-bristled brushes and SLS-free toothpastes should be preferred, as excessively hard toothbrushing or low-quality toothpastes can also irritate the mucosa and pave the way for aphthae.

What are the Treatment Methods for Aphthae?

Aphthae usually heal on their own, but various treatment methods can be used to reduce pain and speed healing. Mouthwashes, antiseptic solutions, topical corticosteroid gels, pain relief sprays and aphthous patches are among the commonly used products. As natural solutions at home, methods such as sage, carbonated water mouthwash, rinsing with salt water can also be applied. However, if aphthae recur frequently or do not go away for more than 2 weeks, a dentist or doctor should be consulted. An underlying systemic disease may also be the cause of canker sores.

Is Aphthae Contagious?

Although aphthae and cold sores often look similar, they have fundamental differences in terms of etiology, symptoms and contagiousness. Cold sores (herpes labialis) are lesions that develop due to herpes simplex virus type 1 (HSV-1) infection, especially in the lip margin and surrounding skin area, with fluid-filled vesicles rupturing and crusting. Cold sores are contagious because they are caused by a virus; they can easily be passed on to other people through close contact or shared objects and tend to recur when the immune system is weakened.

Aphthae, on the other hand, are usually caused by local trauma, vitamin deficiency and immune system misreactions rather than a viral agent; they are not directly contagious. In terms of shape, cold sores are usually a group of water-filled vesicles, whereas aphthae are single or sometimes double or triple limited ulcers that turn into open sores. Cold sores do not usually occur on the oral mucosa except on the lips, whereas canker sores can occur in any part of the mouth.

In conclusion, while cold sores are viral, contagious and blistering lesions, aphthae are painful ulcers that are not caused by infection but by superficial damage to the mucosa and do not carry the risk of infection.

Can Canker Sores in The Mouth Interfere With Treatments?

The severity and pain level of canker sores can affect the use of medication or prostheses, especially those applied to the oral cavity. For example, in patients using orthodontic appliances or dental prostheses, canker sore pain can make regular dental care and treatment difficult.

Painful canker sores can negatively affect cooperation in medication administration and appointment compliance, as they reduce patient comfort. In addition, since aphthous formation increases in cancer patients undergoing chemotherapy or radiotherapy due to the weakened immune system, treatment doses and session times may have to be adjusted accordingly.

Why Are Canker Sores More Common in Children?

Since children’s immune systems are not yet fully developed, infections that occur after injury to the oral mucosa can lead to aphthae more frequently. In addition, their frequently changing diets may increase their sensitivity to new tastes and textures and trigger aphthae outbreaks.

Small wounds caused by teething periods or hard foods can also lead to canker sores in children. On the other hand, lack of hygiene in schools and playgrounds can increase the risk of viral and bacterial infections, leading to more frequent canker sores.

What Can Be Applied At Home For Aphthae?

There are a few simple home remedies you can use to relieve the pain and shorten the healing time. Gargling with salt water or carbonated water balances the acidic environment in the mouth and promotes healing.

Applying natural antibacterial ingredients such as honey and aloe vera on the aphthae reduces pain and reduces the risk of infection. In addition, consuming probiotic yogurt supports gut health and increases overall immune resistance. However, if the pain is severe and the sores are large, it is absolutely necessary to consult a specialist.

Do Dental Prostheses and Orthodontic Treatments Cause Aphthae?

Dentures, orthodontic appliances with brackets or aligners can cause mucosal damage due to friction in the mouth. As a result of this friction, thin sores can form, paving the way for the development of aphthae.

In addition, incorrect pressure points that occur during the process of getting used to using a new prosthesis or appliance can cause simple trauma to the oral mucosa. Using soft tissue protective gels, making regular adjustments and paying attention to oral hygiene during such dental applications are effective in minimizing the risk of aphthous formation.

Does stress trigger aphthae formation?

Yes, intense stress and emotional exhaustion can lower body resistance and trigger canker sores. Stress can cause canker sores to appear more frequently and severely because it weakens the immune system.

Does vitamin deficiency cause aphthae in the mouth?

Vitamin B12, folic acid and iron deficiency play an important role in canker sores. Insufficient intake of these vitamins can weaken the oral mucosa and cause sores to form easily.

Does toothpaste cause canker sores?

Sodium lauryl sulfate (SLS), which is found in some toothpastes, can irritate the tissues in the mouth and predispose to canker sores. SLS-free toothpastes can reduce this problem.

Are canker sores contagious?

No, canker sores are not contagious because they are not caused by viruses or bacteria. There is no risk of transmission from person to person.

Can canker sores cause cancer?

Aphthae are usually harmless and not directly related to cancer. However, it is important to consult a doctor for sores that do not go away for a long time or recur frequently.

Is it possible to prevent aphthae formation?

Although it is difficult to completely prevent canker sores, it is possible to reduce the risk by avoiding trigger factors. Controlling stress, eating a balanced diet and paying attention to oral hygiene can help prevent canker sores.

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