Chronic Canker Sores Treatment and Prevention

Chronic Canker Sores Treatment and Prevention

Chronic Canker Sores Treatment and Prevention

by George M Bailey, DDS

I frequently get canker sores in my mouth. Is there anything I can do to prevent them?
Yes, to a degree! Although there has been a significant amount of research performed on causes, prevention, and treatment, there still is no universal method (it seems everyone has some suggestions, but few work on everyone). May we lay out some of the knowns, and make some suggestions:

Canker sores (also called “aphthous ulcers”) are caused by a virus (either herpes or aphthous—researchers are still arguing about which).

Why do they occur?
Three conditions seem to be necessary for an outbreak:

  1. Susceptibility—there is an obvious genetic link since some people get them and others don’t.
  2. Stress—it is well-documented that outbreaks are most likely to occur with stress
  3. Trauma—trauma is of two types: physical (biting the tongue, abrasive food, etc) and chemical (ingredients in things we put in the mouth)

OK, that’s very interesting, but what can I do?
Susceptibility and stress are frequently beyond our control, so that leaves just the chemical trauma—watch what you put in the mouth!


Chemical Ingredients that may precipitate canker sores (you still need susceptibility and stress). Listed in order of aggravation:


  1. Nuts(esp. English walnuts)
  2. Chocolate(sorry about that)
  3. Sodium lauryl sulfate(the ingredient in toothpastes that provides the foaming (detergent) action. Most toothpastes in North America have this ingredient except those shown below.

canker_sores3 canker_sores4 canker_sores5

Sodium lauryl sulfate free toothpastes.

What is the most effective way to create cankers? (just kidding…but to illustrate a point)
Eat walnut brownies while under stress, then brush your teeth with normal toothpastes. Almost a guaranteed way to produce a mouth full of canker sores!


So how do we minimize or prevent canker sores?

  1. Avoid nuts and chocolate when stressed out.
  2. Eliminate sodium lauryl sulfate in your tooth pastes (read the labels). If you chronically have canker sores, then we would suggest that you replace your current toothpaste with either Biotene®, Tom’s Clean and Gentle®, or Jason Sea Fresh®. (Note: make sure the package says that the toothpaste is “sodium lauryl sulfate free” since formulations change rapidly)
  3. L-Lysine may decrease severity and frequency of occurrence, but most who use this say that one has to use it continuously and daily (1000mg/day), increasing to 3000mg/day at first sign of the canker sore (tenderness and slight swelling, but before the sore erupts—this can be difficult for most of us to do).