Canker sores are small, painful sores that appear in your mouth. In general, canker sores clear up by themselves after a week or so and can be managed at home. However, sometimes you can get a canker sore that won't heal.
If you have a canker sore that won’t heal, don’t ignore it. It may just be a stubborn sore, but it could be a more serious condition, such as oral cancer or another life-threatening illness.
If you don’t fall into the categories below, it could indicate that your persistent canker sore is not normal. Keep in mind that anyone can get a canker sore.
Once a canker sore is noticeable inside your mouth, the pain typically lasts about 10 days. However, it can take another two weeks to heal. Under normal circumstances, cankers sores heal on their own, unless you’re sick or have a compromised immune system that interferes with the healing process. Larger ulcers take longer to dissipate.
Most canker sores are round or oval in shape and appear on the inside of the lips, cheek or tongue. They are swollen and painful and are usually red, yellow, white or gray in color.
Canker sores usually clear up by themselves within a week or two, but if they hang around for longer than this or if you repeatedly get them, you should see your doctor.
Most canker sores are caused by accidentally biting the inside of the mouth, lip or tongue. Poorly fitting dentures, a defective filling or a very sharp tooth can also be responsible.
In addition, there are some medical conditions that can predispose to developing a canker sore that won’t go away. These conditions include viral infections such as chicken pox, and hand, foot and mouth disease.
To help determine whether your persistent canker sore poses a serious health threat, it’s helpful to recall what may have caused it to appear.
In contrast, as stated above, cancer looks different and isn’t usually immediately painful. However, don’t self-diagnose your canker sore, especially if it’s been hanging around and not getting any better.
Canker sores can be very painful and can make eating and drinking difficult.
If your canker sore isn’t better after two weeks, you should see a doctor or dentist. They may prescribe medicine to help relieve the pain caused by canker sore.
If you have a fever or trouble swallowing, tell your doctor. If your canker sores are chronic, don’t go away or keep coming back, there could be larger problems going on.
Getting a fever from your canker sore may not mean anything special, particularly if you are already sick when the sore appears. Fevers are somewhat common if you have three or more sores. You can also experience swollen lymph nodes as your body fights to heal the sore and any resulting infection.
As a rule of thumb, once the canker sore turns whitish-gray, the coagulants and healing proteins in your mouth have begun to repair the lesion.
Oral cancer is a potentially fatal disease that affects the mouth, throat, tongue and lips.
It can be difficult to tell whether your canker sore is oral cancer.
Although these symptoms can be benign, you should always ask a dentist to take a look, in case there is a larger problem. According to Mouthcancer.org, if you have painless canker sores that aren’t healing, this can indicate mouth cancer. The American Dental Association recommends making an appointment to check out your ulcers if any mouth cancer signs or symptoms last more than two weeks.
It’s a good idea to ask your dentist to carry out screening for oral cancer when you attend the dental clinic or dental hospital for your routine annual dental check-up, especially if you habitually suffer from canker sores.
The dentist will carry out a thorough and detailed examination of all the structures in your mouth, including your tongue and lips. If you wear dentures, you will be asked to remove them so that the dentist can examine your gums beneath the dentures.
Some dental hospitals also have special light-emitting tools that allow the dentist to see deeper into the soft tissues of the palate where any abnormalities or suspicious lesions within the mucosa will be highlighted. If any areas of concern are identified, the dentist may use a specialized brush to remove layers of the epithelium in a quick and painless procedure. This procedure is usually carried out if there are areas of unusual coloration present inside your mouth.
The tissue samples will be sent off to an oral cytopathology specialist for examination under laboratory conditions. If cancerous cells are found to be present, you will be referred to an oncology specialist for treatment.
Chronic canker sores are medically known as recurrent aphthous stomatitis (RAS).
Aphthous ulcers (canker sores) occur when the mucous membrane in your mouth breaks open, leaving behind a painful lesion. Since research hasn’t discovered the root cause of the lesions, prevention can be difficult if you are prone to get them.
However, even chronic canker sores aren’t contagious. As a matter of fact, canker sores have no relation to cold sores or fever blisters caused by the herpes simplex virus. Cold sores and fever blisters always occur outside the mouth, whereas canker sores occur inside the mouth.
A team of oral pathologists conducted a study among people with chronic canker sores. They each had suffered at least 3 episodes of recurrent aphthous stomatitis. They published the results under the title "Reduced dietary intake of vitamin B12 and folate in patients with RAS."
Published in the Journal of Oral Pathological Medicine, the study results concluded that these patients with chronic canker sores had a statistically significant deficiency of dietary B12. This points to a deficiency of the folate B12 as one possible trigger for chronic canker sores.
Taking a B12 supplement might reduce the occurrence of canker sores for individuals who are prone to them and don’t get enough B12 in their normal diet.
Most canker sores heal in two weeks. So, few people have to visit a doctor for them.
NOTE: Sodium lauryl sulfate (SLS) is a detergent also used in soap and shampoo. When you brush with toothpaste containing SLS, it causes early canker sores to get worse and may promote larger lesions for those who have RAS. SLS doesn’t improve oral hygiene, but its foaming action makes consumers believe it’s performing a vital task.
With pemphigus, your immune system creates antibodies that attack proteins your cells need to stick together. Consequently, this forces your cells to separate or become unglued. Fluid collects between the layers of skin in your mouth, forming blisters. When these blisters rupture, the fragile top layer of skin opens to create an open sore.
Of all the various types, pemphigus vulgaris is most common. If you have pemphigus vulgaris, you usually get the first blister in your mouth. As the disease progresses, blisters can rupture in the mucous membranes in other areas of the body – eyes, nose, throat, and genitals. Pay attention to whether you experience these symptoms when you get a canker sore that won’t go away.
A dermatologist or ear, nose and throat doctor who has experience dealing with persistent canker sores and pemphigus can help. Before the medicine progressed, Pemphigus patients typically died. Their mucous membranes and skin constantly erupted until fatal infection developed. Today, medications can help victims heal and recover.
As with oral cancer, pemphigus is chronic, and requires regular care. If you develop it, you will need to maintain a careful medical regime for the rest of your life.
Your doctor may prescribe supplements to counteract the side effects of the potent medicines used to treat pemphigus.
A long-lasting canker sore that doesn’t go away could also be herpetiform ulcers, also called stomatitis herpetiformis, which means herpes-like lesions. They look like the lesions that develop from a herpes simplex virus. However, herpetiform ulceration is not caused by the herpes virus. It’s not contagious, unlike true herpes. (If your canker sore is preceded by tiny, fluid-filled blisters, you should get tested for the herpes virus.) Herpetiform ulcers are about one millimeter across, much smaller than normal canker sores. They occur in clusters of up to one hundred.
Stubborn canker sores can be a real pain – literally. If your canker sore won't heal and hangs around for more than three weeks or if you suffer from repeated sores, you should consult your doctor or dentist to treat the underlying cause and rule out anything more serious.