Health Condition

Canker Sores

Healthy Lifestyle Tips

Minor trauma from poor-fitting dentures, rough fillings, or braces can aggravate canker sores and should be remedied by a dentist.

Several reports have found sodium lauryl sulfate (SLS), a component of some toothpastes, to be a potential cause of canker sores.43 In one trial, most recurrent canker sores were eliminated just by avoiding toothpaste containing SLS for three months.44 Positive effects of eliminating SLS have been confirmed in double-blind research.45 SLS is thought to increase the risk of canker sores by removing a protective coating (mucin) in the mouth. People with recurrent canker sores should use an SLS-free toothpaste for several months to see if such a change helps.

Measurements of stress were associated with recurrent canker sores in one preliminary study,46 but not in another.47 More research is needed to determine whether stress reduction techniques might reduce canker sore recurrences.

References

1. Plemons JM, Reps TD, Binnie WH, et al. Evaluation of acemannan in the treatment of recurrent aphthous stomatitis. Wounds 1994;6:40-5.

2. Das SK, Gulati AK, Singh VP. Deglycyrrhizinated licorice in aphthous ulcers. J Assoc Physicians India 1989; 37:647.

3. James APR. Common dermatologic disorders. CIBA Clin Symposia 1967;19:38-64.

4. Werbach MR. Nutritional Influences on Illness, 2d ed. Tarzana, CA: Third Line Press, 1993, 56 [review].

5. Gerenrich RL, Hart RW. Treatment of oral ulcerations with Bacid (Lactobacillus acidophilus). Oral Surg 1970;30:196-200.

6. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared to other oral disease. Oral Surg Oral Med Oral Pathol 1988;66:41-4.

7. Palopoli J, Waxman J. Recurrent aphthous stomatitis and vitamin B12 deficiency. South Med J 1990;83:475-7.

8. Wray D, Ferguson MM, Hutcheon WA, Dagg JH. Nutritional deficiencies in recurrent aphthae. J Oral Pathol 1978;7:418-23.

9. Barnadas MA, Remacha A, Condomines J, de Moragas JM. [Hematologic deficiencies in patients with recurrent oral aphthae]. Med Clin (Barc) 1997;109:85-7 [in Spanish].

10. Olson JA, Feinberg I, Silverman S, et al. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1982;54:517-20.

11. Weusten BL, van de Wiel A. Aphthous ulcers and vitamin B12 deficiency. Neth J Med 1998;53:172-5.

12. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992;51:14-6.

13. Wray D, Ferguson MM, Mason DK, et al. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975;2(5969):490-3.

14. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med 1991;20:389-91.

15. Haisraeli-Shalish M, Livneh A, Katz J, et al. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:634-6.

16. Pang JF. Relation between treatment with traditional Chinese medicine for recurrent aphthous ulcer and human zinc and copper. Zhongguo Zhong Xi Yi Jie He Za Zhi 1992;12:280-2, 260-1 [in Chinese].

17. Endre L. Recurrent aphthous ulceration with zinc deficiency and cellular immune deficiency. Oral Surg Oral Med Oral Pathol 1991;72:559-61.

18. Merchant HW, Gangarosa LP, Glassman AB, Sobel RE. Zinc sulfate supplementation for treatment of recurring oral ulcers. South Med J 1977;70:559-61.

19. Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72.

20. Nasemann T. Kamillosan therapy in dermatology. Z Allgemeinmed 1975; 25:1105-6.

21. Nasemann T. Kamillosan therapy in dermatology. Z Allgemeinmed 1975; 25:1105-6.

22. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared to other oral disease. Oral Surg Oral Med Oral Pathol 1988;66:41-4.

23. Palopoli J, Waxman J. Recurrent aphthous stomatitis and vitamin B12 deficiency. South Med J 1990;83:475-7.

24. Wray D, Ferguson MM, Hutcheon WA, Dagg JH. Nutritional deficiencies in recurrent aphthae. J Oral Pathol 1978;7:418-23.

25. Barnadas MA, Remacha A, Condomines J, de Moragas JM. [Hematologic deficiencies in patients with recurrent oral aphthae]. Med Clin (Barc) 1997;109:85-7 [in Spanish].

26. Olson JA, Feinberg I, Silverman S, et al. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1982;54:517-20.

27. Weusten BL, van de Wiel A. Aphthous ulcers and vitamin B12 deficiency. Neth J Med 1998;53:172-5.

28. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992;51:14-6.

29. Wray D, Ferguson MM, Mason DK, et al. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975;2(5969):490-3.

30. Volkov I, Rudoy I, Freud T, et al. Effectiveness of vitamin B12 in treating recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled trial.J Am Board Fam Med 2009;22:9-16.

31. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med 1991;20:389-91.

32. Haisraeli-Shalish M, Livneh A, Katz J, et al. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:634-6.

33. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981;26:737-40.

34. Ferguson R, Basu MK, Asquith P, Cooke WT. Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration. Br Med J 1976;1(6000):11-13.

35. Ferguson MM, Wray D, Carmichael HA, et al. Coeliac disease associated with recurrent aphthae. Gut 1980;21:223-6.

36. Hunter IP, Ferguson MM, Scully C, et al. Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy. Oral Surg Oral Med Oral Pathol 1993;75:595-8.

37. O'Farrelly C, O'Mahony C, Graeme-Cook F, et al. Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J Oral Pathol Med 1991;20:476-8.

38. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981;26:737-40.

39. Ferguson R, Basu MK, Asquith P, Cooke WT. Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration. Br Med J 1976;1(6000):11-13.

40. Ferguson MM, Wray D, Carmichael HA, et al. Coeliac disease associated with recurrent aphthae. Gut 1980;21:223-6.

41. Hunter IP, Ferguson MM, Scully C, et al. Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy. Oral Surg Oral Med Oral Pathol 1993;75:595-8.

42. O'Farrelly C, O'Mahony C, Graeme-Cook F, et al. Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J Oral Pathol Med 1991;20:476-8.

43. Chanine L, Sempson N, Wagoner C. The effect of sodium lauryl sulfate on recurrent aphthous ulcers: a clinical study. Compend Contin Educ Dent 1997;18:1238-40.

44. Herlosfson BB, Barkvoll P. Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary trial. Acta Odontol Scand 1994;52:257-9.

45. Herlosfson BB, Barkvoll P. The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand 1996;54:150-3.

46. McCartan BE, Lamey PJ, Wallace AM. Salivary cortisol and anxiety in recurrent aphthous stomatitis. J Oral Pathol Med 1996;25:357-9.

47. Pedersen A. Psychologic stress and recurrent aphthous ulceration. J Oral Pathol Med 1989;18:119-22.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.