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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Canker sores facts
• What are canker sores?
• What are symptoms of canker sores?
• What are the causes of canker sores?
• Are canker sores the same as fever blisters?
• What steps can be taken to help canker sores?
• What is the treatment for canker sores?
• What kind of topical medications (gels or ointments) are available for canker sores?
• Can mouthwash solutions be used with canker sores?
• What oral medications are available to help canker sores?
• What should I do if I get canker sores frequently?
• What research is being done in the area of canker sores?
• Patient Comments: Canker Sores - Experience
• Patient Comments: Canker Sores - Topical Medications
• Patient Comments: Canker Sores - Effective Treatments
• Patient Comments: Canker Sores - Symptoms
• Find a local Ear, Nose, & Throat Doctor in your town
• Canker Sores Index

The simple answer is no. Canker sores are generally inside the mouth or the oral cavity and are not contagious. However, fever blisters mostly occur on the lips and outside of the mouth and are very contagious. Fever blisters, or cold sores, are infections caused by the herpes simplex virus (HSV).

If you have canker sores:

• Avoid abrasive foods such as potato chips that can stick in the cheek or gum and aggravate the sores.
  
  
• Take care when brushing your teeth not to stab the gums or cheek with a toothbrush bristle.
  
  
• Avoid acidic and spicy foods.
  
  
• Canker sores are not contagious, so patients do not have to worry about spreading them to other people.
  
  
• A toothpaste free of sodium lauryl sulfate and other ingredients that are irritating to the tissues inside the mouth can be helpful in some patients, as can a toothpaste that inhibits the growth of irritating plaque. Therefore, something as simple as changing toothpastes may help with recurrent canker sores.

Canker sores typically resolve without any specific treatment. But measures can be taken to alleviate the pain and discomfort and to hasten the course. Therapies include topical medications (applied directly on), mouthwashes, and oral medications.

Topical medications include numbing ointments, such as benzocaine (Oragel), which are available in drug stores without a prescription. The ointment should be applied a few times daily directly to the sore in order to reduce irritation form eating, drinking, or brushing. Topical 2% lidocaine (an anesthetic) gel has also been used effectively in some patients, but it may associated with some toxicity, especially in children. In very painful cases, injection of local anesthetics may help relieve the symptoms effectively, but it is usually temporary. However, in April 2011 the U.S. FDA issued a warning about an association between benzocaine and methemoglobinemia, a rare but serious condition in which oxygen delivery to tissues is compromised. Because of this association, the FDA has stated that benzocaine products should not be used on children less than two years of age, except under the advice and supervision of a healthcare professional. Further, adults who use benzocaine gels or liquids to relieve pain in the mouth should follow the recommendations in the product label. Benzocaine products should be stored out of reach of children, and FDA encourages consumers to talk to their healthcare professional about using benzocaine.

Anti-inflammatory (steroid) gels may also be applied locally to reduce the inflammation. These products are generally provided by prescription from a physician or a dentist. The main ingredient in these medications is usually fluocinonide (Lidex) or triamcinolone. Topical antibiotics (for example, tetracycline (Achromycin]) may also be recommended by your doctor.