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.
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.
What should I do if I get canker sores frequently?
Contact your healthcare professional. Most cases of canker sores do not reflect an underlying illness. However, if you are having canker sores frequently, your healthcare professional
can take a patient history and order tests to assure you there isn't a serious underlying cause. Certain diseases are sometimes associated with recurrent canker sores. Examples include Crohn's disease, celiac disease, Behçet's disease, lupus, or even AIDS. It should be mentioned that these are complex diseases and canker sores may be only a part of the disease and not the only feature of the disease. Canker sores also may not be present at all in some persons with these conditions.
Most doctors also recommend that patients who have frequent bouts of canker sores undergo blood and allergy tests to determine if their sores are caused by a nutritional deficiency, an allergy, or some other preventable cause.
What research is being done in the area of canker sores?
Researchers are trying to identify the malfunctions in patients' immune systems that make them susceptible to repeated bouts of canker sores. By analyzing the blood of people with and without canker sores, scientists have found several differences in the immune function between the two groups. Whether these differences cause canker sores is not yet known and more research may need to be performed.
Researchers also are developing and testing new drugs designed to treat repeated canker sores in patients with possible immune causes of canker sores. Most of these drugs alter the patient's immune function. Although some of the drugs appear to be effective in treating canker sores in some patients, the data are still inconclusive. Until these drugs are proven to be absolutely safe and effective, they will not be available for general use.
One of the new medications which has been tested is called
amlexanox (Aphthasol topical paste). This is an anti-inflammatory and an anti-allergic drug. It has shown some promise in treatment of symptoms and healing of canker sores.
More invasive treatment options for canker sores are being investigated, but for now they remain somewhat limited, controversial, and impractical. These options include laser therapy, low intensity ultrasound, silver nitrate, and surgical removal. More studies are necessary before these options can be recommended for treatment of canker sores.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
There are a variety of diseases and conditions that can cause tongue problems, discoloration, and soreness. Though most tongue problems are not serious. Conditions such as leukoplakia, oral thrush, and oral lichen planus may cause a white tongue while Kawasaki syndrome, scarlet fever, and geographic tongue may cause the tongue to appear red. A black hairy tongue may be caused by overgrown papillae on the tongue. Canker sores, smoking, and trauma may cause soreness of the tongue.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Signs and symptoms of celiac disease include malabsorbption (diarrhea, foul smelling gas, bloating, and increased amounts of fat in the stool) and malnutrition (weight loss, edema, anemia, bruising easily, neuropathy, and infertility). Treatment for celiac disease is a gluten free diet, and at times if necessary, medications
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Behcet's syndrome is a disease characterized by three symptoms: genital ulcers, recurring mouth ulcers, and inflammation around the pupil of the eye. Symptoms of Behcet's syndrome may also include inflammation of other areas of the body, such as the brain, joints, skin, retina, and bowels. Oral steroids, antiinflammatory drugs, and steroid gels, pastes, and creams may be used to treat Behcet's syndrome.
Gum problems may be caused by improper brushing and flossing, gum disease, canker sores, treatments and hormonal changes. Symptoms of gum problems include red, swollen, sore and bleeding gums. These symptoms can be prevented by brushing twice a day, flossing daily, eating a well-balanced diet, drinking enough water, not smoking, and relaxing.
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