What are the other names for this condition? (Also known as/Synonyms)

• Aphthous Ulcer - Minor Canker Sore

What is Minor Canker Sore? (Definition/Background Information)

• A Canker Sore is a benign lesion that develops in one’s mouth, at the base of the gums, under the tongue, on the inside of the cheeks, on the roof of the mouth, or on the inside of the lips. It is mainly caused by an injury to the mouth. Canker sores are not contagious and cannot be transmitted from one individual to another
• There are 3 types of Canker Sores each with their own set of associated symptoms:
  • Minor Canker Sores
  • Major Canker Sores
  • Herpetiform Canker Sores
• A Minor Canker Sore is typically a regular-shaped ulcer (about one-third to half an inch in size) that occurs in the mouth. It is the most common type of Canker Sore and can be seen mostly in children and young adults
• The risk factors for the condition may include a family history of Canker Sores and allergic reactions in the mouth to substances such as spicy foods or dental work
• Minor Canker Sores are generally identified or diagnosed on a visual examination. In case it is required, a biopsy may be performed to confirm the diagnosis
• In most cases, Minor Canker Sores usually go away or recede spontaneously on their own. The healing period is usually 1-2 weeks. When necessary, certain gels and pastes can be used to speed up recovery. The prognosis with adequate treatment is generally good
• Minor Canker Sores can be prevented by avoiding injury to the mouth or by avoiding spicy foods. However, the condition can be recurrent

Note: Canker Sores should not be confused with cold sores. Cold sores are caused by herpes simplex virus (HSV) and can be passed on from one individual to another.

Who gets Minor Canker Sore? (Age and Sex Distribution)

• Individuals of any age can develop a Minor Canker Sore. Though, it is more commonly seen in the 10-40 years age group; children, teens, and young adults are affected the most
• Both males and females are affected, but it is more commonly seen in females
• No specific racial or ethnic group bias is seen
• It is estimated that 1 in 5 individuals may experience some type of Canker Sore in their lifetime. Also, a Minor Canker Sore is the most common form of Canker Sore

What are the Risk Factors for Minor Canker Sore? (Predisposing Factors)

The risk factors for Minor Canker Sores may include the following:

• Having a family history of Canker Sores may predispose the individual to the condition
• A hereditary link may play a role in increasing the risk of development. In such individuals, certain environmental factors, such as foods or substances, may trigger the development of such mouth ulcers
• Poorly-fitting dentures; poor oral hygiene
• Orthodontic devices: If caused by allergic reaction to nickel containing orthodontic devices, the condition may be classified as a type of oral contact dermatitis
• Spicy foods
• Contact sports causing injury to the mouth
• Hormonal changes including menstruation, pregnancy, and menopause can increase risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Minor Canker Sore? (Etiology)

The exact cause of a Minor Canker Sore formation is still unknown in a majority of the cases. They are thought to form due to an overreaction by the body immune system. A combination of factors may increase the chances of Canker Sore formation and these include:

• The common triggers include: Injury to the mouth due to dental work (such as braces), aggressive brushing, sports injury to the mouth, cheek/lip/tongue bite, etc.
• Any toothpaste or mouthwash product that contains sodium lauryl sulfate
• Certain foods including chocolate, coffee, strawberries, eggs, nuts, cheese, and spicy or acidic foods
• Helicobacter pylori bacterium can cause Canker Sores. This is the same bacteria that cause ulcers in the stomach
• A diet lacking in vitamin B-12, zinc, folate (folic acid), or iron
• Allergies to certain bacteria found in the mouth
• Certain hormonal shifts during menstruation, pregnancy, or menopause
• Severe emotional stress

Minor Canker Sores may be present in association with other conditions such as:

• Celiac disease, an intestinal disorder, when an individual is sensitive to products that contain gluten
• Inflammatory bowel diseases including Crohn’s disease and ulcerative colitis
• Behcet’s disease, which is an inflammatory condition
• A faulty immune system where cells in the mouth are attacked causing mouth ulcers
• Immune system suppressing conditions such as HIV/AIDS

What are the Signs and Symptoms of Minor Canker Sore?

The first indication is a tingling or burning sensation where the Minor Canker Sore will eventually appear, about a day or two before it is actually visible. The signs and symptoms of Minor Canker Sores may include:

• These are the most common type of Canker Sores and are small in size
• The average size of a Minor Canker Sore is around 0.5 cm; the size is between 1/3rd to ½ inch (or 0.6-0.8 cm)
• The ulcers are white or yellow in color; the mouth ulcers are generally painful
• They are usually oval or regular in shape with redness around the edges
• The signs and symptoms usually last 1 to 2 weeks
• A complete healing of the ulcer may occur with no scarring taking place

How is Minor Canker Sore Diagnosed?

Most often no tests are needed to diagnose Minor Canker Sores. A healthcare provider will be able to diagnose the condition via a visual exam. Sometimes, the following tests may be undertaken, if the condition is severe and persistent.

• Blood test or blood culture to rule out any infections/conditions
• Biopsy of the Minor Canker Sore

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Minor Canker Sore?

Complications are usually not observed with Minor Canker Sores. However, in some cases, the complications may include:

• Recurrence: The sore may recur as a minor or major sore
• Some individuals can have multiple recurrences within a year
• Oral antibiotic rinses (used in treatment) can cause oral infection known as candidiasis (thrush); though it is easily treated

How is Minor Canker Sore Treated?

A majority of the Minor Canker Sores heals spontaneously and no treatment may be necessary. However, the following signs and symptoms may necessitate treatment:

• New Canker Sores appear before the old ones heal
• Frequent outbreaks are noted
• Canker Sores last longer than the usual period of 2 weeks
• Uncontrollable pain that affects eating and drinking
• High fever is associated with the Canker Sores

Minor Canker Sore treatment mainly includes pain management via any of the following methods:

• Mouth rinses or oral gels can be applied to the sores to decrease pain and inflammation. These can be used about 4 times each day, especially before meals. Mouth rinses or oral gel products can be purchased at pharmacy stores without a prescription
• Topical products (pastes, creams, gels, or liquids) to decrease pain and increase recovery that can be applied directly to the mouth ulcers
• Oral antibiotic rinses can be used 4 times daily for 10 days, to provide a coating on the mouth ulcers and prevent the development of new sores
• Oral medications are used for severe cases of Minor Canker Sores. They are usually used for intestinal ulcer treatments, but can be used to manage Canker Sores too
• Cautery of Minor Canker Sores can be done where they are burned, seared, or destroyed with an instrument or using chemicals
• Nutritional supplements may be recommended by a healthcare provider, in some cases of nutritional deficiency
• If the condition is associated with any other underlying disease/disorder, then the treatment of the underlying condition should be considered

The following home remedies can be helpful in decreasing pain and helping in the healing process. The home remedies are usually helpful only with small ulcers. One should always consult a healthcare professional if home remedies are not helping and if the signs and symptoms are severe.

The home remedies for Minor Canker Sores may include:

• Rinsing the mouth with saltwater or baking soda (1 teaspoon of baking soda and ½ cup of warm water)
• Applying a small amount of milk of magnesia to the sores, a few times a day
• Applying ice to the mouth sores

How can Minor Canker Sore be Prevented?

Minor Canker Sores can be mostly prevented by managing sharp tooth surfaces or dental appliances that trigger the condition. The following considerations may be useful in preventing Minor Canker Sores:

• Be careful when eating nuts, chips, pretzels, certain spices, salty/acidic foods as they may irritate the mouth
• Avoid nutritional deficiencies
• Undertake proper oral hygiene on a daily basis (brush teeth after meals, floss once a day, use a soft brush, brush gently, etc.)
• Reduce stress in order to decrease the chances of developing stress-induced mouth sores
• Treat any associated underlying conditions
• Avoid spicy foods
• Use suitable protective gear (helmets, mouth guards) while participating in contact sports

What is the Prognosis of Minor Canker Sore? (Outcomes/Resolutions)

• In general, the prognosis of Minor Canker Sore is usually good. The sores usually go away within 1 or 2 weeks on their own, and the prognosis is generally excellent
• In some, it can last for up to 6 weeks, when the condition is severe. This timeframe can be shortened, if suitable treatment measures are used
• The prognosis of minor sores are better than that of major sores, because scarring on healing of the sores is not seen

Additional and Relevant Useful Information for Minor Canker Sore:

In general, even though Minor Canker Sores are more common than other Canker Sore types; all 3 types of Canker Sores have typically the same set of risk factors.