An aphthous ulcer (aka canker sore) is a type of oral ulcer which presents as a painful open sore inside the mouth or upper throat, caused by a break in the mucous membrane. A canker sore is a little crater on the lips, cheeks, tongue, or most often on the gums. They usually start out as a little red bump. Eventually it will pop and will be a white or yellowish crater like thing with a red border. It burns and stings a lot. It might make consuming food a very hard job. They usually last around 4 to 7 days. If it lasts longer and the following tips don't help, contact a doctor/dentist immediately.

Causes
There are many processes which can lead to ulceration of the oral tissues. In some cases they are caused by an overreaction by the body's own immune system. Factors that appear to provoke them include stress, fatigue, illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies and deficiencies in vitamin B12, iron and folic acid. Oral ulcers are also a common result of ceased cigarette smoking, affecting about two out of five quitters.

Minor physical injuries
Trauma to the mouth is a common cause of oral ulcers. A sharp edge of a tooth, accidental biting (this can be particularly common with sharp canine teeth), sharp or abrasive food (particularly if left overnight), poorly fitting dentures, dental braces or trauma from a tooth brush may injure the mucosal lining of the mouth resulting in an ulcer. These ulcers usually heal at a moderate speed if the source of the injury is removed (for example, if poorly fitting dentures are removed or replaced). Also it is common for these ulcers to occur after dental work, when incidental abrasions to the soft tissues of the mouth are common. Please warn your dentist to this before starting any dental work, so a protective layer of Vaseline can be used to minimize the number if incidental injuries to the soft mucosa tissues.

Stress
Stress gets blamed for pretty much everything that can go wrong with you health wise and canker sores are no exception. It is good to avoid stress anyway. If it helps reduce the occurrence of canker sores, that is even better.

Dietary
Some research has shown that people who develop frequent canker sores also suffer from some sort of nutritional deficiency. Vitamin deficiencies: B1, B2, B6, B12, C and other nutrients: zinc, folic acid, iron, selenium, calcium have all been linked to the sores. Like stress, nutritional deficiency gets blamed for a lot of health problems, and you should already be avoiding it.

Allergic Reactions
There is a whole host of items that could be causing canker sores by through what is really a kind of allergic reaction of the tissues of the mouth to a substance. The list of foods that are suspected here reads like an inventory list of your local grocery store. Have you added anything new to your diet recently? Try systematically removing certain foods to see if this helps clear up the problem. If gluten sensitivity is the cause, prevention means following a gluten-free diet by avoiding most breads, pastas, baked goods, beers etc. and substituting gluten-free varieties where available. Artificial sugars, such as those found in diet cola and sugarless chewing gum, have been reported as causes of oral ulcers as well.

Hormonal Changes and Genetic Dispositions.
These are things that you aren’t going to be able to avoid, so if it is the cause of your canker sores, you might as well just skip on down to the treatment options.

Chemical injuries
Chemicals such as aspirin or alcohol that are held or that come in contact with the oral mucosa may cause tissues to become necrotic and slough off creating an ulcerated surface. Sodium lauryl sulfate (SLS), one of the main ingredients in most toothpastes, has been implicated in increased incidence of oral ulcers.

Infection
Viral, fungal and bacterial processes can lead to oral ulceration.One way to contract pathogenic oral ulcerations is to touch your chapped lips without having washed your hands first.

Viral
The most common is Herpes simplex virus which causes recurrent herpetiform ulcerations preceded by usually painful multiple vesicles which burst. Herpes Zoster (shingles), Varicella Zoster (chicken pox), Coxsackie A virus and its associated subtype presentations, are some of the other viral processes that can lead to oral ulceration. HIV creates immunodeficiencies which allow opportunistic infections or neoplasms to proliferate.

Bacterial
Bacterial processes leading to ulceration can be caused by Mycobacterium tuberculosis (tuberculosis) and Treponema pallidum (syphilis). Opportunistic activity by combinations of otherwise normal bacterial flora, such as aerobic streptococci, Neisseria, Actinomyces, spirochetes, and Bacteroides species can prolong the ulcerative process.

Fungal
Coccidioides immitis (valley fever), Cryptococcus neoformans (cryptococcosis), Blastomyces dermatitidis ("North American Blastomycosis") are some of the fungal processes causing oral ulceration.

Protozoans
Entamoeba histolytica, a parasitic protozoan is sometimes known to cause mouth ulcers through formation of cysts.

Immunodeficiency
Repeat episodes of mouth ulcers can be indicative of an immunodeficiency, signaling low levels of immunoglobulin in the oral mucous membranes. Chemotherapy, HIV, and mononucleosis are all causes of immunodeficiency with which oral ulcers become a common manifestation.

Allergy
Contact with allergens can lead to ulcerations of the mucosa.

Cancer
Oral cancers can lead to ulceration as the center of the lesion loses blood supply and necroses. Squamous cell carcinoma is just one of these.

It is important to note that canker sores are sometimes associated with other medical problems, some of them serious. If the problem becomes frequent, a visit to the doctor is suggested, if for no other reason than to eliminate them as a concern. Medical conditions associated with mouth ulcers The following medical conditions are associated with mouth ulcers: * Behçet's disease * Bullous pemphigoid * Celiac disease (gluten sensitivity) * Crohn's disease * Gingivostomatitis * Leukoplakia * oral lichen planus * Lupus erythematosus * Neutropenia * Oral thrush * Ulcerative colitis

Getting Rid of Canker Sores

Wait

Canker sores will normally go away by themselves in 7-10 days. The pain can be minimized through careful diet (eliminate spicy, acidic, or other foods that irritate them) or by the use of over the counter anesthetics.

Some Folk Remedies to Speed Up the Process

* Regular use of mouthwash may help prevent or reduce the frequency of sores. In fact, informal studies suggest that mouthwash may help to temporarily relieve pain.

* In some cases, switching toothpastes can prevent mouth ulcers from occurring with research looking at the role of sodium dodecyl sulfate (sometimes called sodium lauryl sulfate, or with the acronymes SDS or SLS), a detergent found in most toothpastes. Using toothpaste free of this compound has been found in several studies to help reduce the amount, size and recurrence of ulcers.

* Dental braces are a common physical trauma that can lead to mouth ulcers and the dental bracket can be covered with wax to reduce abrasion of the mucosa. Avoidance of other types of physical and chemical trauma will prevent some ulcers, but since such trauma is usually accidental, this type of prevention is not usually practical.

* Acidophilus taken in either capsule form or as an ingredient in plain yogurt may stimulate the immune system. Taking 2-4 capsules four times a day with milk has proven to both reduce the pain, and speed up the healing process.

* Aloe juice can be used as a mouth rinse several times a day.

* Alum from the spice section of your grocery store will relieve pain and speed healing, but will burn like crazy for a few minutes once it is applied. Do this once or twice a day, but be prepared for the burning, and rinse your mouth out well afterwards.

* Antacid formulas such as Mylanta and Milk of Magnesia have been reported to relieve pain and speed healing. A crystal of Alum Aloe Juice A bowl of baking soda

* Baking soda is a time honored remedy that can be used in powder form, or made into a paste and applied directly to the sore. This is another one that might sting a bit at first, but repeated treatments are reported to clear up canker sores in a couple of days.

* Copper sulfate, also called bluestone, is a remedy that was used as far back as two hundred years ago. It is hard to find, but should clear the sore in a day or two. Consult your doctor before trying this.

* Keep clean: Brush your teeth and rinse your mouth with antibacterial mouthwash often.

* Stay away from salty and acidic foods. # For pain you can use any over-the-counter oral antiseptic gel or spray. # Using a hydrogen peroxide mouthwash can help clean out the canker sore and kill bacteria.

* Rinse your mouth with salt water a.k.a. saline

* Drink sage tea taking time to swish it around in your mouth with every sip. Trying a new toothpaste A bottle of clove oil Gargling her mouth

* Rinse with vinegar mixed with a spoonful of salt three times a day.

* A baking soda / water paste applied directly to the canker sores can help speed healing.

* Try switching to another brand of toothpaste.

* Clove oil applied directly to the canker sore will numb it.

* Drink non sweetened chamomile tea all day and dont eat any solid food but tea.

* Drink unpasteurized goats' milk.

* Blanch salvia and use as a mouth rinse.

* Eat 3 kiwis a day.

* Apply Aloe Vera juice as a mouth rinse.

* Drink carob juice concentrate.

* Saturate coriander leaves in water, strain and use as a mouth wash.

* Brush you teeth with backing soda, or apply backing soda on the ulcer.

* Put horseradish on the ulcer.

* Mix cinnamon with water and gurgle.

* Pour half a liter of boiling water on 2 tablespoonful of Marjoram, cover; wait for 10 minutes and gurgle. Repeat 3-4 times daily.

* Smear carob honey on the ulcer.

Don’t Wait.

Understanding that a canker sore is an ongoing process that runs its course inside your mouth suggests that the quicker you attack the process, the quicker you can reverse it and begin the healing. Even the use of a regular antiseptic mouth wash right from the onset of the sore can stop it in it’s tracks. The idea is to not wait until the canker sore is at full size with maximum pain before you begin treatment. Mouth examinations are a good idea if canker sores are an ongoing problem. As soon as you think one is starting begin your treatment of choice.

Prevent Them Any Way You Can

Understanding a bit about the cause of canker sores can help. If you have a problem with them, anything you can do that helps your immune system is going to help the canker sore problem. Vitamin intake, proper rest, stress reduction exercise and good diet can all help. Avoid foods that may produce mouth trauma. Some even suggest potato chips should be avoided by children who have problems with canker sores. Most people who have chronic canker sore problems report the use of SLS free toothpaste to be the single best preventive measure they have found. They also recommend frequent mouth washing and frequent changing of toothbrushes. The real idea is that anything that makes the mouth cleaner and eliminates bacteria is going to help.