Canker sores are painful, recurring ulcers (white spots) that appear inside the mouth on the cheeks or edge of the tongue.
The prevailing view is that the sores are triggered by stress, which can cause the body's immune system to overreact to bacteria normally present in the mouth. Canker sores can also be precipitated by a number of actions, such as irritating the mouth cavity with a rough filling or a jagged or chipped tooth or wearing ill-fitting dentures. Maybe you've unconsciously gnawed the inside of your cheek, used a toothbrush with very hard bristles, or brushed too vigorously. Occasionally, even eating acidic, spicy, or salty foods-tomatoes, citrus fruits, hot peppers, cinnamon, nuts, or potato chips-can be the initiating factor.
Some experts believe recurring cankers are an allergic reaction to food preservatives (benzoic acid, methylparaben, or sorbic acid, to name a few) or to something in a food. They single out gluten, the protein found in wheat and some other grains, as the most likely offender.
Canker sores is suspected to result from a reaction of the immune system. Additional factors may include the following: Bacterial infections, Hormonal disorders, Stress, Trauma, Heredity, Food allergies or sensitivities (acidic foods such as pineapple), Deficiencies of iron, folic acid, or vitamin B12
Some studies have suggested an association with Helicobacter pylori, the same bacteria that cause peptic ulcers.
Recurrent canker sores have been associated with inflammatory bowel diseases, such as Crohn disease and ulcerative colitis. In these cases, the development of canker sores may signal a flare-up of the bowel disease.
Celiac, or abdominal, sprue, a disease of the intestines caused by sensitivity to gluten, causes malabsorption and is associated with development of canker sores. Gluten refers to a group of proteins found in wheat, barley, and rye.
Beh¨et disease is a condition characterized by canker sores, genital sores that resemble canker sores, and inflammation of the eye.
Infection with the AIDS virus also has been associated with canker sores.
It is a common misconception that canker sores are a form of herpes infection. This is not the case.
Canker sores are diagnosed by their typical appearance. No testing is needed in the majority of cases.
The doctor, however, must consider the possibility of herpes or fungal infections, trauma, or sores that will not heal that could signal cancer. The oral lesions of hand-foot-and-mouth disease can appear similar to canker sores.
Canker sores may be seen in people with HIV infection, with inflammatory and other bowel diseases, and with certain medical conditions.
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