Canker Sores Got Your Tongue?

Kick Your Cankers.

Canker sores, otherwise known as aphthous ulcers, are the most common inflammatory disease of the lining of the mouth, yet are still poorly misunderstood.  Females, adolescents and children are more frequently affected and for some people, cankers are a recurrent (and painful!) problem.  Cankers (pictured below) which have a white base with a red border and can affect the tongue, cheeks and palate, are different than cold sores, which are caused by the herpes simplex virus.            

Canker Sore

A number of precipitating factors including trauma, stress, autoimmune response, nutritional deficiencies, hormonal changes and sensitivities to certain foods have been postulated as canker causes. 

Mooooove Over Canker Sores

One food in particular that seems to be a probable cause?  Cow’s milk.  A study in 2009 using 50 subjects with recurrent cankers and 50 healthy subjects aimed to determine the level of antibodies (a protein produced by the immune system when it detects harmful substances) to cow’s milk protein in the blood.  Increased immune response to cow’s milk was found in 32 of the 50 patients with recurrent cankers indicating a strong association with antibodies against cow’s milk protein as canker causers.  These findings have been confirmed in other studies.

It’s possible that the milk proteins penetrate the lining of the oral mucosa, inciting a major immune response in which the body attacks foreign cow proteins, causing ulceration to the mouth lining (including your cheeks, palate and tongue).  When subjects in the study cut dairy from their diets, ulcers resolved! However, ulcers recurred after reintroducing dairy to the diet. 

I personally got a lot of cankers as a child and teenager.  I also used to drink a glass of milk every night with dinner as well as use milk in cereal most mornings.  When I went to college, my milk consumption decreased dramatically and for the last 9 years I haven't had milk at all and by no coincidence I also no longer get cankers!

It seems that ditching dairy could be a solution to this painful problem. 

When you kick cankers and don't miss a beat!

When you kick cankers and don't miss a beat!

Bet Your B12 On It

Don't drink dairy, but still have a canker sore conundrum? Nutritional deficiencies from poor intake or malabsorption of Vitamin B12, folate and iron could also be to blame.  

Several studies evaluating effectiveness of B12 treatment have shown improvement in frequency and severity of lesions.  In randomized, double-blind, placebo-controlled study (translation: study participants are randomized to an intervention group or control group (that receives a placebo) and neither the participants nor the researchers know who was assigned to which group. Study results are more reliable this way) of 58 patients suffering from recurrent cankers, 31 patients in the intervention group were given a 1,000 microgram dose of vitamin B12 for 6 months while the control group was given a placebo.  Although pre-test B12 levels were not statistically significantly different among the 2 groups, those in the intervention group noted significant improvement in level of pain, number of ulcers and duration of outbreaks.  About ¾ of patients in the intervention group were free from ulcers at the end of the treatment period compared with ⅓ of patients in the control group. Although response to Vitamin-B12 injection in other studies has been fairly rapid, the response in the treatment group here was delayed until about 4 months of treatment, perhaps due to a relatively low dose of B12. Results have to be interpreted carefully due to small sample size.  

Another study done in 2010 found that deficiencies of vitamin B12, folate and iron, occurring alone or together, have been associated with canker sores in patients of all ages.  The overall frequency of nutritional deficiencies (iron, B12 or folate) was over half of the 32 adult patients with recurrent cankers versus 7% of controls living in the same geographic areas.  Subjects who reported no family history of cankers had complete remission of symptoms when their nutritional deficiencies were reversed.   

Although it's still uncertain by which mechanism deficiency of Vitamin B12 may be involved in the development of cankers, exploring treatment with this vitamin seems to merit further investigation. Whether or not canker sores are a problem, those following a plant-based diet should supplement regularly with Vitamin B12.  From these studies one can also presume that increasing dietary intake of iron and folate with wholefood, plant-based sources such as dark leafy greens may help ward off cankers.   

Sweet Relief

Obviously it's preferable to prevent canker sores in the first place, but what do you do if you develop one of these pesky ulcers?  Try the following tips:

1. Avoid irritating agents such as toothpaste containing sodium-lauryl sulfate (SLS) and mouthwash that contains alcohol.  Try these instead:

2.  Avoid citrus fruits or juices, tomatoes and spicy or salty foods during an outbreak to reduce symptom severity.

3. Suck on a small ice cube to reduce pain and swelling.

4. Make a DIY mouth rinse consisting of 1 teaspoon baking soda, 2 tablespoons pure aloe vera juice to   and 1/2 cup warm water.  Once daily until sore heals, rinse for 10 seconds and spit to reduce inflammation and relieve pain.   

5. Applying pure organic honey to the sore has also been shown in studies to provide some sweet relief!

Hope this helps you kick your cankers.  NOTE: If you have a sore or ulcer in your mouth that does not go away after 2 weeks, you should consult your healthcare provider.  

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