This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.
There are 28 references cited in this article, which can be found at the bottom of the page.
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Canker sores are small sores in the mouth that typically last less than 2 weeks. However, some canker sores are larger, slower to heal, and more painful.[1] There are several medical treatment options as well as over-the-counter medicines and home remedies that may help to relieve your canker sore pain. If you have recurring canker sores, make an appointment with your doctor to rule out any underlying causes.
Steps
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See your physician if canker sores are a recurring problem for you. If you have had canker sores more than once in the last 6 months, you should see your physician. If your child has a canker sore, talk to their doctor before using any home remedies. Most home remedies are considered safe for children over 2 years of age, but it is always best to speak to a doctor first. You should also see your physician if you have:[2]
- A large canker sore
- A fever associated with the canker sore
- Difficulty swallowing
- Sores that are spreading
- Sores that last more than 2 weeks
- Sores that are still painful after using home remedies
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Get treated for any underlying conditions. Canker sores may be the result of an underlying condition, which will also require treatment. For example, if you have Crohn’s disease and have recurrent canker sores, then you would need to have treatment for the Crohn’s disease as well as for the canker sore.[3]
- Other conditions that can lead to canker sores include celiac disease and Behcet's disease.[4]
- Canker sores can also be triggered by stress, hormone imbalances, a weakened immune system, vitamin deficiencies, or mouth injuries.[5] Allergies to certain foods, such as cheese, nuts, chocolate, coffee, or citrus fruits, may also be a factor.[6]
- Canker sores are not contagious or particularly dangerous, but they make eating and chewing more difficult. They can also be a sign of a more serious underlying problem.
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Request a test for vitamin deficiencies if you have frequent canker sores. If you get canker sores a lot, it might mean you have a deficiency in vitamin B12 or iron. Ask your doctor to do a blood test to check for these deficiencies.[7]
- If the tests show you have a deficiency, your doctor will probably recommend vitamin supplements. Let them know if you’re currently taking any other supplements or medications so you can avoid any harmful interactions.
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Ask your doctor about topical corticosteroids to treat your sores. Steroid treatments can help reduce pain and inflammation from a canker sore. If over-the-counter pain medications and home remedies aren’t enough, ask your doctor if they can prescribe a steroid cream or paste that you can apply directly to the canker sore.[8]
- Some common steroid treatments for canker sores include 1% triamcinolone dental paste (Kenalog), 0.05% fluocinonide cream (Metosyn), and hydrocortisone (Corlan) 2.5 mg pellets.
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Talk to your doctor about Debacterol for severe pain. Another medication that can be used for canker sore pain is Debacterol. This topical treatment can provide rapid relief by cauterizing the canker sore. This medicine should only be applied by a trained doctor or dentist.[9]
- Debacterol is available by prescription only.
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Apply dental wax to minimize irritation if you wear braces. Some dental work, such as braces, may irritate a canker sore. If you have dental work that may be irritating the canker sore, ask your dentist for some dental wax to cover the dental work and minimize the irritation.
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See if viscous lidocaine is an option. You can apply viscous lidocaine directly to the canker sore for pain relief. Lidocaine is an anesthetic, which means that it will numb the pain. Keep in mind that lidocaine should not be swallowed or used more than 4 times per day.[10]
- Never give lidocaine to a baby or a child under 3 years old unless your doctor instructs you to. If you’re pregnant or breastfeeding, tell your doctor before using lidocaine.
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Numb the pain with a benzocaine gel. Benzocaine gels contain a numbing medication that can provide quick relief from canker sore pain. These gels are available in most drug stores. Read the instructions and use the product as directed.[11]
- Examples of products that contain benzocaine include Anbesol, Kank-A, Orabase, and Zilactin-B.
- Some people can develop a rare blood disorder (methemoglobinemia) after using benzocaine, so don’t use more than the recommended amount. Children under the age of 2 are especially at risk, so don’t use these products to treat a baby or toddler unless your pediatrician recommends it.[12]
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Try an over-the-counter pain reliever. Try taking an over-the-counter pain reliever such as acetaminophen or ibuprofen to help you deal with pain from canker sores. Read and follow the dosage instructions and do not take more than the recommended amount.[13]
- If you are still in pain after taking one of these pain relievers, call your doctor.
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Use a hydrogen peroxide rinse to speed up healing. Hydrogen peroxide is an antiseptic that can help heal canker sores by killing bacteria and keeping the wound clean. Mix equal amounts of water and a 3% solution of hydrogen peroxide. You can either dab the mixture directly on the sore or swish it around in your mouth for a few minutes, then spit it out.[14]
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Dab milk of magnesia on the sore for relief and protection. Put a little milk of magnesia on a cotton swab and apply it directly to the canker sore 3-4 times a day.[17] This will soothe the sore and help minimize irritating acids in your mouth.
- You can buy milk of magnesia in most drugstores.
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Dissolve a deglycyrrhizinated licorice tablet in your mouth. Deglycyrrhizinated licorice or DGL tablets may provide some relief from canker sore pain and help to heal the tissue as well.[18] Place one of these tablets in your mouth and allow it to dissolve right next to the canker sore. Make sure to read and follow the manufacturer’s instructions for use.
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Ask your doctor about vitamin supplements. Some vitamins or other dietary supplements may help heal canker sores more quickly. Although you can get these supplements over-the-counter, it’s a good idea to ask your doctor first, especially if you’re taking other medications or have any health conditions. Some supplements that may help include:[19]
- Zinc gluconate lozenges
- Vitamin B complex
- l-Lysine supplements
- Vitamin C
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Apply ice to canker sores to relieve pain and swelling. Ice can be an effective, easy way to relieve the pain of a canker sore. To use ice on a canker sore, take an ice cube or ice chip and let it melt onto the sore. Repeat as needed. The cold will numb the area and provide some relief from the pain.[20]
- Ice will also help calm any inflammation around the sore.
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Use a saltwater rinse to soothe pain and speed up healing. To use a saltwater rinse, mix teaspoon (5 g) of salt with 1 cup (240 mL) of warm water. The salt will dissolve better in warm water. Swish the solution in your mouth and use it about 3 times per day.[21]
- When you’re done rinsing your mouth, spit out the salt water.
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Hold a steeped herbal tea bag on the sore. While there’s not a lot of scientific evidence to support this treatment, some people find that a steeped herbal tea bag can relieve canker sore pain.[22] Let an herbal tea bag soak in warm water for about 5 minutes. Use just enough water to soak the tea bag. Then, remove the bag from the water and place it directly on the canker sore. Leave the tea bag in place for at least 10-15 minutes, 4 to 5 times per day.
- Some herbs you might find soothing include licorice root, goldenseal root, sage leaves, chamomile, peppermint, and cloves.
- If you don’t have tea bags, make a paste or salve by mixing a teaspoonful (about 1 g) of dried herbs with 1–2 tablespoons (15–30 mL) of coconut oil. Dab the paste directly onto the sore.
- Alternatively, check your pharmacy or health food store for an herbal mouthwash, such as a sage and chamomile mouthwash.[23]
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Apply honey directly to the sore to promote faster healing. Honey is soothing and has anti-inflammatory and antibiotic properties, and studies show that it can speed up the healing of mouth sores.[24] If available, raw, organic honey is best. Apply a small amount of honey directly to the sore and allow it to dissolve. Do this 4 to 5 times per day.
- For the greatest medicinal benefits, get raw manuka honey.[25] You may be able to find this kind of honey in your local health food store or pharmacy, or you can order it online.
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Soothe your sore with a mixture of coconut and essential oils. Some essential oils, such as lavender oil, may help heal canker sores faster.[26] Mix 3 drops of essential oil with 1 teaspoon (4.9 mL) of coconut oil. Apply the mixture to the canker sore using a cotton ball or a cotton swab. Alternatively, you can gargle it, but spit it out when you’re done.[27] Repeat this process 4 to 5 times per day. Choose from the following essential oils to make your mixture:
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Practice good oral hygiene to minimize irritation. To heal and prevent canker sores, brush your teeth twice a day and try and floss each day. Make sure that you brush all tooth surfaces and use a gentle up and down stroke when brushing. Use a soft toothbrush that will not irritate your gums or mucous membranes. Finally, avoid toothpastes and mouthwashes that contain sodium lauryl sulfate, which may cause or irritate canker sores.[33]
- Proper oral hygiene can also prevent new sores from forming, so make take good care of your mouth even when you don’t have a sore!
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Stick to soft, bland foods. It can be hard to eat when you have a painful canker sore. To minimize irritation, eat foods that are gentle and soft, such as creamy soups, yogurt, or mashed potatoes.
- You can also make your food easier to eat by mashing it up or blending it in a food processor.
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Minimize inflammation with cold foods and drinks. Cold fluids can numb your pain and reduce swelling and irritation. Sip cold water or other mild, non-acidic beverages, such as iced tea. Non-acidic popsicles might also help.
- Sometimes cold fluid can cause pain if it touches the sore directly. If this happens, try drinking through a straw.
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Steer clear of foods and beverages that may irritate your canker sore. There are a number of foods that may make a canker sore hurt more and increase the time that it takes to heal as well. Some things that you should avoid include:[34]
- Spicy foods, such as hot sauces, barbecue sauces, and peppery sauces
- Very hot liquids
- Anything you think you might have a sensitivity to, including gluten-containing products (anything with wheat in it), dairy, chocolate, coffee, strawberries, eggs, nuts, and cheese
- Acidic foods like citrus fruit and juices, tomatoes, and tomato sauces
- Oral products containing sodium lauryl sulfate
Expert Q&A
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QuestionHow long does it take for your ulcer to heal?Luba Lee, FNP-BC, MSLuba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.
Board-Certified Family Nurse PractitionerA small canker sore should resolve within 7-10 days. However, some larger ones can take up to 6 weeks. -
QuestionHow do you numb the pain of a canker sore?Luba Lee, FNP-BC, MSLuba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.
Board-Certified Family Nurse PractitionerUsing a cotton swab, you can put topical analgesics containing benzocaine on your canker sores 3 to 4 times throughout the day, such as an over-the-counter Anbesol or Orabase. If you are treating a canker sore for a child that is 2-years-old or younger, you should ask your doctor if it is appropriate to give them these numbing medicines.
Tips
References
- ↑ https://www.aaom.com/index.php%3Foption=com_content&view=article&id=82:canker-sores&catid=22:patient-condition-information&Itemid=120
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/symptoms-causes/syc-20370615
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/symptoms-causes/syc-20370615
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/basics/causes/con-20021262
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK546250/
- ↑ https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/c/canker-sores-aphthous-ulcers-in-children.html
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK546250/
- ↑ https://www.uofmhealth.org/health-library/zd1065
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/basics/treatment/con-20021262
- ↑ https://medlineplus.gov/druginfo/meds/a682701.html
- ↑ https://maaom.memberclicks.net/index.php%3Foption%3Dcom_content%26view%3Darticle%26id%3D86:canker-sores-treatment%26catid%3D22:patient-condition-information%26Itemid%3D120
- ↑ https://www.fda.gov/drugs/drug-safety-and-availability/risk-serious-and-potentially-fatal-blood-disorder-prompts-fda-action-oral-over-counter-benzocaine
- ↑ https://www.aafp.org/afp/2000/0701/p160.html
- ↑ https://maaom.memberclicks.net/index.php%3Foption%3Dcom_content%26view%3Darticle%26id%3D86:canker-sores-treatment%26catid%3D22:patient-condition-information%26Itemid%3D120
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/diagnosis-treatment/drc-20370620
- ↑ https://www.rdhmag.com/patient-care/prosthodontics/article/16406376/hydrogen-peroxide-in-dentistry
- ↑ https://medlineplus.gov/ency/article/000998.htm
- ↑ https://pubmed.ncbi.nlm.nih.gov/2632514/
- ↑ https://www.aafp.org/afp/2000/0701/p149.html
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/diagnosis-treatment/drc-20370620
- ↑ https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=zd1065&lang=en-ca
- ↑ https://www.readersdigest.ca/health/conditions/5-everyday-things-treat-canker-sores/
- ↑ https://www.aafp.org/afp/2000/0701/p149.html
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603684/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837971/
- ↑ https://pubmed.ncbi.nlm.nih.gov/22558691/
- ↑ https://www.takingcharge.csh.umn.edu/how-do-i-choose-and-use-essential-oils
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890698/
- ↑ https://nymag.com/strategist/article/how-to-treat-canker-sores.html
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630710/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054083/
- ↑ https://www.poison.org/articles/2010-dec/tea-tree-oil
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/basics/prevention/con-20021262
- ↑ https://www.mayoclinic.org/diseases-conditions/canker-sore/symptoms-causes/syc-20370615
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