R.G from Ramat Shlomo, Jerusalem, asks:
What are mouth sores and what can we do about them? 

Published in The English Update, No.1, July 8 2010
Mouth sores, otherwise known as canker sores or aphthous stomatitis are common lesions in the mouth affecting 20-50% of the population.


The common syndrome is one of painful, bitter, pale, punched-out lesions on the inside of lips, the gums or the roof of the mouth. The ulcers are usually less than 1cm in diameter and develop over 3-4 days. They usually heal within 7-10 days. Some people have a rare episode, some people have the occasional recurrence and some people seem to be never free from ulcers. Commonly they affect people from the ages of 5-30 years.


The cause of these sores is not clear. No infection (virus, bacteria) has been found to be the culprit. Triggers for an outbreak of sores can be stress, trauma (eg rubbing of a brace or other dental appliance) or certain foods and medications (eg. nurofen/advil). Patients with recurrent or troublesome sores should see their doctor to make sure that the sores are indeed regular mouth ulcers and not something else. Low Vitamin B and iron levels are associated with mouth sores and should be tested and treated accordingly. Rarely, there is an association with bowel diseases such as Gluten Intolerance (Celiac Disease) or Inflammatory Bowel conditions such as Crohns Disease and these should be considered by the doctor in cases of severe ulcers.


Treatment of the sores starts with avoiding the salty or bitter foods that exacerbates the pain. Often no medical treatment is needed, just a bit of patience! Medication starts with creams applied locally, either an anesthetic cream or a steroid cream applied as needed for a few days. There is a debate whether taking vitamin supplements can combat mouth sores; obviously if there is a vitamin deficiency this should be found and treated. Regular use of chlorhexidine mouth wash ("Tarodent" in Israel) can reduce the frequency of attacks in people who have particularly bothersome ulcers. In general, and not just for preventing ulcers, I recommend regular check-ups at the dentist, twice daily tooth-brushing and maintaining good oral hygiene. Remember, people often grow out of these sores as they get older.



Dr Alexander King is a Family Doctor in the center of Jerusalem


Appointments call *3555 (Maccabi)


Please email your questions for Dr. King to the299@gmail.com