Understanding Canker Sores: Symptoms, Causes, and Treatments

Understanding Sore White Marks on the Gum

Discovering a strange new lesion or spot in your mouth can be unsettling. Small white spots or bumps on the gums are common and typically harmless, but how can you identify them? Knowing the difference between a canker sore and other oral conditions can provide peace of mind or alert you when it's time to see a dentist.

What is a Canker Sore?

A canker sore is a small, round, shallow ulcer that forms inside the mouth. Canker sores are one of the most common causes of sore white marks on the gums. They usually appear on the soft tissues of the mouth, including the gums, inner cheeks, lips, tongue, and throat.

Canker sores typically start off as a small red or white bump that develops into an open ulcer. The center appears white or yellow with a red border. They tend to be oval-shaped and quite painful, ranging in size from 2 to 6 millimeters.

While canker sores can be bothersome, they are not contagious and are rarely a cause for concern. They often heal within 1-2 weeks without treatment. The exact cause is unknown, but potential triggers include:

• Stress or anxiety
• Hormonal changes
• Sodium lauryl sulfate in toothpaste
• Food sensitivities
• A weakened immune system
• Trauma or injury to the mouth

Canker sores typically don't require medical treatment unless they are very large, painful, or persist longer than 2 weeks. Over-the-counter topical numbing agents and anti-inflammatory creams can provide temporary relief.

Other Causes of Sore White Marks on the Gum

While most cases are benign canker sores, sometimes sore white spots indicate other conditions that require dental evaluation. It's important to monitor symptoms and see a dentist if you have any uncertainty about what's causing gum irritation.

Leukoplakia

Leukoplakia appears on the gums, tongue, or insides of the cheek as a flat white patch or plaque-like lesion. Unlike canker sores, the tissue is thickened and may have a fuzzy texture. While mostly harmless, leukoplakia can occasionally represent precancerous cell changes.

Oral Thrush

Oral thrush is a fungal infection caused by an overgrowth of Candida yeast. Typical signs include creamy white patches on the tongue, inner cheeks, gums, tonsils, or back of the throat. The lesions may look scraped or bumpy and can't be scraped off easily. Thrush often affects those with weakened immune systems and typically requires prescription antifungal medication.

Oral Lichen Planus

Oral lichen planus is an inflammatory condition that produces lacy white patches on the insides of the cheek or gums, often accompanied by a burning sensation. It may represent an autoimmune reaction and has a small risk of developing into cancer. Lichen planus requires oral medicine to help manage discomfort.

Chemical Burns

Chemical burns can occur inside the mouth after exposure to strong acids or other caustic agents. Chemicals in some oral healthcare products, like mouthwash or teeth whitening strips, may cause white patches, ulcerations, and sloughing off of gum tissues. Seek immediate medical care if you experience signs of chemical burns inside the mouth.

When to See Your Dentist

Schedule an urgent dental appointment if you experience any of the following:

• Severe pain that impacts your ability to eat, drink, or sleep
• Rapidly worsening swelling in the gums
• White lesions persisting longer than 2 weeks
• Red, swollen gums that bleed easily
• Ulcers accompanied by a high fever and difficulty swallowing

Your dentist can examine any mouth irritation and sore spots, determine if additional testing or a biopsy is needed, and provide appropriate treatment. Most instances of white bumps and spots on the gums are harmless, but it's important to monitor symptoms and seek care when necessary.

Preventing Sore White Spots on the Gum

While canker sores sometimes form spontaneously, you can take steps to avoid factors that trigger them:

• Reduce stress through relaxation techniques, exercise, or speaking with a therapist if needed.
• Use toothpaste for sensitive teeth that is SLS-free.
• Rinse your mouth after eating acidic or spicy foods.
• Avoid any foods you may be allergic or sensitive to.
• Improve nutrition through fruits, vegetables, and supplements if deficient.
• Quit smoking and tobacco use, which can irritate the gums.

Practicing excellent oral hygiene can also help prevent sore white spots on your gums:

• Brush gently twice a day with a soft or extra-soft toothbrush.
• Floss daily to remove plaque from between teeth.
• Schedule regular dental cleanings and exams.
• See your dentist about treatment options if you have severe gum disease.

While sore mouth lesions are common, avoid dismissing them as just a canker sore if symptoms seem unusual or severe. Checking in with your dentist can provide peace of mind and ensure proper treatment.

Treating Canker Sores

Although canker sores tend to heal on their own within a couple of weeks, you can help manage irritating symptoms in the meantime:

• Rinse with salt water or antiseptic mouthwash to keep the area clean.
• Apply over-the-counter topical ointments with active ingredients like benzocaine or lidocaine to numb pain.
• Avoid spicy, acidic, or irritating foods that can aggravate the sore.
• Take over-the-counter pills to reduce inflammation, like ibuprofen or acetaminophen.
• Apply ice cubes or cold compresses to numb pain.
• Stick to soft, bland foods and avoid chewing directly on sore spots.

For severe or very large canker sores, your dentist may prescribe a steroid oral paste or other medication. Luckily, canker sores generally resolve quickly on their own without needing extensive treatment.

When to Seek Medical Care

Schedule an appointment with your physician or dentist if you experience any of the following:

• Sore white patches on the gums persisting longer than 2 weeks
• Extreme pain making it difficult to eat, drink, or swallow
• Sores accompanied by high fever
• Rapidly worsening swelling and redness
• White spots that spread throughout the mouth
• Suspected oral herpes, oral thrush, or other infection
• Immune deficiency that slows healing
• Unexplained weight loss

While most common sore mouth spots are benign, it's important to monitor for symptoms that seem worrisome. Your dentist or doctor can examine the irritated area, provide a diagnosis, and recommend appropriate treatment to help resolve the problem.

Preventing Future Canker Sores

While canker sores can form spontaneously, you may be able to lower your risk by:

• Using toothpaste and mouthwash formulated for sensitive teeth
• Avoiding tissue injury inside the mouth
• Eating soft, bland foods when you have active sores
• Rinsing your mouth after meals
• Reducing stress through relaxation techniques
• Getting plenty of sleep and eating a balanced diet
• Quitting smoking and tobacco use

You may also have luck preventing recurrent canker sores by avoiding triggers if you can pinpoint substances that tend to cause flare-ups for you.

Talk to your doctor if you experience frequent canker sores to identify any underlying conditions that may be contributing, like nutritional deficiencies, immune disorders, or hormonal shifts.

When are Canker Sores Contagious?

Canker sores are not contagious in most cases. You cannot spread the sores to other people through casual contact.

However, some herpes viruses and other infections can sometimes mimic the appearance of a canker sore. If your sore has any of the following characteristics, it could potentially be contagious:

• Located on the outer lips or face instead of inside the mouth
• Contains pus
• Crusted over
• Part of a widespread rash
• Accompanied by a fever or swollen lymph nodes

Oral herpes, hand-foot-and-mouth disease, oral thrush, and impetigo can lead to blisters or sores around the mouth that have the potential to spread through contact. See your doctor promptly if you suspect any mouth sore could be infectious.

How Long Do Canker Sores Last?

The duration of a canker sore can vary depending on the size, severity, cause, and whether you aggravate it. However, they typically follow this healing timeline:

• Days 1-3: The sore starts off as a tingling, burning red spot or bump.
• Days 4-7: The bump erupts into an open ulcer with defined borders and a yellowish-white center.
• Days 8-10: The ulcer may have a grayish coating and start improving in pain and appearance.
• Days 11-14: Scabbing occurs as the sore heals. Pain continues fading.
• Days 15-21: The area where the canker sore occurred blends back in with the surrounding tissue once fully healed.

So you can expect a typical minor canker sore outbreak to last about 1-2 weeks before it resolves on its own. The duration can extend longer when multiple canker sores are present.

Healing Time for Severe Canker Sores

Major canker sores are larger and deeper ulcers over 10 millimeters wide. Due to their size and severity, major canker sores take longer to heal and usually last between 2-6 weeks.

The most important thing is to avoid further irritating severe or major canker sores so they can heal faster. Your dentist may recommend special pastes or medications to help treat serious outbreaks.

Treatments to Heal Canker Sores Faster

While canker sores usually go away on their own within 1-2 weeks, you can help speed healing by:

• Using OTC numbing creams containing benzocaine, lidocaine, or similar ingredients.
• Rinsing with salt water to keep the area clean.
• Taking OTC pain relievers like ibuprofen to reduce inflammation.
• Applying a protective layer such as oral wound gel to shield the sore.
• Using cauterizing agents recommended by your dentist.
• Getting prescription treatment for severe canker sores.

Avoiding anything acidic, salty, crunchy, or spicy that could aggravate the canker sore will also enable faster progress in the healing process.

When to See a Doctor

In most cases, you don't need to seek medical treatment for a minor canker sore. But you should schedule an appointment with your doctor or dentist if you experience:

• Severe pain making it difficult to eat, drink, or talk
• Sores lasting longer than 2 weeks without improvement
• Fever, body aches, and swollen lymph nodes
• Multiple large canker sores or sore throat
• Rapid worsening of swelling and redness
• White patches spreading throughout the mouth
• Unexplained weight loss

Your physician or dentist can examine your mouth, determine if testing is needed, and provide medical treatment for severe or worsening canker sores when necessary.

Home Remedies for Canker Sores

You may be able to find relief from irritating canker sores with these home remedies:

• Salt water rinse: Swish with a saline solution to cleanse the area.
• Baking soda paste: Make a paste with baking soda and water and apply directly.
• Hydrogen peroxide rinse: Dilute hydrogen peroxide and swish gently.
• Ice cubes or cold compress: Apply something cold to numb pain.
• Tea tree oil: Dab on pure tea tree oil using a cotton swab.
• Aloe vera gel: Apply the soothing gel directly to the sore.
• Honey: Apply manuka honey to help heal the sore.

Avoiding irritants like spicy, crunchy, or acidic foods can also help relieve canker sore discomfort while it heals.

Canker Sore vs. Cold Sore

Canker sores and cold sores can look similar at first glance, but there are distinct differences:

• Location: Canker sores occur inside the mouth, while cold sores form on the outer lips or skin.
• Color: Canker sores have a yellow-white center with a red border. Cold sores often appear entirely reddish.
• Shape: Canker sores are round with defined edges. Cold sores are more irregularly shaped.
• Cause: Canker sores are triggered by things like stress or oral injury. Cold sores are caused by the herpes simplex virus.
• Contagiousness: Canker sores are not contagious, but cold sores are very contagious.
• Duration: Canker sores typically last 1-2 weeks. Cold sores usually resolve in 2-4 weeks.

The main way to distinguish the two is that canker sores form inside the mouth from irritation, while cold sores occur on the exterior lip/skin due to herpes viruses.

Conclusion

Discovering sore white spots or marks on your gums can be concerning. However, common canker sores are benign and resolve on their own within a couple of weeks in most cases. While canker sores can be painful and annoying, they are rarely a major concern.

Use OTC numbing and anti-inflammatory products to find relief while the canker sore runs its course. Make an appointment with your dentist or doctor if your sore is severe, persists longer than 2 weeks, or seems atypical. Identifying and addressing the cause of any oral lesions provides peace of mind.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.