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Causes
By Mayo Clinic staffThe precise cause of canker sores remains unclear, though researchers suspect that a combination of several factors contributes to outbreaks, even in a single individual. These factors include:
- A minor injury to your mouth from dental work, overzealous brushing, sports mishaps, spicy or acidic foods, or an accidental cheek bite
- Food sensitivities, particularly to chocolate, coffee, strawberries, eggs, nuts, cheese and highly acidic foods, such as pineapple
- Food allergies
- A diet lacking in vitamin B-12, zinc, folate (folic acid) or iron
- An allergic response to certain bacteria in your mouth
- Helicobacter pylori, the same bacteria that cause peptic ulcers
- Celiac disease, a serious intestinal disorder caused by a sensitivity to gluten, a protein found in most grains
- Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis
- Behcet's disease, a rare disorder that causes inflammation throughout the body, including the mouth
- A faulty immune system that attacks healthy cells in your mouth instead of pathogens, such as viruses and bacteria
- HIV/AIDS, which suppresses the immune system
- Hormonal shifts during menstruation
- Emotional stress
- Toothpastes and mouth rinses containing sodium lauryl sulfate
Unlike cold sores, canker sores are not associated with herpes virus infections.
References
- Morelli JG. Disorders of the mucous membranes. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/174218004-3/925169573/1608/1550.html#4-u1.0-B978-1-4160-2450-7..50665-4--cesec7_12116. Accessed Dec. 4, 2009.
- Leggiadro RJ. Infections of the oral cavity. In: Long SS, et al., eds. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/174218004-3/925169573/1679/31.html#4-u1.0-B978-0-443-06687-0..50030-8--cesec16_721. Accessed Dec. 4, 2009.
- Travers JB, et al. Physiology of the oral cavity. In: Cummings CW, et al. Otolaryngology: Head & Neck Surgery. 4th ed. http://www.mdconsult.com/das/book/body/174218004-4/0/1263/586.html?tocnode=49543605&fromURL=586.html#4-u1.0-B0-323-01985-4..50067-8--cesec61_2453. Accessed Dec. 4, 2009.
- Common mouth sores. American Dental Association. http://www.ada.org/public/topics/mouth_sores.asp. Accessed Dec. 4, 2009.
- Mouth sores. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec08/ch112/ch112a.html. Accessed Dec. 4, 2009.
- Amsterdam JT. Oral medicine. In: Marx JA, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.: Mosby; 2006. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-323-05472-0..00068-2--s0160&uniq=174218004&isbn=978-0-323-05472-0&sid=925188259.Accessed Dec. 4, 2009.
- Rakel D, et al. Recurrent aphthous ulceration. In: Rakel RE. Integrative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/174218004-8/925191198/1494/118.html#4-u1.0-B978-1-4160-2954-0..50075-2_3684. Accessed Dec. 4, 2009.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 9, 2009.
- Benzocaine topical products: Sprays, gels and liquids — risk of methemoglobinemia. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm250264.htm. Accessed Apr. 8, 2011.
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