THE 5 MOST FREQUENTLY ASKED QUESTIONS ABOUT CANKER SORES AND MOUTH ULCERS

Dr. Claudia Bruns, interview.

Dr. Manolo Orellana, specialist in Pathology, responds.

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Although they seem harmless, many people have doubts about how to take care of the pain that certain mouth sores can generate, and more importantly, to know if they can be a sign of other dangerous systemic diseases. On this occasion, we have the valuable collaboration of Dr. Manolo Orellana, specialist in Oral Pathology and Medicine (Universidad AutónomaMetropolitana, Mexico City). Find out here the most relevant information about this type of lesions.

1. What is the difference between herpes and canker sores?

Dr. Orellana Dr. Orellana: Although it is true that both are quite similar diseases , their origins are very different. Oral aphthous ulcers are usually recurrent and are associated with a constant local irritation of the oral mucosa. They appear more frequently in people with hormonal disturbances (e.g. menstrual cycle/pregnancy), or who suffer from allergies, auto-immune diseases, nutritional deficiencies, and/or emotional stress.Clinically, they appear on the inside of the mouth, on the soft tissues such as gums, lips, tongue and cheeks. They are small white or yellowish ulcers with a red border, usually painful, especially when eating or drinking, or very hot foods.

Whereas oral herpes is caused by the herpes simplex virus (HSV-1), which can be "passively" in our body until some change in our immune system activates it and those famous vesicles appear in the lip region. Unlike canker sores, herpes goes through several stages: first there is a tingling or itching, then the vesicles appear and, finally, these vesicles burst and form a scab. It can also appear on the gums, hard palate and back of the tongue. The virus is usually acquired during childhood, when there are fewer symptoms, but later reappears during adolescence.

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2. How is each one served?

Dr. Manolo Orellana:

If you have canker sores, you should know that you do not have to use a specific treatment to get rid of them, since they do it by themselves with the passage of time and automatically (1 to 2 weeks). However, your dentist may recommend mouthwashes, topical ointments or medications taken, which can accelerate the healing process or relieve pain.

In the case of oral herpes, there is no specific treatment that completely eliminates it, because it is a virus, once it enters the organism, it will remain there forever, albeit in an inactive form, to have occasional reappearances. It can be reactivated in case of immunosuppressive diseases, UV rays, hormonal changes, etc. However, the correct treatment is the administration of antivirals topically (creams/ointments) or systemically in the first stage of the infection, i.e. in the tingling and itching sensation, mainly to cut the contagion and pain.

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3. What do you think of home remedies, such as using baking soda to apply while seeking professional help?

Dr. Manolo Orellana:

I understand that many people, in desperation because of the pain, choose to do any rinse at home. The truth is that there are no miracle home treatments... it is the body itself that solves the problem in a couple of weeks, unless it is something more serious. Of course, you can buy a chlorhexidine rinse at the pharmacy , which helps maintain a cleaner oral environment, which may help reduce symptoms . DO NOT use commercial alcohol rinses because they are more irritating. There are also hyaluronic acid ointments to soothe the pain and promote early regeneration of the affected tissue. However, it is VERY IMPORTANT that you evaluate if after 2 weeks the discomfort or the presence of ulcers continues... it is important that you see an oral health specialist.

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4. How do you know if an ulcer is cancer?

Dr. Manolo Orellana:

Any change in the oral mucosa that is prolonged or that we cannot see as "normal" is a sign that should alert us, for example:

- Mouth ulcers that do not heal for 7 to 10 days and bleed easily.

- Increase in volume of a sore, without apparent cause.

- Color changes in the oral mucosa (white, red, black spots).

- Difficulty moving the tongue or opening the mouth.

- Foreign body sensation when swallowing.

Immediately see your dentist or oral health care provider. BIOPSY is still the best diagnostic method for oral cancer. Early diagnosis is vital to fight this cancer and give our patients a chance to live.

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‍5.How does diet and stress influence the development of sores?

Dr. Manolo Orellana:

A good diet, rich in protein and vitamins, low in sugar, is a crucial factor in preventing various diseases, including oral diseases, including cancer. And at the same time, let's not forget to have a good oral hygiene, which helps reduce bacterial plaque and maintains a healthy oral environment.

INCLUDE IN YOUR DIET:

- Red fruits: strawberries, raspberries, blueberries and blackberries.

- Citrus fruits: oranges, tangerines, lemons, grapefruit and grapefruit.

- Vegetables, especially those rich in carotenoids.

- Oily fish and purified fish oil.

- Nuts and seeds

- Tea (particularly green tea).

AVOID:

- Smoking (major risk factor for cancer)

- Alcoholic beverages, especially when fasting.

- Fried foods

- Smoked meat and sausages.

- Very hot or irritating foods that cause pain: hot peppers, chili.

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Although it is difficult to measure, recent studies indicate that stress is another major trigger of oral cavity diseases such as canker sores, autoimmune lesions and burning mouth syndrome. This occurs because poor stress management alters several physiological responses in the body, e.g., it can lower defenses, reduce the quantity or quality of saliva, alter sugar metabolism, etc.

I would like to give special thanks to Dr. Manolo Orellana for sharing his knowledge, who has great experience in the clinical and microscopic study of diseases affecting the oral cavity and lesions located in soft tissues and bones of the head and neck region. We will surely touch on the subject of oral cancer on another occasion, to resolve doubts about the risks and treatment.

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