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Mouth Diseases

Having Canker Sore Every Day

11/30/2010

Question:

It is hard to believe, but I have had canker sores inside my mouth every single day for 9 years. I always have at least 10 canker sores on my tongue, cheek, roof of the mouth and inside my lips every day. It normally heals within 7-10 days and then new sores come while the old ones haven’t gone. I know that it is not herpes because it is only inside my mouth and my genital area never gets anything like that.

My doctor gave me acyclovir, sometimes famvir, for 2 years and they don’t help at all because that is the treatment for herpes. I know that it is fine to get canker sore someone, but I always have them, 365 days a year. It is very hard for me to eat, talk and it is very stressful.

I am 28 now and could this be passed on to a child? I really don’t know what to do. Do you have any idea what is wrong with me? My sores are white with red border.

Answer:

It sounds as though you have aphthous ulcers, and based upon the presentation and frequency, most likely Recurrent Aphthous Ulcers or RAS. Have you seen and or discussed this problem with your dentist or a dermatologist?

Aphthous means "fiery or burning" and describes the symptoms associated with these lesions. There are a multitude of possible causes for this condition, most likely related to contact hypersensitivity. This is a very common oral lesion and it is believed to be the result of a T-Cell mediated reaction resulting in mucosal destruction and ulceration.

As mentioned there are many possible causes or associative relationships of the disease;

1. Allergies (Dairy, citrus, cinnamon)
2. Genetics
3. Hormonal
4. Stress
5. Trauma
6. Microbial (Bacteria, Fungus, Molds)
7. Nutritional
8. Hematologic disorders
9. Medications

Treatment is more palliative in conjunction with determining the etiology and removing or alleviating the causative agents. Some clinicians will use steroids - both topical and systemic - and/or steroid-sparing agents (cyclosporine, dapsone, chromolyn), in addition to a long list of other immunologic modulating therapeutics.

That is why I am suggesting that you have your dentist (oral medicine specialist) or a dermatologist evaluate this condition.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University