口腔潰瘍基本知識 How to Treat Canker Sores or Mouth Ulcers

Canker sores, also known as mouth ulcers, can form on the gums, inner cheeks and lips (anywhere inside of the mouth). Canker sores, while annoying, are common, and usually heal in a week or two. They are not to be confused with cold sores, which form on the outside of the mouth. Here are a few suggestions to help deal with these pesky ulcers.

 

Part 1 of 4: Avoiding Canker Sores

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   Try to stop the cause. Canker sores can be caused by a variety of factors. If you have several cankers or you get them repeatedly, consider^[1]:
   • Brushing your teeth more gently. Brush your teeth gently with a soft-bristled toothbrush. Floss daily.
   • Changing your toothpaste. Toothpastes or mouthwashes that contain sodium lauryl sulfate can cause canker sores and continue to aggravate them. Try substituting natural toothpaste into your regimen.
   • Relaxing. Many people get canker sores during times of intense emotional stress. Like acne and eczema, canker sores can be exacerbated by stressors.
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   Pay attention to your diet. Diet can have a significant effect — beneficial and detrimental — on canker sores.
   • Avoid spicy or acidic foods, which can irritate sores further. Peppers and sodas should be shunned. Fruits and vegetables such as lemons, oranges, pineapples, apples, figs, tomatoes, and strawberries may also cause canker sores.^[2]
   • Get more B12, zinc, iron, and folic acid.^[2] Take a vitamin supplement, or multiple supplements, that contain these every morning.
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   Try not to irritate the inside of your mouth if at all possible. Canker sores often appear after cuts and lesions break open the skin inside the mouth.
   • Chew slowly. Many people get canker sores after accidentally biting the inside of their cheek or lip while chewing. While eating, take small portions into your mouth and chew slowly.
   • If you have braces or other orthodontics, eliminate areas that protrude into the skin. Talk to your orthodontist about eliminating sharp corners or wires that may cut into the skin. Ask for orally-safe wax that can be applied to orthodontics to help ward off cuts and other injuries.
   • Ill-fitting dentures may also cause canker sores.^[2] Talk to your dentist about options concerning your dentures.
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   Take a lysine nutritional supplement. Nutritional lysine supplements, like L-lysine, provide essential amino acids that help with tissue growth and repair. This can reduce the occurrence of canker sores and limit the expansion of small canker sores.
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   Treat other medical conditions that may cause or make canker sores worse. Simple canker sores, which are common and appear three or four times a year and last up to a week, are likely not caused by underlying health problems. Complex canker sores, which last longer and are likely to recur, may be due to underlying health problems.^[2]
   • Individuals with compromised immune systems may be at higher risk for canker sores.
   • Individuals with gastrointestinal tract diseases, such as Celiac disease and Crohn's disease, may also be at higher risk for complex canker sores.

Part 2 of 4: Treating Canker Sores with Home Remedies

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   Use a salt or baking soda rinse. Mix a few pinches of salt in a glass of warm water. Swish around inside your mouth and spit out, repeating two or three times a day.
   • An alternative to this is baking soda. Mix one teaspoon baking soda with several ounces of warm water. Swish and spit out.
   • Alternatively, create a paste with equal parts baking soda and water. Dab the paste over the canker sore with a Q-tip and let dry.
   • Salt water and baking soda both help the mouth heal itself by reducing the acidity and bacteria in the mouth.
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   Use a 3% hydrogen peroxide solution.
   • Pour a little bit of it into a plastic soda cap and dilute with an equal amount of water.
   • Dip the Q-tip into the peroxide solution and dab it only on the canker sore.
   • Turn the Q-tip around and repeat.
   • Empty the cap and rinse it with water.
   • Take care not to swallow any of the hydrogen peroxide if possible.
   • Hydrogen peroxide is an antiseptic that will reduce the amount of bacteria in your mouth and help the canker sore heal.
   • The canker sore should go away in about 2-3 days if you do it twice a day.
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   Use milk of magnesia. Dab it on active spots a few times a day. The antacid effect of milk of magnesia neutralizes the acidic environment, changing the pH, and making it less supportive of the bacteria in the mouth that aggravate the canker sore.^[3]
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   Use an antihistamine/antacid mix. Combine one part diphenhydramine (sold as Benadryl) with 1 part antacid, such as Maalox or Kaopectate. Swish around your mouth and spit out.
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   Use OTC mouthwash. Regular old mouthwash does work, although there are different OTC mouthwash solutions that are specifically targeted to help treat canker sores. They include:
   • Diphenhydramine suspension washes (Benadryl Allergy liquid and others). These types of washes generally treat the pain of the canker sore. The mouthwash solution should not be swallowed.^[4]
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   Treat the pain (optional). You can take over-the-counter painkillers, or apply benzocaine gels (such as Anbesol and Orajel) directly onto active sores.
   • Suck on ice chips. Try to hold them over the sores, allowing them to melt over the area. Ice should help numb the pain and reduce inflammation.
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   Try other miscellaneous remedies. Three of these remedies are designed to change the pH in your mouth. The theory here is that changing the pH will make your mouth less hospitable to the bacteria that are causing the canker sore:
   • Eat yogurt daily.
   • Apply a wet black teabag to the ulcer.
   • Squeeze the oil of a Vitamin E capsule onto the sore, repeating several times per day.
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   Use a lemon. Squeeze the lemon with a lemon squeezer or just squeeze is on the ulcer straight away.
   • If you squeezed the lemon with a lemon squeezer, wash your hands, put your finger in the juice then dab it on your ulcer.
   • Repeat it before breakfast, after breakfast, before lunch, after lunch, before tea, after tea, before dinner, after dinner and right before you sleep.
   • Leave it on for 1-5 minutes. Then rinse off, if needed.

Part 3 of 4: Knowing When to See a Doctor

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   Visit a specialist if you get frequent sores. If you're constantly battling canker sores and none of the above fixes are working, perhaps there's an underlying issue.^[5] For some conditions, canker sores are an early and important sign that something else is wrong.
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   Schedule an appointment with a gastroenterologist. Consider investigating whether you have Celiac Disease, Crohn's Disease, or inflammatory bowel disease. All three are autoimmune conditions that can cause frequent mouth sores.
   • You might also ask the doctor if it's possible you have Helicobacter pylori, more commonly known as H. pylori, which can cause stomach ulcers.
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   Schedule an appointment with an immunologist. If you've ruled out gastrointestinal disease, consider visiting an immunologist. There are a few rare immune conditions that can manifest as persistent mouth sores.

Part 4 of 4: Treating Canker Sores with Prescription Medications

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   Request a prescription mouth rinse. You have two options for prescription mouth rinses:
   • Dexamethasone, a steroid mouth rinse that should reduce pain and inflammation. Dexamethasone should reduce the number of recurrences, but is generally reserved for more severe cases.^[4]
   • Tetracycline, an antibiotic used for more extreme cases. Your sores will heal quickly, but your mouth will be susceptible to a fungal condition called thrush. Thrush is an infection of yeast fungus in the mucous membranes of the mouth.
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   Request topical gels and ointments. Topical ointments such as benzocaine (Anbesol), amlexanox (Aphthasol) and fluocinonide (Lidex, Vanos) may relieve pain and speed healing if applied as soon as canker sores appear.^[6] Doctors usually suggest treating sores with ointments 2-4 times during the day.
   • Other oral medication not specifically intended to treat canker sores may be helpful in treating canker sores. Cimetidine (Tagamet) and colchicine, gout medicines, are sometimes effective in treating canker sores.^[6]
   • Steroidal oral medications are generally used as a last resort, only when canker sores don't respond to other medications. Doctors still don't know what exactly causes canker sores.^[2]
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   Request cauterization. Cauterizing — or burning the surface tissue — sores can keep open sores from getting bigger, and the burn will eventually heal over. Most cauterizations are performed with chemical solutions, such as silver nitrate.

From WikiHow