IF SYMPTOMS PERSIST Dr. Jose Pujalte, Jr.

“... the canker, and the grief are mine alone!” – Lord Byron (1788-1824), English poet, On this Day I Complete My Thirty Sixth Year (1824)

While the big ones like cancer and stroke may overwhelm us, it’s the common inconveniences like ingrown toenails and canker sores (singaw!) that we’re most likely to whine about. Definition. A canker sore (other name: aphthous ulcer) is known for its exquisite pain in the mouth, under the tongue, inside the cheeks, on the gums. These are usually small (the dot, size 72 on Times New Roman), round to oval shallow lesions with red borders and a yellow or white center. They make chewing and talking painful. It’s somewhat hard to describe but oh well, just like pornography you know it when you see it (and in this case, when you feel it). Types. There are three: minor, major, and herpetiform canker sores. The minor I have already described above. They heal without scarring in one or two weeks. A major canker sore is about a half-inch wide (12mm) with irregular edges and may take up to six weeks to heal, leaving a scar. Herpetiform canker sores are about 3 mm in diameter but occur in clusters of 10 to 100. Like minor sores, they heal in one to two weeks without scarring. Watch out for fever and swollen lymph nodes (kulani). Causes. Several factors contribute to an outbreak and these combine to make a mouthful of misery: dental work and too forceful tooth brushing, sports accidents involving the mouth, spicy and acidic foods, food allergies, hormonal changes during menstruation, stress, a diet deficient in iron, folic acid, and Vitamin B-12, emotional stress and HIV/AIDS. The bacteria implicated in peptic ulcers – Helicobacter pylori – may also a cause of canker sores. Home Remedies. Before visiting your favorite doctor or dentist, you may consider self-treating. Try rinsing with salt water or one teaspoon of baking soda in a half-cup of warm water. The sore can also be covered with a paste made from baking soda. Another favorite is milk of magnesia applied directly on the lesion thrice a day. Ice chips on the lesion dulls the pain. Diagnosis and Treatment. There are no special tests needed for canker sores. However, the doctor may investigate more thoroughly if these are just manifestations of an underlying condition. A mouth rinse may be prescribed that contains dexamethasone (steroid) that reduces inflammation. Tetracyline is antibiotic taken orally and cut healing time. Ask for convenient oral paints or pastes applied to each lesion. Prevention. Avoid food that irritates your mouth – these are usually hot and spicy stuff. Good oral hygiene means flossing every day, using a soft toothbrush and brushing correctly. Ask your dentist to demonstrate optimal brushing technique. And finally, mother was right – don’t eat and talk at the same time. There’s a greater chance of biting the inside of the mouth and end up with a canker in a few days after. E-mail [email protected]