Canker sores, also known as “mouth ulcers” plague the lives of millions of people all over the world. These small oral ulcers can make life unbearable when eating, drinking, speaking, or swallowing. Frustration sets in when your dentist or doctor doesn’t know how to respond to your questions about these annoying and recurring ulcerations.
Unfortunately, the public ends up creating their own “canker sore” problem, by using commercial toothpastes, which contain an ingredient that has been proven to be linked to canker sores. It’s called Sodium Lauryl Sulfate (SLS), and is placed into toothpaste (and some mouthwashes) in order to create foaming. (Sodium Lauryl Sulfate is also the main ingredient in your shampoo).
The harshness of this chemical has been proven to create microscopic damage to the oral tissue which lines the inside of your mouth, which then leads to Canker Sores.
The Science of Canker Sores:
For discussions sake, several terms are interchangeable. Canker Sores are also known as: Mouth Ulcers, Aphthous Ulcers, Recurrent Aphthous Stomatitis, or Oral ulcers.
Some people (and doctors) confuse canker sores with “cold sores” (fever blisters). We know both are painful, annoying, and recurring. Here are the major differences:
-only occur inside the mouth
-not viral (not caused by a virus
-Caused by damage to oral tissue, often by Sodium Lauryl Sulfate, a common foaming agent ingredient in almost all toothpaste.
- Mostly on outside of mouth – sometimes on the inside of the mouth, but only on “hard” surfaces (palate).
-The first sign is appearance of small blisters (vesicles)
What Causes Canker Sores ( Mouth Ulcers)?
One of the most exciting advances has been the establishment of the link between canker sores and an ingredient common to almost all toothpastes. The additive SLS or sodium lauryl sulfate may be a culprit in canker sore formation.
SLS ( sodium lauryl sulfate ) acts just like a detergent. It is used in the laboratory as a membrane destabilizer and solubilizer of proteins and lipids. SLS is used in toothpaste to emulsify (mix) oil and water based ingredients together. In your toothpaste it creates the foam you get when brushing. Since it is classified as a soap, you will easily understand, why this ingredient can cause drying inside the mouth for many individuals. The dryness is one of several factors that will lead to bad breath. To avoid this, you must stop using toothpaste that contains SLS. Also, to avoid dryness and bad breath, I recommend toothpaste that oxidizes the mouth, and mouthwash that does not contain alcohol (a drying agent).
The thought is that SLS may, in susceptible individuals, cause microscopic trauma or membrane disruption to the skin cells in the mouth. This along with trauma or actions of the immune system may lead to canker sore formation.
Recent studies have shown a link between the use of toothpastes containing SLS and the occurrence of RAS (canker sores).
The following is a synopsis of 3 European Scientific Studies:
In the clinical studies, patients using SLS toothpaste displayed a greater amount of desquamation (loss of a layer of skin lining the inside of the mouth). This has led to the theory that SLS may contribute to RAS (canker sores) by causing injury to the oral epithelial cells (skin cells lining the inside of the mouth).
SLS, by denaturing protective mucus proteins, may also disrupt the protective layer of mucus which lines the inside of the mouth (a denatured protein is a protein which has lost its three dimensional shape thereby becoming nonfunctional and useless). The denaturing of mucus proteins makes the cells lining the mouth more susceptible to injury and canker sore formation.
2. Herlofson, Bente and Pal Barkvoll The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers Acta Odontol Scand 1996; 54(3): 150-153
3. Barkvoll, Pal and G. Rolla Possible effects of sodium lauryl sulfate (SLS) on the oral mucosa [abstract] J Dent Res 1989; 68:991
What has been especially exciting is the fact that many of my patients have experienced tremendous improvements as a result of using SLS free toothpaste. Additionally, many of the visitors to this website have also found canker sore relief by using an SLS free toothpaste.
Research is being conducted to determine what makes a person susceptible to canker sores in the first place as well as what actions and mechanisms trigger canker sore outbreaks. Among those things that may trigger an attack or make a person more susceptible are:
A. SLS found in Toothpaste and some mouthwashes
Current theories on the causes of canker sores have focused on the immune system. This research suggests that canker sores may be caused by the body’s own immune system attacking the cells lining the inside of the mouth.
The first canker sores usually occur between the ages of 10 and 20. During life, episodes usually, but not always, become less frequent and less severe. Interestingly, women often report increased susceptibility to canker sore formation during certain times of their menstrual cycle. Some women report complete relief from canker sores during pregnancy.
Interestingly, canker sores ( mouth ulcers ) affect people to varying degrees of severity. Some people may get an occasional outbreak of canker sores once or twice a year while others may suffer near continuous overlapping episodes of canker sores ( mouth ulcers ).
On the Subject of Preventing Canker Sores (Mouth Ulcers)
Secondly, trauma to the inside of the mouth may trigger the production of canker sores. This trauma includes overzealous tooth brushing, biting your cheek or tongue, and scraping the inside of your mouth with hard or sharp foods (like hard pretzels).
Cut down on eating foods like potato chips, hard pretzels, cut apples, and hard candies which might nick, abrade, or otherwise traumatize the oral tissue.
As far as overzealous brushing, most people can not consciously stop brushing so hard, because tooth brushing is such an ingrained habit. Find a soft nylon toothbrush and brush your teeth gently. One is available here.
We know that many bite the insides of their cheeks while sleeping or out of nervousness and stress. We suggest that a mouth guard be worn during sleep. This is often very effective at preventing further oral trauma. Contact your dentist for more information.
Reactions to certain food products may be responsible for many cases of canker sores. Among the foods that may cause canker sores in certain people are: nuts, peanut butter, sea food, wheat products, chocolate, and milk.
Treatment of Canker Sores (Mouth Ulcers)
Usually canker sores clear within 7-14 days without treatment. During this time, however, the canker sores can be painful especially when people eat or drink. Treatment helps ease the pain and may help reduce the amount of time it takes for the ulcers to go away.
Other Viable Treatments:
1. Anti-Microbial Mouthwashes
2. Analgesic (Pain Relieving) and Protective Ointments and Gels:
3. Corticosteroid Rinses and Gels:
Systemic Conditions Associated with Canker Sores (Mouth Ulcers)
Those infected with HIV may also develop “canker sore like” ulcers.
Some digestive conditions display canker sores as part of their disorder. These include: Crohn’s Disease, Celiac Disease, Ulcerative Colitis, and gluten hypersensitivity (wheat allergy).
Consult your physician if any of the above sound like they may be part of your “canker sore” problem.