Canker Sore Cures That My Doctor Didn’t Know About

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So – have you ever felt like sometimes you know more than your doctors? I feel that a lot actually, partially because I’m addicted to research, partially because I have a hard time taking “no” for an answer; but also because it seems like doctors go to school, do some on-the-job training, and aside from what the drug reps shove in their faces between patient visits, that’s where their knowledge and authority ends.

Case in point: One time I went into the doctor after being diagnosed with a form of heart disease and asked about krill oil vs fish oil. My doctor had never even heard of krill oil. HELLO? There are MegaRed commercials all over the TV.

The newest event to make my stomach grumble was treatment for, as indicated by the title of this blog, canker sores.. or aphthous ulcers.

I was on vacation and out of the blue got hit with not one, not two, not three, but half a dozen canker sores in various spots of my mouth. And when one finally would go away, another popped up. After dosing up with ibuprofen, Viscous Lidocaine (a topical numbing gel that’s prescription strength) and some Tylenol #3 with Codeine that I had leftover from the dentist.. and after trying countless over the counter canker sore “remedies” like:

I decided to call in the doctors. This was ruining my vacation.

So the first call was to my regular doctor. It was after-hours so I left a message with the answering service. She called me back and basically said yeahhh we don’t know why canker sores happen and there really isn’t much to do for them, aside from OTC pain relievers, popsicles, and Anbesol/Orajel type numbing gels that you’ve already tried. You just have to wait for them to go away.

Seriously? It’s 2010 and there’s absolutely nothing you can do to help me with a canker sore problem that’s so bad I can barely have this conversation with you because talking is excruciating, eating is impossible..

I wanted a second opinion. So I called another one of my doctors. He, too, said all he could think of would be Lidocaine visc 2%, and I already had some of that from the dentist. He confirmed my other doctor’s statement that canker sores are a medical mystery and can be caused by anything from stress to the wrong toothpaste to mouth trauma.

I appreciated his time, but this was frustrating me.

You’ve probably seen the doctor contributors on talk shows say “be an active participant in your health care”.. that defines me to a T. It’s rough, though, because a lot of medical personnel are offended when you seem like a know-it-all, and a lot of providers feel threatened for some reason like you’re trying to do their job. However, every once in awhile you’re lucky to match up with that one great practitioner who is glad to take your findings into consideration and admits they don’t always have time to stay as educated as they’d like to. I had a great doctor, unfortunately his business went under and he closed up shop.

But alas, I started Googling. Hit the Mayoclinic web site. Then the online PDR. Turns out there are quite a few things available that I hadn’t tried – by prescription and OTC – to help with canker sores. So neither doctor spent 5 minutes online researching before ruling out any treatment they could provide? And this was the stuff I could find PUBLICLY available. Doctors have medical journals and special databases full of info… don’t they?

I paced the hotel room, trying to figure out a game plan that didn’t involve going, web site print-outs in hand, into urgent care or an emergency room for some stupid canker sores. That would be super expensive and waste an entire night. I called my dentist.

He sympathized with my condition and apologized that my previous doctors didn’t know that another cause of canker sores can be nutrition-related and some can actually be caused by a virus. He said if I was in town I could come to his office for an emergency appointment in which he would use a series of special lasers to treat the areas where the sores were occuring. This treatment would shorten healing time by TEN DAYS and highly reduce the risk of new sores appearing. I said I would definitely consider this when I got back home, but needed something now to allow me to enjoy this pricey vacation.

He offered some more Tylenol #3 and recommended I get a tube of SLS-free toothpaste right away. Actually he wasn’t sure what the compound was called at first; but because I watch a lot of Dr. Oz I knew what he was referencing when he said special toothpaste.

There are a number of different makers of SLS-free toothpaste, and I’ve requested samples from just about each one of them. Not all of them contain fluoride, so be careful if that’s something you need in your toothpaste. The best I’ve found so far include:

  • Tom’s of Maine, which features a cousin of licorice root that actually mimicks the SLS foaming action without the harsh side effects
  • Biotene, which is low-foaming but also contains calcium and a number of special enzymes which control dry mouth
  • Therabreath, which utilizes a patented system where you brush with the toothpaste and DON’T rinse with water; you rinse with their special mouthwash that, when mixed with the toothpaste residue, ensures a spotless clean and prevention of bacteria which cause bad breath (hence the name Therabreath)

SLS, by the way, is sodium lauryl sulphate – a super foaming agent present in most toothpaste. Even though there are other ways to get your teeth equally clean and fresh-feeling, SLS is in there because the manufacturers have done focus groups and determined people like to feel foam in their mouth while brushing. Unfortunately, some people are unknowingly allergic to SLS; some people’s mouths dry out from the irritant characteristics of SLS; and…AND – canker sores are provenly aggrevated by SLS.

My dentist also recommended that I find a product called Herpetrol, but not the gel. He said the pills will shorten the life of the sores and make your body more resilient to future sores; something about the immune system. BTW that gel “sister” product has most of the same ingredients as the pills, along with pain-relieving and soothing topical offerings but he said what I needed at this point were the pills. Side note: I spent half a day at various drug and food stores in the area, even health food stores, and no one carried Herpetrol tablets. I did find them online, though. Unfortunately I wasn’t able to wait around for shipping so I copied down the ingredients and picked up them individually.

For the record, it’s an antioxidant blend along with high-dose L-Lysine which is an amino acid that your body cannot unfortunately store and keep on hand for canker sore outbreaks. I already take a pretty good assortment of antioxidants via my multivitamin and other food concentrates, but I did buy L-Lysine 500mg tablets and a “B-100 Complex” supplement. To match the Herpetrol, I took 4000mg of Lysine per day and one of the B-100’s.

He advised staying away from acidic and carbonated foods and drinks – basically anything that makes it hurt more means it’s further damaging the tissue area because the pain comes from an inflammatory response. Further, my dentist said it was also important to keep my mouth clean, so brushing my teeth at least twice a day and flossing once was key.

I thanked him very much and before giving him the number for a local pharmacy to call in the Tylenol #3, I asked him if he had ever heard of Aphthasol paste being successfully used to treat canker sores. He said no and asked me more about it. I told him it popped up when I was Googling after two doctors told me there was nothing to do for canker sores. I said that it was new and apparently was a sort of anti-inflammatory and antihistamine blended topical treatment in a base of.. paste. I was pleasantly surprised when he perked up and asked me to read him the entire prescribing information with all of the medical jargon that’s provided for doctors’ consideration when treating patients. He thanked me for letting him know about a treatment that could potentially help his other patients, and said this drug definitely had potential. He would call this in right away for me. Side note: He initially prescribed a 5gm tube of the generic (amlexanox 5%) but it turned out the manufacturers stopped producing 5gm tubes and only offer 3gm. Also there is no generic; it’s still brand-name only. But it was only $25. This stuff works. It’s a little messy and confusing to get applied the right away, but after a few tries you get the hang of it.

  • You dry the sore area and put a tiny dab of the paste on your slightly-moistened finger and then press it on the sore. That’s it. Do it a few times a day, doesn’t matter if you swallow it etc.
  • I determined that the finger route was not going well for me and because of the odd location of some of the sores, cutting the “head” off a Q-tip and gently using the remaining “stick” as the “finger” worked a ton better.

Now, on to the virus issue. That boggled me a bit because I was always under the impression that cold sores were: a) outside the mouth, b) caused by a virus; and canker sores were: a) inside the mouth only, b) never caused by a virus. Turns out that if canker sores are overly painful or constantly recurrent, while it’s unlikely that they’re CAUSED by a virus, in those cases it’s probable that a virus is inhibiting the body’s natural resources used to kill them off. And it’s actually the same virus that causes cold sores: herpes.

So there’s a gel called Zovirax that you can apply to the canker sores a few times a day, and again no worries if you swallow. HOWEVER, that gel is brand-name only and costs about $175 if you don’t have insurance. That was WITH my prescription discount card. I believe the full retail was like $250 for a tiny tube. Needless to say, I asked about an oral version. The pharmacist said there was a generic Zovirax (Acyclovir) to be taken orally and the only thing to consider is that tablets might take longer to get the mouth problem under control since they go through your entire blood stream, and also taking oral antivirals can cause more side effects than just using a topical gel. But he called my dentist and asked if switching to capsules would be okay. They discussed dosage instructions and he finally agreed. 400mg 3x per day for 7 days. Basically taken like an antibiotic: make sure you finish it even if you feel better. I guess it’s primarily used for genital herpes and shingles, believe it or not.

Now, when I got back home I *DID* go in for the laser procedure. I did NOT, however, think to ask about the price. It was $52 for the office visit plus $98 per “area” he needed to “laser”. I had 3 areas so the grand total was about $350. Oh well, I figured, I spent that much at the mall on vacation so why not. It was interesting, too, because he doesn’t do this procedure often so his entire staff was in the room wearing special goggles and observing his every move. It was like on House when they’re in the observation room. But I digress.

The laser is switched to 3 different frequencies of light and with each different frequency the wand is held at different lengths from the sore areas. It disinfects in numerous ways, killing all bacteria, viruses, and any other foreign microbes.

He sent me home with some Vicodin for the still-there pain, and also a prescription mouthwash that you rinse with twice a day. It’s called Peridex and it wipes your mouth seriously clean, then attaches itself to the tissue in your mouth and sort of “time releases” itself throughout the day so you have continual benefit. It’s used a lot for periodontal disease, he said. The only negative is that it makes your mouth feel kinda tingly, and my tongue actually went numb for the first couple of times, making it impossible to taste anything I was eating. It can also temporarily stain teeth brown if used for a long period of time – the pharmacist said that isn’t likely unless you use it for months and months without a break, and even then your dentist can remove the stains at an annual cleaning. It’s actually on the $4 generic list as chlorhexidine at most pharmacies now so that was great.

Since I was doing so much to get this canker sore problem under control, it’s hard to say what ultimately was responsible for its dormancy.. but I wanted others to know that there ARE treatment options out there. I only wish one of my doctors would have stumbled on a blog like this during our talk.

17 Responses to “Canker Sore Cures That My Doctor Didn’t Know About”

  1. Aidan Esme

    What a G-R-E-A-T resource! I am actually sending this to my doctor. THANK YOU!

    Reply
  2. Carter C.

    This post came up when I googled fish oil vs krill oil. Anyway I have been taking fish oil for awhile and was considering a change after seeing MegaRed on the shelves and after hearing dozens of weekend radio programs spamming my eardrums with their krill oil claims. My family doctor had no idea what krill oil was either by the way! so after paying my $30 office visit co-pay at my most recent physical, I decided to just go for it. I ordered my first bottle of MegaRed with your discount link, wish me luck.

    Reply
  3. dan
    • The Wise Guys

      That’s a good question. I’ll reach out to their Media Affairs department and ask. I’m happy to see that more companies are finally jumping on the krill oil bandwagon. Their product is 1000mg per softgel which is great. However the omega-3/phospholipid/astaxanthin ratio seems a little off for that dosage, so it may be a custom blend or one of the lesser known sources. I’ll let you know what they say. BTW here’s more info on the product in question: http://www.naturesbounty.com/VF/LABELS/L013123-NB.PDF

      Reply
  4. The Wise Guys

    They wrote me back, but they are being cryptic. Here is their response: “The Krill Oil is from Antarctica. Our supplier is proprietary information.”

    I have asked them for clarification, and also asked them why their source would be proprietary when other major brands happily disclose their supplier. It makes you wonder.

    Reply
  5. The Wise Guys

    Here is the latest. I think this is as far as we will get.:

    “Thank you for contacting Nature’s Bounty. Our Krill Oil does not use any of these registered trade mark names that you mentioned. The krill are from Antartica. Our Quality Control and Quality Assurance programs are internally and independently audited to ensure top quality products and that our performance measures are continually met. Our Quality Assurance professionals monitor manufacturing and packaging processes to ensure product integrity, purity and accuracy of contents. Our Quality Control laboratory employs degreed and qualified chemists who test our raw materials and finished products to ensure that they meet our stringent specifications for consistency and quality of product. We endeavor to conform to the United States Pharmacopeia/National Formulary (USP/NF) requirements, which are industry standard for purity and testing. If a USP/NF procedure does not exist for a product, other published referenced works are consulted, such as the European Pharmacopeia, etc. Our products are subject to rigorous testing before, during and after manufacture, including analysis by High Performance Liquid Chromatography, Gas Chromatographs, Fourier Transform Infrared Spectroscopy, Thin Layer Chromatography, Ultraviolet/ Spectrophotometry, wet analysis and Near Infrared Spectrophotometry.

    Additionally, the FDA recently enacted Good Manufacturing Practices (GMPs) for the dietary supplement industry. These regulations define standards for manufacturers of dietary supplements and require manufacturers to evaluate the identity, strength, purity and composition of their products.”

    Reply
  6. A Friendly Visitor

    You should consider taking the whole food version instead of the L-Lysine supplement. In a good quality pea protein powder called AIM ProPeas 749mg of actual Lysine is included per serving (8oz prepared protein shake). What is the difference between Lysine and L-Lysine? The “L-” version refers to the amino acids L-Structure of the Lysine molecule. You see, L-Lysine has been identified to be the active ingredient, if you will, and is just a portion of the whole Lysine compound that is isolated and put in pill form. But it takes your body an extra step to process and absorb its benefits. In the pea protein powder I mentioned, you get the entire package, and thus your body will better recognize and utilize the substance. You can read the full information on ProPeas at http://www.chrisbyrnes.com/propeas.

    Reply
  7. SMB

    Swish coconut oil around. Spit it out, don’t swallow

    Reply
  8. Andrea

    Listerine also helps – swish with it and let it soak in a bit, then put Kanka on. Otherwise, just time heals canker sores. It’s an autoimmune response to stress of some sort, usually.

    Reply
  9. Tammy

    Great info!! Another thing to note is that frequent canker sores can be an indication of a food allergy like celiac disease or Crohn’s Disease.

    Reply
  10. b.a.

    The only thing that helps me is Percocet, Lidocaine rinse and a day off work because I talk on the phone for a living and if I even move my mouth one bit when I have a canker sore it is death. Seriously.

    Reply
  11. Andy Smith

    hey all. advice on aphthasol paste that i picked up from my pharmacist. pack it in there. it can feel gritty and crumbly but take a nice heap and really lay it on the sore like it was plaster on a hole in the wall. pack it on tight and hold it there until it shapes into a form when you let go. it will feel weird, hurt, and then after 5 minutes you can let whatever is going to happen, happen. so if its going to break off and only pieces remain on the sore and the rest you swallow thats fine. but as long as it got complete coverage for at least a few solid minutes youve let it do its job. itll knock out the inflammation and prevent the sore from growing. i do it 6 times a day in combo with lidocaine and vicodin extra strength. i hadnt heard of l-lysine before and i wanted to try it before i posted here. you guys ROCK for putting me on to l-lysine and ive done research on it too now. there ARE clinical studies backing up l-lysine for both cold sores and canker sores and for canker sores in a major university double blind study only 1 patient out of 428 didnt see a remarkable improvement in their canker sore symptoms and healing time. thats pretty impressive!

    Reply
  12. tara

    i have been suffering with cankersores for the past 25 years! They are awful, I cannot describe the pain enough to someone who has never had them. I’ve tried everything over the years, talking with a mouthful of them is torture!
    My “eye dr” of all people told me a few months ago to oil pull with virgin, organic, cold pressed coconut oil for 15 minutes per day, amazing! I seriously can never thank him enough. Although, I still get them here & there, they are no where near as painful, my headaches have all disappeared as well. I think the coconut oil soothes my mouth, and doesn’t cause the pain from being all dry. I also brush with Toms of Maine, non SLS natural toothpaste, other then that, I really haven’t changed much, my cankersores are 95% better!!!!!

    Reply
    • The Wise Guys

      For those who aren’t familiar, can you explain what pulling is and how to do it? 🙂

      Reply
      • Tong

        Oil pulling or oil swishing is a folk remedy where oil is “swished” (kavala graha) or “held” (snigda gandoosha) in the mouth. Practitioners of oil pulling claim it is capable of improving oral and systemic health, including a benefit in conditions such as headaches, migraines, diabetes mellitus, asthma, and acne, as well as whitening teeth. Its promoters claim it works by pulling out toxins, which are known as ama in Ayurvedic medicine, and thereby reducing inflammation.

        Reply
  13. Tong

    I’m pleased I found this article, really. I have one question, if that’s okay. I am prone to canker sores but also have very sensitive teeth. The SLS-free toothpastes I’ve seen so far are not for sensitive teeth. Sensitive teeth toothpastes contain the ingredient Potassium. Thanks.

    Reply
    • The Wise Guys

      You’re right, there aren’t many visible options on the mass market for SLS-free Sensitive Teeth formulations of toothpaste. Tom’s of Maine has one that a lot of people seem to like. Here’s a snippet of their marketing of it:

      “Natural Sensitive Care SLS-Free Antiplaque Toothpaste for Sensitive Teeth Wintermint Using potassium nitrate, a naturally occurring, clinically proven active ingredient, we have formulated this toothpaste to help soothe the pain of sensitive teeth. We also use the natural ingredient glycyrrhizin (from purified licorice root) to create a patent-pending natural foaming experience for ingredient dispersal without SLS. Glycyrrhizin needs no additional processing and is gentle on gums. SLS-free: The foaming properties of glycyrrhizin replace the need for SLS (which may, for some people, occasionally be irritating) or an SLS alternative. Reduces sensitivity: We use clinically proven potassium nitrate, a naturally ocurring mineral, to reduce tooth sensitivity. Soothing brushing experience: We’ve added xylitol (from birch trees or corn), gentle glycerin, and organic aloe for their soothing properties. Mild natural flavor: Delicious natural flavor oils leave your mouth feeling clean and fresh.

      Except for Tom’s of Maine Natural Sensitive Care SLS-Free Antiplaque Toothpaste, all sensitive toothpaste products on the market today contain a synthetic form of potassium nitrate. The potassium nitrate is chemically synthesized from nitric acid, ammonia, natural gas and soda ash/potash. In our search for a more minimally processed alternative to this synthetic potassium nitrate, we have found a naturally derived source of potassium nitrate – a natural, technical grade that has been recrystallized and purified to meet pharmaceutical quality standards. In our production process, natural deposits of sodium nitrate known as caliche ore mined in Chile are combined with potassium chloride concentrated from natural brines in solar evaporation ponds, where the potassium nitrate naturally crystallizes from the solution.”

      There must be cheaper prices, but here’s its Amazon link. Supply and demand, I’m sure. http://www.amazon.com/Toothpaste-Sensitive-SLS-free-AntiPlaque-Wintermint/dp/B0010Y5CMG/ref=as_sl_pd_tf_sw?&linkCode=wsw&tag=wyjefasi-20

      Reply

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