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Health Condition

Canker Sores

  • Aloe

    A gel containing the herbal Aloe vera polysaccharide acemannan may speed the healing of canker sores.

    Dose:

    Follow label instructions
    Aloe
    ×
     

    A gel containing the Aloe vera polysaccharide acemannan was found in one double-blind trial to speed the healing of canker sores better than the conventional treatment Orabase Plain.1 The gel was applied four times daily. Because acemannan levels can vary widely in commercial aloe gel products, it is difficult to translate these results to the use of aloe gel for canker sores.

  • DG Licorice

    Deglycyrrhizinated licorice (DGL) and warm water applied to the inside of the mouth may speed the healing of canker sores. Chewable DGL tablets may have the same effect.

    Dose:

    Mix 200 mg DGL in 200 ml in warm water and swish in mouth several minutes, four times per day
    DG Licorice
    ×
     

    Licorice that has had the glycyrrhizic acid removed is called deglycyrrhizinated licorice (DGL). Glycyrrhizic acid is the portion of licorice root that can increase blood pressure and cause water retention in some people. The wound-healing and soothing components of the root remain in DGL.

    A mixture of DGL and warm water applied to the inside of the mouth may shorten the healing time for canker sores, according to a double-blind trial.2 This DGL mixture is made by combining 200 mg of powdered DGL and 200 ml of warm water. It can then be swished in the mouth for two to three minutes, then spit out. This procedure may be repeated each morning and evening for one week. Chewable DGL tablets may be an acceptable substitute.

  • Probiotics

    Topical and/or oral use of Lactobacillus acidophilus and Lactobacillus bulgaricus may help people with recurrent canker sores.

    Dose:

    Apply powdered culture topically several times daily and orally take 1.5 billion colony-forming units two times daily
    Probiotics
    ×
     

    According to preliminary reports, some people with recurrent canker sores may respond to topical and/or oral use of Lactobacillus acidophilus3 and Lactobacillus bulgaricus.4 However, a double-blind study found no effect of acidophilus bacteria on the healing time of canker sores.5

  • Vitamin B-Complex

    People with recurrent canker sores may have a B vitamin deficiency. Supplementing with vitamins B1, B2, and B6 has been reported to provide relief.

    Dose:

    300 mg B1 daily, 20 mg B2 daily, 150 mg B6 daily
    Vitamin B-Complex
    ×
     

    Several preliminary studies,6,7,8,9 though not all,10 have found a surprisingly high incidence of iron and B vitamin deficiency among people with recurrent canker sores. Treating these deficiencies has been reported in preliminary11,12 and controlled13 studies to reduce or eliminate recurrences in most cases. Supplementing daily with B vitamins—300 mg vitamin B1, 20 mg vitamin B2, and 150 mg vitamin B6—has been reported to provide some people with relief.14 Thiamine (B1) deficiency specifically has been linked to an increased risk of canker sores.15 The right supplemental level of iron requires diagnosis of an iron deficiency by a healthcare professional using lab tests.

  • Zinc

    Zinc deficiency has been linked with recurrent canker sores, so treating the deficiency may lead to relief. Long-term zinc supplementation requires extra copper to avoid deficiency.

    Dose:

    150 mg daily plus 1 to 2 mg of copper per day to prevent copper deficiency
    Zinc
    ×
     

    Zinc deficiency has also been linked with recurrent canker sores in preliminary studies16 and in one case report.17 A preliminary trial found that supplementation with up to 150 mg of zinc per day reduced recurrences of canker sores by 50 to 100%; participants who were zinc deficient experienced the most consistent benefit.18 However, a double-blind trial (that did not test people for zinc deficiency) did not find zinc supplements helpful for recurrent canker sores.19

  • Agrimony

    Agrimony is an astringent herb that can be used as a mouth rinse to soothe the pain of canker sores. The herb contains tannins that can bind up fluids and possibly relieve inflammation.

    Dose:

    Refer to label instructions
    Agrimony
    ×
     

    Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

  • Chamomile

    Chamomile has healing properties and swishing a tincture made of strong tea may have a soothing effect on the lining of the mouth.

    Dose:

    Refer to label instructions
    Chamomile
    ×
     

    Because of its soothing effect on mucous membranes (including the lining of the mouth) and its healing properties, chamomile may be tried for canker sores and other mouth irritations.20 A strong tea made from chamomile tincture can be swished in the mouth before swallowing, three to four times per day. Goldenseal has also been used historically as a mouthwash to help heal canker sores.

  • Cranesbill

    Cranesbill is an astringent herb that can be used as a mouth rinse to soothe the pain of canker sores. The herb contains tannins that can bind up fluids and possibly relieve inflammation.

    Dose:

    Refer to label instructions
    Cranesbill
    ×
     

    Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

  • Echinacea

    The antiviral, immune-enhancing, and wound-healing properties of echinacea may make this herb a reasonable choice for canker sores.

    Dose:

    Refer to label instructions
    Echinacea
    ×
     

    The antiviral, immune-enhancing, and wound-healing properties of echinacea may make this herb a reasonable choice for canker sores. Liquid echinacea in the amount of 4 ml can be swished in the mouth for two to three minutes, then swallowed. This procedure may be repeated three times per day. However, no research has investigated the possible effects of this treatment.

  • Goldenseal

    Goldenseal has been used historically as a mouthwash to help heal canker sores.

    Dose:

    Refer to label instructions
    Goldenseal
    ×
     

    Because of its soothing effect on mucous membranes (including the lining of the mouth) and its healing properties, chamomile may be tried for canker sores and other mouth irritations.21 A strong tea made from chamomile tincture can be swished in the mouth before swallowing, three to four times per day. Goldenseal has also been used historically as a mouthwash to help heal canker sores.

  • Molmol

    Myrrh is a traditional remedy with wound-healing properties that has a long history of use for mouth and gum irritations.

    Dose:

    Refer to label instructions
    Molmol
    ×
     

    Myrrh, another traditional remedy with wound-healing properties, has a long history of use for mouth and gum irritations. Some herbalists suggest mixing 200 to 300 mg of herbal extract or 4 ml of myrrh tincture with warm water and swishing it in the mouth before swallowing; this can be done two to three times per day.

  • Oak

    Oak is an astringent herb that can be used as a mouth rinse to soothe the pain of canker sores. The herb contains tannins that can bind up fluids and possibly relieve inflammation.

    Dose:

    Refer to label instructions
    Oak
    ×
     

    Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

  • Periwinkle

    Periwinkle is an astringent herb that can be used as a mouth rinse to soothe the pain of canker sores. The herb contains tannins that can bind up fluids and possibly relieve inflammation.

    Dose:

    Refer to label instructions
    Periwinkle
    ×

    Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

     
  • Tormentil

    Tormentil is an astringent herb that can be used as a mouth rinse to soothe the pain of canker sores. The herb contains tannins that can bind up fluids and possibly relieve inflammation.

    Dose:

    Refer to label instructions
    Tormentil
    ×
     

    Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

  • Vitamin B12

    Recurrent canker sores might be related to vitamin B12 deficiency, but research has shown that even without deficiency supplementing this vitamin may be beneficial.

    Dose:

    3 to 1,000 mcg daily
    Vitamin B12
    ×

    Several preliminary studies,22,23,24,25 though not all,26 have found a surprisingly high incidence of iron and B vitamin deficiency among people with recurrent canker sores. Treating these deficiencies has been reported in preliminary and controlled studies to reduce or eliminate recurrences in most cases.27,28,29 In addition, a double-blind study found that supplementing with vitamin B12 prevented recurrences even in people who were not deficient in the vitamin.30 The amount used in that study was 1,000 mcg twice a day for six months. Supplementing daily with B vitamins—300 mg vitamin B1, 20 mg vitamin B2, and 150 mg vitamin B6—has been reported to provide some people with relief.31 Thiamine (B1) deficiency specifically has been linked to an increased risk of canker sores.32 The right supplemental level of iron requires diagnosis of an iron deficiency by a healthcare professional using lab tests.

  • Witch Hazel

    Witch hazel is an astringent herb that can be used as a mouth rinse to soothe the pain of canker sores. The herb contains tannins that can bind up fluids and possibly relieve inflammation.

    Dose:

    Refer to label instructions
    Witch Hazel
    ×
     

    Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

References

1. Plemons JM, Reps TD, Binnie WH, et al. Evaluation of acemannan in the treatment of recurrent aphthous stomatitis. Wounds 1994;6:40-5.

2. Das SK, Gulati AK, Singh VP. Deglycyrrhizinated licorice in aphthous ulcers. J Assoc Physicians India 1989; 37:647.

3. James APR. Common dermatologic disorders. CIBA Clin Symposia 1967;19:38-64.

4. Werbach MR. Nutritional Influences on Illness, 2d ed. Tarzana, CA: Third Line Press, 1993, 56 [review].

5. Gerenrich RL, Hart RW. Treatment of oral ulcerations with Bacid (Lactobacillus acidophilus). Oral Surg 1970;30:196-200.

6. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared to other oral disease. Oral Surg Oral Med Oral Pathol 1988;66:41-4.

7. Palopoli J, Waxman J. Recurrent aphthous stomatitis and vitamin B12 deficiency. South Med J 1990;83:475-7.

8. Wray D, Ferguson MM, Hutcheon WA, Dagg JH. Nutritional deficiencies in recurrent aphthae. J Oral Pathol 1978;7:418-23.

9. Barnadas MA, Remacha A, Condomines J, de Moragas JM. [Hematologic deficiencies in patients with recurrent oral aphthae]. Med Clin (Barc) 1997;109:85-7 [in Spanish].

10. Olson JA, Feinberg I, Silverman S, et al. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1982;54:517-20.

11. Weusten BL, van de Wiel A. Aphthous ulcers and vitamin B12 deficiency. Neth J Med 1998;53:172-5.

12. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992;51:14-6.

13. Wray D, Ferguson MM, Mason DK, et al. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975;2(5969):490-3.

14. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med 1991;20:389-91.

15. Haisraeli-Shalish M, Livneh A, Katz J, et al. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:634-6.

16. Pang JF. Relation between treatment with traditional Chinese medicine for recurrent aphthous ulcer and human zinc and copper. Zhongguo Zhong Xi Yi Jie He Za Zhi 1992;12:280-2, 260-1 [in Chinese].

17. Endre L. Recurrent aphthous ulceration with zinc deficiency and cellular immune deficiency. Oral Surg Oral Med Oral Pathol 1991;72:559-61.

18. Merchant HW, Gangarosa LP, Glassman AB, Sobel RE. Zinc sulfate supplementation for treatment of recurring oral ulcers. South Med J 1977;70:559-61.

19. Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72.

20. Nasemann T. Kamillosan therapy in dermatology. Z Allgemeinmed 1975; 25:1105-6.

21. Nasemann T. Kamillosan therapy in dermatology. Z Allgemeinmed 1975; 25:1105-6.

22. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared to other oral disease. Oral Surg Oral Med Oral Pathol 1988;66:41-4.

23. Palopoli J, Waxman J. Recurrent aphthous stomatitis and vitamin B12 deficiency. South Med J 1990;83:475-7.

24. Wray D, Ferguson MM, Hutcheon WA, Dagg JH. Nutritional deficiencies in recurrent aphthae. J Oral Pathol 1978;7:418-23.

25. Barnadas MA, Remacha A, Condomines J, de Moragas JM. [Hematologic deficiencies in patients with recurrent oral aphthae]. Med Clin (Barc) 1997;109:85-7 [in Spanish].

26. Olson JA, Feinberg I, Silverman S, et al. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1982;54:517-20.

27. Weusten BL, van de Wiel A. Aphthous ulcers and vitamin B12 deficiency. Neth J Med 1998;53:172-5.

28. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992;51:14-6.

29. Wray D, Ferguson MM, Mason DK, et al. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975;2(5969):490-3.

30. Volkov I, Rudoy I, Freud T, et al. Effectiveness of vitamin B12 in treating recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled trial.J Am Board Fam Med 2009;22:9-16.

31. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med 1991;20:389-91.

32. Haisraeli-Shalish M, Livneh A, Katz J, et al. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:634-6.

33. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981;26:737-40.

34. Ferguson R, Basu MK, Asquith P, Cooke WT. Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration. Br Med J 1976;1(6000):11-13.

35. Ferguson MM, Wray D, Carmichael HA, et al. Coeliac disease associated with recurrent aphthae. Gut 1980;21:223-6.

36. Hunter IP, Ferguson MM, Scully C, et al. Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy. Oral Surg Oral Med Oral Pathol 1993;75:595-8.

37. O'Farrelly C, O'Mahony C, Graeme-Cook F, et al. Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J Oral Pathol Med 1991;20:476-8.

38. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981;26:737-40.

39. Ferguson R, Basu MK, Asquith P, Cooke WT. Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration. Br Med J 1976;1(6000):11-13.

40. Ferguson MM, Wray D, Carmichael HA, et al. Coeliac disease associated with recurrent aphthae. Gut 1980;21:223-6.

41. Hunter IP, Ferguson MM, Scully C, et al. Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy. Oral Surg Oral Med Oral Pathol 1993;75:595-8.

42. O'Farrelly C, O'Mahony C, Graeme-Cook F, et al. Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J Oral Pathol Med 1991;20:476-8.

43. Chanine L, Sempson N, Wagoner C. The effect of sodium lauryl sulfate on recurrent aphthous ulcers: a clinical study. Compend Contin Educ Dent 1997;18:1238-40.

44. Herlosfson BB, Barkvoll P. Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary trial. Acta Odontol Scand 1994;52:257-9.

45. Herlosfson BB, Barkvoll P. The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand 1996;54:150-3.

46. McCartan BE, Lamey PJ, Wallace AM. Salivary cortisol and anxiety in recurrent aphthous stomatitis. J Oral Pathol Med 1996;25:357-9.

47. Pedersen A. Psychologic stress and recurrent aphthous ulceration. J Oral Pathol Med 1989;18:119-22.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.