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Complex Canker Sores: What They Are and How To Treat Them

complex canker sores


Regular canker sores are bad enough, but complex canker sores are even worse. Unlike standard canker sores that cause annoying — but manageable — discomfort, complex canker sores become debilitating over the span of weeks or even months.

If you’re frequently bothered by canker sores that make eating, drinking and even talking difficult, you may have recurring complex canker sores. Here’s what you should know about identifying and treating these painful mouth ulcers.

What Are Canker Sores?

Regular canker sores, or aphthous ulcers, are shallow white lesions with inflamed pink borders that occur inside the lips and mouth. The sores are typically 1-4 mm in size, but aggressive sores can be larger than 5 mm. 

Though they’re often confused with cold sores, canker sores are not contagious or caused by a virus. They do cause irritating pain in the mouth and can take weeks to heal, even with traditional therapies. 

How To Spot a Complex Canker Sore

The most obvious difference between a regular canker sore and a complex canker sore is the size. Regular canker sores are only a few millimeters in size, while complex canker sores spread to 5 mm or more. 

Complex canker sores also tend to take longer to heal. Instead of healing on their own over the span of one or two weeks, complex canker sores continue to create pain and discomfort for up to six weeks at a time.

It’s also important to know that complex canker sores may be accompanied by other seemingly unrelated symptoms, such as:

  • Fever
  • Swollen lymph nodes
  • Lethargy

These complications indicate that your complex canker sores aren’t just an oral health issue; they’re signs of a more serious underlying problem that needs to be addressed. 

What Causes Complex Canker Sores?

In most cases, complex canker sores develop as a complication of an underlying health issue or disease. Only your doctor can determine the underlying condition responsible for triggering your painful mouth ulcers. 

Autoimmune Diseases

Your immune system is designed to work with your body to protect against foreign invaders, but for people with autoimmune diseases, that’s not always what happens. 

Celiac disease, for example, is a severe autoimmune disease that causes the body to attack the small intestine when gluten is introduced. The damage these attacks cause interferes with the body’s ability to absorb essential nutrients. Over time, untreated celiac disease creates serious health complications, including numerous oral health issues like complex canker sores, enamel defects and excessive tooth decay. 

Other autoimmune diseases linked to complex canker sores include inflammatory bowel disease, lupus and Behcet’s disease. 

Vitamin or Mineral Deficiencies

Vitamins and minerals such as iron, zinc, folic acid, and vitamins B1, B2, B6, B12 and C are fundamental to your core health and wellness. Untreated nutrient deficiencies are known to contribute to canker sore development. 

Zinc, for example, is an essential trace element that the body needs in small doses each day to properly function. Though zinc doesn’t receive a great deal of attention as a nutrient, it actually supports hormone production, immunity and digestion.

Fortunately, zinc is readily available in most multivitamins and mineral supplements. You can also obtain zinc from high-protein foods, grains and legumes. With proper levels of zinc, antioxidants in the body can work in full force to fight free radicals and protect the body from diseases. 

Food or Oral Care Allergies

A severe allergic reaction to specific foods or oral care products may also trigger complex canker sores. 

Toothpaste and mouthwash products containing sodium lauryl sulfate (SLS) are especially notorious for irritating the mouth. SLS is a “surfactant” that produces cleansing and foaming action. Though the The United States Food and Drug Administration (FDA) claims SLS is safe, thousands of studies associate SLS with skin irritation and organ system toxicity.

complex canker sores

Treatment Options for Complex Canker Sores

Treating your complex canker sore outbreak involves two steps.

  1. Take action to reduce your immediate pain and discomfort.
  2. Make an appointment with your doctor to identify the underlying cause of your complex canker sores.

For the first step, try some of the following remedies that often help relieve regular canker sore pain. Keep in mind that since complex canker sores are larger and more aggressive than regular canker sores, the treatments may not work with the same efficacy. 

Mouth Rinses

Antimicrobial rinses reduce the number of bacteria and microbes in the mouth, which can protect the gum tissue from canker sores in the future. The deep cleaning effect of antimicrobial rinses can also control plaque and prevent canker sores from becoming aggravated by excess bacteria. 

Rinses such as Listerine, Peridex and Periogard are all popular options for people vulnerable to frequent canker sore outbreaks. 

Oral Medication

Though no available pharmaceutical medications treat canker sores, you can try over-the-counter oral medications like ibuprofen, acetaminophen or naproxen to alleviate your discomfort. Zinc throat lozenges may also help reduce canker sore symptoms. 

Topical Analgesics

Over-the-counter topical anesthetics like benzocaine (Kank-A) and Orajel provide safe, temporary numbing of painful sores. You can apply these local anesthetics several times a day to relieve discomfort. 

Natural Remedies

Milk of magnesia, best known by the brand name Maalox®, can be blended with Benadryl® or another antihistamine to alleviate canker sore pain. Milk of magnesia is an antacid that coats your canker sore to prevent irritation, while the antihistamine treats inflammation and creates a sedative effect. 

The Luminance RED

The Luminance RED is specifically designed for treating canker sores and other ulcers in your mouth. This therapy harnesses powerful, medically optimized light to shorten healing time and decrease the frequency of canker sore outbreaks.  

Tips for Preventing Complex Canker Sores From Recurring

The only thing better than a fast-healing canker sore is a canker sore that never develops at all! In addition to seeing your doctor, use these tips to help avoid future complex canker sore outbreaks:

  • Avoid acidic foods like citrus fruits and tomatoes
  • Improve your sleep habits
  • Try new stress management techniques
  • Start taking daily vitamins
  • Improve your dental hygiene

When you combine your doctor’s expert advice with small yet powerful lifestyle improvements, you make it possible to manage and prevent complex canker sores in the future.

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