Painful Canker Sore? Why Your Mouth Is Inflamed & Medically Approved Next Steps

A canker sore can make something as simple as eating, drinking, or talking feel surprisingly painful. If you have a tender, round sore inside your mouth, you're not alone. Canker sores—also called aphthous ulcers—are very common and usually harmless. But they can be uncomfortable, and in some cases, they may signal an underlying issue that deserves attention.

Here's what you need to know about why your mouth may be inflamed and what medically approved steps you can take next.

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What Is a Canker Sore?

A canker sore is a small, shallow ulcer that forms on the soft tissues inside your mouth. Unlike cold sores, canker sores:

• Appear inside the mouth (tongues, cheeks, lips, soft palate, or gums)
• Are not contagious
• Are not caused by the herpes virus

They typically look like:

• A round or oval sore
• White, yellow, or gray in the center
• Surrounded by a red border
• Tender or painful, especially when eating acidic or spicy foods

Most canker sores heal on their own within 7 to 14 days.

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Why Is Your Mouth Inflamed?

A canker sore forms when the lining of your mouth becomes damaged or irritated. The exact cause isn't always clear, but research has identified several common triggers.

1. Minor Injury

Small injuries can lead to inflammation and ulcer formation. Common causes include:

• Biting your cheek or tongue
• Dental work
• Braces or sharp tooth edges
• Aggressive brushing

Even minor trauma can trigger a canker sore in sensitive individuals.

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2. Stress and Fatigue

Emotional stress and lack of sleep can weaken your immune response. While stress does not directly "cause" a canker sore, it may make you more prone to developing one.

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3. Nutritional Deficiencies

Low levels of certain nutrients are associated with recurrent canker sores, including:

• Vitamin B12
• Folate
• Iron
• Zinc

If you experience frequent sores, your doctor may recommend blood work to check for deficiencies.

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4. Food Sensitivities

Some foods can irritate the lining of your mouth and trigger inflammation:

• Citrus fruits
• Tomatoes
• Spicy foods
• Chocolate
• Coffee
• Nuts

Toothpastes containing sodium lauryl sulfate (SLS) may also contribute in some people.

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5. Hormonal Changes

Some people, especially women, notice canker sores during hormonal shifts, such as menstruation.

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6. Underlying Medical Conditions

Occasionally, recurrent or severe canker sores may be linked to:

• Celiac disease
• Inflammatory bowel disease (Crohn's disease or ulcerative colitis)
• Behçet's disease
• Immune system disorders

If your sores are frequent, large, or slow to heal, it's important not to ignore them.

If you're experiencing persistent mouth inflammation and want to understand your symptoms better, Ubie's free AI-powered Stomatitis symptom checker can help you identify potential causes and determine if you should seek medical care.

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Types of Canker Sores

There are three main types of canker sore:

1. Minor Canker Sores (Most Common)

• Small (less than 1 cm)
• Heal within 1–2 weeks
• Do not scar

2. Major Canker Sores

• Larger and deeper
• More painful
• May take several weeks to heal
• Can leave scars

3. Herpetiform Canker Sores

• Clusters of dozens of tiny ulcers
• May merge into larger sores
• Not related to herpes

Major or herpetiform sores warrant medical evaluation.

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Medically Approved Next Steps

Most canker sores resolve without prescription treatment. However, you can take steps to reduce pain and support healing.

✅ 1. Protect the Area

• Avoid spicy, acidic, or salty foods
• Choose soft foods
• Use a soft-bristled toothbrush
• Switch to SLS-free toothpaste if prone to sores

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✅ 2. Reduce Pain

Over-the-counter options may include:

• Topical numbing gels (benzocaine or lidocaine)
• Protective pastes that coat the sore
• Antiseptic mouth rinses

These don't cure the canker sore, but they can make daily life more comfortable.

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✅ 3. Support Healing

Your doctor may recommend:

• Topical corticosteroid gels (for inflammation)
• Prescription mouth rinses
• Nutritional supplements (if deficiencies are identified)

Do not use steroid treatments without medical guidance.

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✅ 4. Address Underlying Causes

If canker sores are frequent (more than 3–4 times per year), unusually painful, or accompanied by other symptoms (like digestive issues or fatigue), it's time to investigate further.

A healthcare professional may:

• Order blood tests
• Review your diet
• Evaluate for immune-related conditions
• Refer you to a specialist if needed

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When Should You Be Concerned?

Most canker sores are mild. However, you should speak to a doctor promptly if you experience:

• A sore lasting longer than 3 weeks
• Severe pain that prevents eating or drinking
• High fever
• Swollen lymph nodes
• Very large or spreading ulcers
• Frequent recurrences
• Unexplained weight loss
• Sores accompanied by joint pain or digestive symptoms

While rare, persistent mouth ulcers can occasionally signal more serious conditions, including oral cancer. That does not mean your sore is dangerous—but if something is not healing, it should be evaluated.

Do not ignore symptoms that feel different from your usual experience.

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What Not to Do

When dealing with a canker sore, avoid:

• Picking at the sore
• Using alcohol-based mouthwashes (they can worsen irritation)
• Applying aspirin directly to the ulcer
• Ignoring recurring patterns

Home remedies like saltwater rinses may help with comfort, but they are supportive—not curative.

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How Long Will It Take to Heal?

For most people:

• Pain improves within a few days
• Healing occurs within 1–2 weeks
• No permanent damage remains

If your sore follows this pattern, that's reassuring.

If not, medical input is important.

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Can You Prevent Canker Sores?

There's no guaranteed prevention strategy, but you can reduce risk by:

• Managing stress
• Getting adequate sleep
• Maintaining a balanced diet
• Avoiding trigger foods
• Practicing gentle oral hygiene
• Treating underlying health conditions

If deficiencies are found and corrected, recurrence often improves.

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The Bottom Line

A canker sore is a common cause of mouth inflammation and pain. Most are minor, temporary, and heal on their own. Still, they shouldn't be dismissed if they are:

• Severe
• Recurrent
• Long-lasting
• Accompanied by other symptoms

Listening to your body is important.

If you're dealing with mouth sores and aren't sure what's causing them, use Ubie's free Stomatitis symptom checker to get personalized insights about your symptoms and guidance on when professional evaluation may be necessary.

Most importantly, speak to a doctor if your symptoms persist, worsen, or raise concern. While canker sores are usually harmless, persistent mouth inflammation deserves professional evaluation to rule out serious or potentially life-threatening conditions.

Taking action early is not overreacting—it's responsible healthcare.

Your mouth should not stay inflamed indefinitely. If it does, it's time to get answers.