Q: Dr. B,
I have been plagued with canker sores my entire life. What can I do to prevent them? What causes them? When I do get them, how can I get them to be less painful?
A: Canker sores, for some, are a constant issue that is difficult to prevent and tiresome. Typically, they appear when you’re tired, stressed, and malnourished. Large doses of sun and alcohol consumption can also be culprits. Within the last few years, there have been studies indicating that sodium lauryl sulfate (SLS) can predispose one to canker sores.
A commonly overlooked reason for canker sores is mechanical in nature. A rough spot on a night guard, denture, orthodontic retainer, or Invisalign aligner can be the impetus for the formation of the sore. I’ve actually seen instances where a sharp edge of a tooth (created by grinding) will incite a canker sore in the exact same location of the tongue or cheek. This, of course, is easy to identify and fixed by smoothing down the tooth.
If the canker sore appears in the same spot each time, see your dentist, and have him identify any sharp areas that mechanically abrade that area and have her round or smooth the sharp spot on the tooth.
Here’s the fix
- Sleep eight hours a night
- Manage your stress
- Eat well
- Take vitamins (especially the B’s)
- Drink less alcohol
- Do not use products in your mouth that contain SLS
Many of my patients balk at the notion that canker sores may be related to alcohol consumption. I don’t ask my patients to stop drinking alcohol, but one can titrate in order to find the amount of alcohol that triggers a canker sore. This may take a few Friday and Saturday nights of going out, but you’ll have fun experimenting!
Mark Burhenne DDS
Mark Burhenne DDS is a family dentist and award-winning blogger who has written numerous articles on oral health and advised 
{ 4 comments… read them below or add one }
I have been suffering from canker sores most of my life. After reading this article I pitched my Crest toothpaste and bought sls free toothpaste (Rembrandt Canker Sore). My canker sores almost immediately went away and they have not come back. I must have a chemical sensitivity to sls or something?
I have had the same experience. I have had Canker Sores my entire life. It is genetically embedded in our family DNA. I found a similar article about SLS. I found Berts Bees Natural Toothpaste that is SLS free and I have been doing very well. Have only had two canker sores since. One was because I was out of town and used a small amount of Crest at the hotel and got a canker sore the next day. I am working on notifying my family about this.
A treatment that works well for me when I do have a canker sore is a prescription product called Debacterol. It has been a lifesaver.
I have had dentures for 60 years and many canker sore outbreaks. I treat it with pure glycerine, it heals it overnight at the first symptom. Just pour a little in the denture and put it back. Inexpensive and sugary sweet.
Ditching crest toothpaste was one of the best things I’ve done. I went from Crest to using Tom’s, and haven’t had Canker sores since!