How to beat debilitating canker sores; a personal guidebook

For the past decade, I’ve been in an on-going battle with canker sores. I had my first major outbreak about 10 years ago this month (20+ ulcers lining my mouth and tongue) and had no idea what caused them, how to fight them or how to restructure my diet to make sure they didn’t get worse.

Since then, I’ve continued to get outbreaks consistently (probably 5–8 per year). Thankfully, none have been as bad as the first, but they are still very painful and can cast a grey cloud over life when they’re at their peak. To try and help, I’ve received advice from countless medical doctors, natural doctors, acupuncturists, dentists, oral surgeons, friends, family and websites. Despite all this advice, I haven’t found a definitive way to keep my cankers sores away. However, by compiling the best advice, I’ve been able to reduce the number of outbreaks to 2–3 per year and have greatly reduced the intensity of them.

One thing that’s been incredibly frustrating throughout my entire experience with canker sores is the lack of knowledge on the subject. It’s 2020 and we can’t pinpoint what causes outbreaks or how they can be cured. My goal here is to share what works for me and hopefully help others who experience debilitating canker sores as well.

Before continuing, I want to make this clear; I am not a doctor. Please consult your doctor, dentist or oral surgeon before following any of my advice.

Throughout this guide, I mention two types of sores - minor and major. I determine the intensity of my sores using what I call a “tongue mobility test.” It’s pretty simple; if you can use your tongue to rub the inside and outside of your teeth and gums without much pain, you have minor sores. If you can’t reach part of your mouth or apply pressure to part of your mouth using your tongue without extreme pain, you likely have major sores. For major sores, I would recommend visiting a doctor, dentist, or oral surgeon as soon as possible. There are prescriptions I list below that have been a huge help for me.

The do’s and dont’s of MINOR canker sore treatment

Do:

• Cover the impacted area with alum for 30–60 seconds and rinse thoroughly (do not swallow alum). Alum dries out the sores which has proven to be effective for me. Repeat 3–5x per day.
• Wash your mouth with warm salt water after each meal and before bed. I use roughly a quarter cup of lukewarm water and a large spoonful of salt, then rinse for 30 seconds.
• Get lots of rest (8+ hours of sleep per night if possible)
• Exercise

Do not:

• Eat foods that provoke canker sores (see list below)
• Use toothpaste containing sodium lauryl sulfate (check the inactive ingredients list on your toothpaste. This stuff is pure poison for people who are prone to canker sores. Avoid this even when you don’t have an outbreak)
• Drink alcohol
• Smoke or vape
• Put yourself in stressful situations (if possible)

The do’s and dont’s of major canker sore treatment

Do:

• See a doctor, dentist or oral surgeon
• If possible, ask for a prescription of Chlorhexidine Gluconate 0.12% Oral Rinse. During major outbreaks, I use this before bed and after breakfast and it’s been very effective at expediting the healing process. You can’t eat or drink for an hour after using this rinse, so plan accordingly. Ask for the blue kind and not the green; it doesn’t stain your tongue as bad.
• For the most persistent and severe cases, ask about a prescription of Doxycycline (or a similar antibiotic). This is not to ingest, but instead, dissolve in 15ml of water, rinse for 2 minutes (which seems like a long time) and spit out. Doing this 4x per day for 5 days has shown tremendous results and starts to curb the pain of severe sores within the first 24 hours
• If the pain is unbearable, ask for a prescription of oral, viscous lidocaine. It won’t help with the healing process, but it can help with pain management.
• Continue to wash your mouth with warm salt water after each meal (I know, this can be excruciating, but keeping your sores clean is VERY important to the healing process.)
• Continue to get lots of rest (8–10+ hours of sleep per night if possible)
• Get light exercise each day. This can be a struggle in the midst of a bad outbreak, but for me, it can help relieve the stress of so much pain.

Do not:

• Eat foods that provoke canker sores (see list below)
• Use toothpaste containing sodium lauryl sulfate
• Drink alcohol
• Smoke or vape
• Put yourself in stressful situations (if possible)

As a very last resort for major outbreaks, a prescription for a steroid pill or gel can generally kill off all sores in 5–7 days. However, these can weaken your immune system and shouldn’t be used frequently. Because of this and other factors, my doctor has been very hesitant to prescribe these for me so far.

Canker sore food and drink guide

What NOT to eat…

• Spicy foods
• Fruits with high acidity (citrus, strawberry, blueberry)
• “Hot” foods (as defined by Chinese medicine)
• Anything with tomatoes (salsa, ketchup, pasta sauce, etc)
• Crunchy or crispy foods (small bits can aggravate the sores)
• Fried foods
• Bread (again, small bits can aggravate your sores)
• Dairy
• Chocolate
• Foods with lots of sugar or corn syrup

What to eat…

• Plain, soft foods like rice, quinoa, beans, avocado, etc
• Smoothies (my favorite when experiencing an outbreak is a handful of spinach, a handful of fresh mint leaves, ~2 cups almond milk, 3 dates, 2 bananas and a healthy scoop of peanut butter)
• Peanut butter or other nut butters (smooth, no chunks)
• Plainly cooked fish
• Soup (no tomatoes or food listed above, not too warm)
• Watermelon slush (blend watermelon, mint leaves and ice. Watermelon and mint are both cooling foods and are a lifesaver for canker sores)

What NOT to drink…

• Alcohol
• Coffee
• Very warm liquids
• Soda or other sugary drinks
• Milk (or other dairy products)

What to drink…

• Water
• Ice water (cold is good for canker sores)
• More water (lots of it; stay very hydrated!)
• Iced tea (if you need a caffeine fix like me. Watch out for the dozens of sugary iced tea drinks out there)

Nutritional supplements

To help keep my immune system strong, I met with a nutritionist who has recommended a few supplements that help with canker sores. I’ve been on this nutrition plan for about 8 months and have only had one major outbreak since (I previously had one every 1.5–2 months). For all supplements, I buy the brand Biotics. They’re available on Amazon and from what I’ve seen, offer some of the highest quality supplements available.

When I have no sores…

• 6 lysine capsules daily
• 1 pill of B12 daily
• 5 drops vitamin D daily

In the midst of an outbreak…

• 20 lysine capsules daily
• 1 pill of B12 daily
• 5 drops vitamin D daily

Things I’ve tried that do not work for me

There’s no shortage of advice on treating canker sores and over the years, I’ve tried almost anything you can think of. The list below is treatments that have proven ineffective for me. I’m not saying they can’t work for others, but I’ve had no luck.

• Milk of magnesia
• Placing salt directly on the sores
• Rinsing with an over the counter mouthwash (like Listerine)
• Canker sore healing patches
• Orajel
• Aloe vera
• Hydrogen peroxide
• Watermelon powder
• Placing used tea bags on the sores

Canker sores are weird, and these methods may not work for everyone. But, hopefully this guide can be helpful for someone who suffers from these stupid sores like me. Please feel free to comment with other advice that works for you; I’m always willing to try new methods.