Canker Sores, also known as recurrent aphthous stomatitis, are sores that appear in the mouth when the immune system is weakened.

Canker Sores occur in up to 25% of the population and are common in young adults. They are classified as minor (less than 10 mm/1/3 inch and last 3-14 days), major (greater than 1 cm/1/3 inch and last for 3-6 weeks) and herpetiform (consisting of many small lesions clustered together to form larger irregular ulcers).
Canker Sores are quite painful. The cause is unknown, but they usually appear with one of the following:
- Infection.
- Hormonal disorders such as PMS or pregnancy.
- Stress.
- Trauma to the mouth.
- Food allergies or reactions to acidic foods (such as pineapple, tomato and chilli).
- Deficiencies of iron, vitamin B1, calcium and vitamin C.
- Some medications.
- Helicobacter pylori, the bacteria that causes peptic ulcers.
- Inflammatory bowel disease, such as Crohn's disease and ulcerative colitis.
- Coeliac disease (gluten intolerance).
- HIV/AIDS or other immune deficiency diseases.

There is no permanent cure for Canker Sores. Treatment can reduce pain and clear up the sores, but they will often recur.
- Rinse the mouth with a solution of 1/2-teaspoon salt dissolved in 1 cup of warm water.
- Your Doctor may prescribe topical steroid creams.
- Mouthwashes with local anaesthetic may help reduce pain.
- Avoid anything that could cause irritation to the mouth, such as hard toothbrushes, hot drinks or spicy, acidic foods.
- Chew slowly and carefully, without talking.

1) See your Dentist to repair any damage to your teeth.
2) Ask your Pharmacist if your medications may be triggering the canker sores.
3) If diet is inadequate, supplements may be beneficial.
4) Your Pharmacist can recommend mouthwashes containing local anaesthetic (e.g lidocaine) to ease the pain.
5) If an underlying infection or disease is present, see your Doctor for treatment.

A nutritious diet can boost the immune system and reduce the recurrence of Canker Sores. Diet should be high in vitamin E, calcium, vitamin B1, iron and water.
- Vitamin E sources include wheat germ, nuts and soy products.
- Calcium sources include dairy products, spinach, sunflower seeds and sardines.
- Vitamin B1 (thiamine) sources include whole grains, sunflower seeds, seafood and beans.
- Iron sources include red meat, green leafy vegetables and legumes.
- Drink plenty of water (8 glasses per day) to prevent the mouth from drying out.

- Vitamin supplements may be of benefit if the diet is inadequate. Vitamin B1, vitamin E, calcium and iron supplements are recommended for Canker Sores.
- Vitamin C is highly recommended, as many dietary sources must be avoided due to their acidic content.
- Liquorice may help reduce Canker Sores. Ensure you use pure Liquorice, as Liquorice-flavoured lollies does not have the active ingredients.