Do you ever get sores in your mouth that seem to appear for no reason and then disappear just as mysteriously? Chances are they’re aphthous ulcers — better known as canker sores.

These are irritating breaks in the protective lining of the mouth (oral mucosa) — akin to a blister without its dome — that are yellowish/grayish in the center surrounded by an aggravated red border. They typically develop in movable, thinner oral membranes such as the cheeks and lips, under the tongue, or the soft palate at the back of the mouth. Because they expose underlying tissues, canker sores can be quite painful, especially when eating or drinking.

Recurrent aphthous ulcers (RAS) affect up to 25% of the population, making them one the most common oral conditions. They are considered “minor” when they are smaller and “major” when they exceed 1 centimeter in diameter. Larger ones take more time to heal and may cause scarring. A less common type is herpetiform aphthae, so named because the small clusters of ulcers that characterize it are similar in appearance to those caused by the herpes simplex virus (HSV1). However, unlike herpes-related cold sores and fever blisters, canker sores in any form are not contagious. Another difference is that ulcers from the herpes virus occur more frequently on the gums and hard palate.

No Clear Cause

There is no clear cause for canker sores. They often appear during stressful periods and times when resistance is down, suggesting an immune system malfunction. They may also be an allergic reaction to ingredients in food or oral products like toothpaste or mouthwash or related to an underlying medical conditions such as gastrointestinal diseases or nutritional deficiencies.

Canker sores usually resolve on their own within seven to ten days. Various over-the-counter and prescription treatments can help facilitate healing and help minimize pain along the way. If they do not resolve within two weeks; or they increase in severity, frequency or duration; or you’re never without a mouth sore it’s important to seek dental or medical attention as they could signify a more serious condition.

If you would like more information about canker sores, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “Mouth Sores.”

When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?

For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.

Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.

Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:

• It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
• A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
• Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
• Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!

Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!

If you would like more information about flossing and oral hygiene, contact us or schedule an appointment for a consultation.