You’ve had them. I’ve had them.
Perhaps you’ve even got one now.
They can be extremely painful, and they can interfere with eating and sleeping.
They’re not as dangerous as other conditions, but they can be a real pain in the… mouth.
I’m talking about canker sores, those pesky little lesions that appear out of nowhere on the gums and inner lips, causing pain and swelling.
Canker sores have been nuisances throughout recorded history. The ancient physician Hippocrates wrote about canker sores over 2400 years ago. He gave them the name “aphthae”—and they’re still known as “aphthous ulcers” in medical terms. The condition of having canker sores is called “aphthous stomatitis.”
One thing that may shock you about your mouth is that it’s covered with the same mucous membrane lining as your intestines—and the two are more or less connected through the esophagus.
As a result, it’s common for patients to get irritation of both places at once—and what you do to relieve the pain in one can frequently help with the other.
Over the years, I’ve developed a 4-step protocol to both preventing these painful nuisances from occurring and treating them when they do occur.
And much of it has to do with keeping that mucous membrane as healthy as possible.
Two of the steps are things you need more of… and two of them are things you need to stay away from.
Put these healing agents on your wounds
You need good quantities of several nutrients in order to avoid recurrent aphthous stomatitis, at least in part.
But maintaining the health of the mucous membrane lining is directly associated with one nutrient in particular: zinc.
In fact, healing anything in the body (including the minor injuries incurred by long-distance running) requires good zinc levels in the body. And the major antioxidant enzymes — including glutathione peroxidase (GPx), catalase (CAT) and superoxide dismutase (SOD) — rely on zinc, as well as other trace minerals copper and selenium, as co-factors.
Evidence of the importance of zinc in the healing of canker sores can be seen in several recent studies. In one study, patients with recurrent aphthous stomatitis (RAS) had statistically lower zinc (and selenium) levels than those without RAS. The theory is that the deficiency of zinc and other trace elements lead to lipid peroxidation (oxidative stress), which could contribute to the appearance of RAS.1
Another natural healer of mucous membrane linings, particularly ulcerations, is a substance called deglycyrrhizinated licorice (DGL, which is the compound that’s left when glycyrrhizin is removed from licorice).
Chewable DGL is well-known as a treatment for peptic ulcers and gastritis, and it’s one of my preferences in treating ulcerations of the stomach and small intestine.
DGL was being shown as a treatment for chronic mouth ulcers as far back as 25 years go. In one study, when 20 patients with canker sores were given DGL for two weeks, 15 of them experienced a 50 to 75 percent improvement within ONE DAY.
And their sores were completely healed within three days.2
The power of DGL to heal mucous membrane linings was recently demonstrated in the study of a different kind of oral mucous membrane irritation—one that was caused by radiation therapy for cancer. The condition, called oral mucositis, was treated in a double-blind, randomized prospective trial using steroids in one group and DGL in the other.
Both reduced pain to an equal amount, although the steroid obviously suppresses healing of the tissue.3
What the food in your belly can do to your mouth
Believe it or not, there are some things you may be doing—including what you’re putting into your mouth—that could be giving you canker sores, making them worse, and making them come back.
And as soon as you know what they are, then you can stop doing them.
When a patient comes to me for help with their canker sores, in addition to testing for nutritional deficiencies, I look at what they’re eating and drinking that they might be sensitive or allergic to.
Even 25 years ago, it was recognized that food sensitivities and food allergies are an important cause in patients with recurrent aphthous stomatitis. Now, with the emergence and acceptance of the diagnosis of non-ceoliac gluten sensitivity (NCGS) within much of the medical community, it is becoming more common to recommend avoiding gluten to patients with a variety of inflammatory and chronic conditions, including canker sores.
The most recent demonstration of this was a study published last year, in which even small amounts of wheat significantly increased aphthous stomatitis.4
However, gluten isn’t a solo act when it comes to those painful, inflamed sores in your mouth. Other foods implicated in chronic mouth ulcerations include cow’s milk dairy, citrus, and coffee, among others.
Is your dental hygiene too rough on your mouth?
Finally, there’s something you’re doing AFTER you eat that may, in fact, be the culprit of your mouth sores.
And that, my friend, is brushing your teeth.
You see, there’s a chemical in most toothpastes called Sodium Lauryl Sulfate, or SLS for short, which causes the mucous membranes of the mouth to become porous and leaky, and it can cause irreparable damage to the cells of the gums.
SLS is actually a coarse detergent that’s put in toothpastes (and many other household items) to scrub the tooth enamel. However, it also has a caustic, irritating effect on the gums.
The toxicity of SLS is well researched, with more than 15,000 references available to date—some of which show it to cause skin irritation as well.
Not surprisingly, a number of studies show that you can prevent canker sores by using an SLS-free toothpaste — and, if they’ve already occurred, you can at least significantly reduce both pain and duration of your existing canker sores.5,6,7
Unbelievably, it appears that SLS isn’t even necessary for proper gum and tooth health. It turns out that SLS-free toothpastes are just as effective statistically as the versions that contain SLS.8
4 steps to a canker sore-free mouth
So, preventing and treating cancer sores really boils down to just four simple steps — two DO’s and two DON’Ts — which are amazingly easy and effective.
▶ DO get plenty of nutrients: Since studies have shown that patients suffering from recurrent canker sores are also deficient in the B vitamins (particularly B1, B2, and B6, but also B12).9 I always add B complex vitamins to my cocktail for preventing and treating canker sores. Folic acid, technically a B vitamin, is also necessary for the healing of any mucous membrane lining.
▶ DO use lozenges and chewables: Put zinc gluconate lozenges in your mouth and suck on them until they’re all gone. The canker sore absorbs the zinc, and what it doesn’t absorb is digested and reaches your bloodstream through your digestive tract. There is even some evidence that zinc can help to prevent the damage done by SLS-containing toothpaste! Try also chewing DGL, which enables it to touch the ulcers directly and enhance the healing within minutes.
▶ DON’T use toothpaste containing SLS: Stop any future damage in your mouth before it starts by switching toothpastes. Many health stores, and even supermarkets, have begun to carry varieties that are free of SLS.
▶ DON’T consume common irritants: Eliminating the most common food sensitivities—including gluten, cow’s milk dairy, yeast, and citrus—is worth trying at least on a trial basis to see if your symptoms improve.
Fortunately, you don’t need a prescription for anything I include in my protocol—but it’s a good idea to check with your doc before starting any new vitamin regimen or supplementation program. He can test you for specific nutritional deficiencies and work with you on how much you need to take in order to get your levels to where they need to be.
And while you can do an elimination diet on your own, it’s much easier and more effective to do it in collaboration with a professional who knows how to read the signs—and when you’ve “eliminated” something as the cause of your canker sores and you can go back to enjoying it as before.
Wishing you the best of health,
Dr. Glenn S. Rothfeld
Nutrition & Healing
Vol. 11, Issue 1 • January 2017
Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.