Painful canker sores / what causes them?!

Painful canker sores / what causes them?

ever since i was around the age of 7 I've been getting very painful canker sores and I've noticed while I get them i different spots, most ALWAYS occur under my tongue at the very tip. once the size was soo big I seriously could not talk and had a bad lisp. usually the size isn't too big, but its soo painful. I avoid things such as citrus fruits, and spicy foods but i cant figure out why they still occur and WHY in the same spot everytime?!?!

ps. I read somewhere that if they occur in the same spot over and over you should contact a doctor. why is that?

2 weeks ago
one more thing: jus yesterday I had no canker sores whatsover. I went out to the mall and felt a tingling sensation under my tongue at the tip where i always get this sore and in 20 mins, voila! a canker sore and it was pretty big. just came outta nowhere.

The exact cause of aphthous ulcers is unknown. Factors that provoke them include stress, fatigue, illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies, the foaming agent in toothpaste (SLS), and deficiencies in vitamin B12, iron, and folic acid.[3] Some drugs, such as nicorandil, also have been linked with mouth ulcers. In some cases they are thought to be caused by an overreaction by the body's own immune system.

Trauma to the mouth is the most common cause of aphthous ulcers.[citation needed] Physical trauma, such as that caused by toothbrush abrasions, laceration with sharp foods or objects, accidental biting (particularly common with sharp canine teeth), or dental braces can cause mouth ulcers by breaking the mucous membrane. Other factors, such as chemical irritants or thermal injury, may also lead to the development of ulcers. The large majority of toothpastes sold in the U.S. contain Sodium lauryl sulfate (SLS), which is known to cause aphthous ulcers in certain individuals. Using a toothpaste without SLS will reduce the frequency of aphthous ulcers in persons who experience aphthous ulcers caused by SLS.[4][5][6] However, some studies find no connection between SLS in toothpaste and mouth ulcers.[7]

Artificial sugars, such as those found in diet cola and sugarless gum, have been reported as causes of aphthous ulcers as well. They can also be linked to an increased intake of acids such as ascorbic acid (one form of Vitamin C) or citric acid. In this case the sores disappear after intake decreases (for example, by substituting ascorbate salts for ascorbic acid).

Another possible cause of aphthous ulcers may be opportunistic activity by combinations of otherwise normal bacterial flora, such as aerobic streptococci, Neisseria, Actinomyces, spirochetes, and bacteroides.[citation needed] According to small-scale experiments by one patent applicant Hau, (6,248,718 ), topical preparations of high doses of penicillin resulted in accelerated healing of mouth ulcers.

There is a commonly held belief that another cause of aphthous ulcers is gluten intolerance (Coeliac disease), whereby consumption of wheat, rye, barley and sometimes oats can result in chronic mouth ulcers. However, two small studies of patients with Coeliac disease have demonstrated no link between the disease and aphthous ulcers.[8][9] If patients with aphthous ulcers do happen to have gluten intolerance, they may experience benefit in eliminating breads, pastas, cakes, pies, cookies, scones, biscuits, beers and so on from their diet and substituting gluten-free varieties where available.[8]

Although the exact cause is not known, aphthous ulcers are thought to form when the body becomes aware of and attacks molecules which it does not recognize.[10] The presence of the unrecognized molecules garners a reaction by the T-cells, which trigger a reaction that causes the damage of a mouth ulcer. People who get these ulcers have lower numbers of regulatory T-cells.[10]

Repeat episodes of aphthous ulcers can be indicative of an immunodeficiency, signalling low levels of immunoglobulin in the mucous membrane of the mouth.[citation needed] Certain types of chemotherapy cause mouth ulcers as a side effect.[11] Mouth ulcers may also be symptoms or complications of several diseases listed in the following section. The treatment depends on the believed cause.

A common urban myth is that aphthous ulcers are directly connected to the onset of the herpes simplex virus. In reality, ulcers associated with herpes (or cold sores) are of an entirely different nature from mouth ulcers, which are not contagious.