There’s been a lot of debate over the use of vitamin B12 in preventing and treating canker sores for the last few years. And more research is definitely needed in this area. But current evidence suggests that high doses of B12 really could be a solution for anyone suffering from canker sores.
What Exactly Are Canker Sores?
Canker sores (aka recurrent aphthous stomatitis (RAS) or aphthous ulcers) are small, shallow lesions that occur in the soft tissues inside the mouth. This can include the gums, inner cheeks, tongue or lips. The sores normally have a white or yellow center. They aren’t dangerous or contagious, but they hurt a lot more than they look like they should! Some patients have trouble eating or even speaking if they have particularly bad sores.
One of the main things to point out is that canker sores are not the same as cold sores. They have different causes, different effects, and different treatments. As a rule of thumb, if you’ve got a sore on the outside of your mouth, it’s probably a cold sore – and it definitely isn’t a canker sore.
There’s still some confusion over what causes canker sores, and nobody knows for certain. Genetics, a poor immune system, allergies and vitamin deficiencies have all been implicated in the past, and probably all play a role to some extent. Local trauma can also trigger a sore.
Of course there’s nothing you can do to change your genetics or any allergies you might have, so we’ll concentrate on the vitamin deficiencies that are easily correctable. The vitamins that seem to have the greatest impact are cobalamin (B12) and folate/folic acid (B9), which tend to be interlinked anyway (see here).
It’s worth noting that people suffering from vitamin deficiencies are more likely to have a generally poor diet and nutrition. This in turn will result in an impaired immune system, further increasing the risk of developing canker sores.
Who Gets Canker Sores?
Canker sores are pretty common, although as many people self-medicate (and because they tend not to be a serious health risk), it’s hard to get precise figures. It’s generally thought that anywhere between 25-40% of the US population get canker sores at some point in their lives, normally before they’re 50.
The groups most at risk are teens and young adults, particularly during exams or at any other times of stress. This is probably because of the well-documented negative impact that high stress levels have on the immune system.
How Vitamin B12 Can Help
In a scientific study a couple of years ago, B12 supplementation was described as a ‘simple, effective and low risk’ method to reduce the incidence and severity of cold sores.
As B12 and B9 deficiencies are risk factors for canker sores, it makes perfect sense that increasing your B12 and B9 intake should help to prevent the sores from developing. For the vast majority of people, simple oral supplements will be all that’s needed to restore the amount of these vitamins in your body to healthy levels.
Other options such as sublingual tablets, nasal sprays, skin patches and fortified foods are also available. A few people might need injections, but it’s rarely necessary, and it’s best to see a doctor first.
If your vitamin levels are healthy and you don’t have any nutritional deficiencies, then you stand a much better chance of not getting canker sores.
Some people are simply genetically predisposed to suffer from canker sores more than most, and sadly there isn’t a lot you can do about it. Ensuring you get enough vitamins will help, but it’s not a surefire preventative measure for everyone.
Recent research found that the positive effects of high doses of cobalamin don’t extend to lower doses. The scientists gave the participants regular multivitamins to ensure that they got the recommended daily allowance (RDA) of vitamin B12. All participants experienced minor RAS before the study (and over 80% of cases are minor anyway). The study found no evidence that the multivitamins helped to prevent oral lesions. It seems that to be effective, higher doses of B12 are required.
Canker Sore Treatment
As mentioned above, if you increase your vitamin intake now, it might help in the future but it won’t do you any good straight away. But if you came here looking for a short-term fix, we won’t leave you disappointed!
The drug acetaminophen (often sold under the brand name Tylenol) should help to reduce pain caused by canker sores, as will other standard painkillers. The US National Institutes of Health also recommends a few more basic treatments:
- Avoid hot drinks
- Drink cold fluids (water or iced tea), through a straw if necessary to avoid the sore
- Try sucking on a popsicle or holding an ice cube to the sore until it’s numb
- Minimise the need to chew – cut food up small or mash it, drink yoghurt etc.
- Gargle salt water (seriously)
- Watch out for spicy foods, as well as anything acidic like citrus fruits
- Be careful when brushing your teeth – you don’t want to hit the sore!
Even without treatment, mild canker sores normally disappear in 7-10 days, and even more serious lesions will be completely gone within a few weeks. Canker sores rarely leave a scar.
Top image by TheBlunderbuss, obtained through Wikimedia Commons under a CC BY-SA 3.0 license.
Other images, from top to bottom, are courtesy of stock images and bulldogza, both at www.freedigitalphotos.net.