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Oral canker sores (ulcers)

Mouth ulcers or mouth ulcers are quite common in the population, but fortunately, nutritionist-dietitians can intervene in the management.

Women are more often affected than men. Mouth ulcers are white, yellow or grey blisters or bubbles surrounded by a reddish circle. They cause pain that may be aggravated by eating, drinking or talking. Most ulcers heal spontaneously in 7 to 14 days.

It is recommended to avoid hard/spicy/acidic/salty foods and gargle with salt water (or a commercial mouthwash specially designed for this purpose) to avoid pain from mouth ulcers. Talk to your doctor or pharmacist for other alternatives.

 

The triggering factors are:
  • Anxiety and stress ;
  • • Oral trauma (biting of the inside of the cheek or lip, tongue) or irritation (ill-fitting dentures or orthodontics, too vigorous brushing);
  • Symptoms of specific pathologies (diabetes, ulcerative colitis, Crohn's disease, celiac disease, Behçet's disease) or viral infections (HIV, chickenpox, shingles);
  • Vitamin and mineral deficiencies, especially folate and vitamin B12;
  • Ingestion of certain foods (chocolate, coffee, peanuts, eggs, cereals, almonds, strawberries, tomatoes, dairy products);
  • Some medications ;
  • Hormonal changes (e.g. menstruation, pregnancy).

To date, according to the scientific literature, there is no "miracle" recipe to prevent mouth ulcers. On the other hand, taking a vitamin and mineral supplement such as vitamins B1, B2, B6, B12 and folate, as well as iron, could help prevent recurrences.

 

On the food side, to reduce the risk of mouth ulcers, it is advisable to maintain a diet rich in folate and vitamin B12 and avoid foods that could trigger mouth ulcers. To do this, a diet by elimination or combination can help to get your hands on the food(s) that trigger(s) mouth ulcers.

 

Folate-rich food sources
  • Liver
  • Legumes (edamame, chickpeas, lentils and beans)
  • Hulled sunflower seeds
  • Enriched grain products
  • Dark green vegetables (spinach, escarole, collard greens, broccoli, asparagus, etc.)

 

Dietary sources of vitamin B12
  • Dairy products (milk, cheese, yogurt)
  • Eggs
  • Meat and poultry
  • Fish and seafood
  • Fortified soy beverage and soy products fortified with vitamin B12 (see label and Nutrition Facts table)

 

This advice does not replace the advice of a doctor or pharmacist. If symptoms persist or worsen, you should promptly consult your doctor.

References

Murchison, D. Le Manuel MSD, version pour professionnels de la santé. Stomatite aphteuse récidivante. [online] [https://www.msdmanuals.com/fr/professional/troubles-dentaires/symptômes-des-pathologies-dentaires-et-buccales/stomatite-aphteuse-récidivante] (last consulted on November 2018)

Kacker A, Cornell W, Zieve D, Conaway B. (2017). Mouth sores. MedlinePlus, [online] [https://medlineplus.gov/ency/article/003059.htm] (last consulted on November 2018)

Wellness Library (2011). Mouth Ulcer. [online] [https://www.pinnaclehealth.org/wellness-library/blog-and-healthwise/wellness-collection/article/en-us/sig258359/%5D] (last consulted on November 2018)

PharmaCodex. Aphtes buccaux. [online] [http://www.pharmacodex.org/index.php/info-patho-mvl/aphtes-buccaux/] (last consulted on November 2018)

Les diététistes du Canada (2014). Sources alimentaires de folate, [online] [https://www.dietitians.ca/Downloads/Factsheets/Food-Sources-of-Folate-FRE.aspx] (last consulted on November 2018)

Les diététistes du Canada (2017). Sources alimentaires de B12. [online] [https://www.dietitians.ca/Downloads/Factsheets/Food-Sources-of-Vitamin-B12-FRE.aspx] (last consulted on November 2018)

https://www.youtube.com/watch?v=jURMvKJ-6sw&feature=youtu.be

 

Image source: www.revmed.ch

 

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