Although there are three main types of canker sores, which are based on the size, how long they last and whether or not they leave scarring, they all go through the same stages before healing.
Before a mouth sore actually forms, it will typically begin with a slight tingling or burning sensation at the site where the sore is going to develop. Sores can be anywhere inside the mouth, including the tip or underside of the tongue, roof of the mouth (called the soft palate), the floor of the mouth, the inner cheeks and lips, as well as the gums and even the tonsil area. Typically there is no feeling of malaise involved. Canker sores are distinguished from cold sores partly by the fact that they appear only inside the mouth, whereas cold sores of fever blisters appear on the outside of the mouth.
By around the second day, a raised reddened area forms and the pain may increase. This stage may last a day or so before the sore actually erupts and the open lesion develops.
By around the third day the canker sore officially rears its ugly head in all its glory: it is now a shallow ulcer that can be round or oval and white or yellowish in color, surrounded by a bright red rim. The center is often covered by a white or greyish membrane. It is now quite painful and sensitive, especially when you try to eat or drink anything. This stage can last anywhere from three to seven days. During this period the pain may stay the same or even increase, making eating and drinking, and sometimes even talking, excruciatingly painful.
By the seventh or eighth day, the symptoms thankfully start to subside. The pain will likely start the recede as the sore begins to heal. The ulcer grows smaller as healthy tissue closes over it and eating and drinking start to feel less painful. Some sores may take longer to heal. Major aphthae are large, deep ulcerations, often 1/2 inch in diameter or more, and can take as long as two to four weeks to heal. Most canker sores do not leave a scar, by major aphthous ulcers may cause scarring.
If your canker sore is taking a long time to heal or it is exceedingly painful, you should have it evaluated by your doctor. In rare cases canker sores can be associated with immuno-compromised conditions.
This is best stage of all: the ulcer is completely gone. However, for some people it is only temporary relief and soon one or more canker sores are forming again. If you suffer from frequent outbreaks there may be underlying health issues involved. Some people find their frequent sores are caused by a nutritional imbalance or vitamin deficiency, a gastrointestinal condition such as celiac disease, or even the sodium laurel sulfate in toothpaste. The latter may be resolved by simply switching toothpastes to a product that is SLS-free. You can find several brands such as Toms of Main, Jason Powersmile and Rembrandt C at drugstores or health food stores. Some people find this really makes a difference on the frequency of their outbreaks.
Preventing Your Canker Sore From Getting Worse
While it isn’t always possible to prevent your lesion from developing, you may be able to take some steps to help speed the healing process.
According to a research study by Ben Gurion University, a daily 1000 mcg dose of vitamin B12 has been shown to reduce or even eliminate canker sores. It is certainly worth a try.
Gargling with a mixture of hydrogen peroxide and water, salt and water or baking soda and water four times per day may help. Hydrogen peroxide helps kill bacteria and baking soda helps alkalinize the mouth, preventing it from being too acidic.
Other home remedies that may promote healing include bee propolis, aloe vera, and licorice root.