In her weekly column, nutritionist Nonie De Long provides insight into possible causes and offers a variety of holistic remedies for the painful sores
Dear Nonie, I was wondering if you knew of an alternative treatment for mouth sores. I have been suffering with these for about three years now. My family doctor said they were caused by inflammation and prescribed an ointment that has not been all that effective. Is there a nutritional reason for getting these? — Mona
Mouth or canker sores can be a painful nuisance and it’s accurate to say they can be caused by nutritional imbalances, particularly if they’re recurrent. So let’s take a deeper look.
What are Canker Sores?
First, let’s clarify what we’re talking about. Canker sores come in a few varieties:
Small/ Minor: small in size, not as painful, go away within a few weeks
Large/Major: larger in size, deeper, more painful, take up to six weeks to clear, can scar
Herpetiform: pinpoint sized, but often occur in clusters, sometimes joined; often happen in immunocompromised or elderly people; don’t typically scar.
Sometimes canker sores crop up regularly and sometimes they never seem to completely go away. They can also be accompanied by a fever, external cold sores, swollen glands, and other symptoms of immune activation. In such cases it’s always best to consult with a professional to identify the cause and correct the problem.
Investigate the Cause
In all cases, your first action should be to chart the breakouts with symptoms alongside a diet and stress diary. This can help you discern any correlations. Food intolerances can trigger canker sores, as can menstrual cycles and stress, so charting can be helpful to identify any routine triggers.
Your doctor isn’t wrong that inflammation can be the cause. But that can be very difficult to pin down because so many things can cause inflammation! So let’s look at the contributing factors to better break it down:
- Poor diet (causes imbalances/ deficiencies, leading to inflammation and low immunity/ gut problems)
- Poor digestion (causes imbalances/ deficiencies leading to inflammation)
- Celiac disease (causes poor assimilation, imbalances/ deficiencies leading to inflammation and low immunity or immune system over stimulation)
- Bowel disorders (causes poor assimilation, imbalances/ deficiencies leading to inflammation and low immunity or immune overstimulation)
- H. pylori (causes poor digestion/ assimilation, imbalances/ deficiencies leading to inflammation and low immunity)
- Gut biome imbalance (causes poor assimilation, imbalances/ deficiencies leading to inflammation and low immunity or immune overstimulation)
- Food intolerances/ reactions (cause inflammation and immune stimulation/ weakened immunity and sometimes can cause breakouts on contact)
- Nutritional deficiencies/ imbalances (cause inflammation and immune stimulation/ weakened immunity)
- Certain diagnoses: herpes, HIV/ AIDS, Behcet’s disease (cause inflammation and immune stimulation/ weakened immunity)
- Toothpaste allergy (can cause sores on contact, for which I recommend diatomite and or xylitol as a safe alternative dental cleansing agent)
The best method to determine the cause is to start observing when you get sores, with charting and symptom details. You can co-chart stress, menstrual cycles, and food habits. This will help you begin to see if there are any correlations. It’s good to be thorough with charting because I have even seen sensitivities so great that the ingredient in a supplement will cause canker sores.
Holistic Mouth Rinses
For this type of problem the holistic solution is to sleuth out the contributing factors and address them, rather than just treating the symptoms. But for symptom management while trying to determine cause, I recommend the following:
Hydrogen Peroxide Mouth Rinse:
1 oz 3% hydrogen peroxide (available at most drug stores)
1 oz water (preferably filtered)
Directions for use:
Mix the two together and use as a mouth gargle/ rinse regularly (morning and night) to help heal and prevent mouth sores. Rinse and spit out. Never swallow the solution!
The peroxide helps stop the pain of canker sores while disinfecting current outbreaks. It can help diminish breakouts and I recommend it over commercial mouth rinses that damage healthy bacteria in the mouth. It can also help with problem tonsils if used as a gargle and an added benefit will be whiter teeth.
Again, it should not be swallowed so exercise caution when using it. It’s not fatal if swallowed in this dilution but can cause upset tummy and stabilizers in pharmaceutical peroxide may be unhealthy to ingest.
Some people may shy away because it isn’t recommended to ingest it, but regular fluoridated toothpaste shouldn’t be swallowed either and can actually be toxic in large enough doses. The amount of fluoride in a tube of toothpaste may actually be sufficient to kill a small child. Visit this site to learn more.
Coconut Oil Pulling:
1 tsp – 1 tbsp coconut oil (virgin, organic)
Directions for use:
Take 1 tsp to 1 tbsp or so of coconut oil when watching TV in the evening after brushing your teeth. Swish it all around for as long as you can, ideally up to 10 minutes. Pull it through your teeth.
This also works the muscles of the cheeks so prepare for it to be a challenge until you get good at it. It’s very moisturizing to gums and can help soothe and heal canker sores, without damaging the bacteria in the mouth like commercial solutions do. It can be added in after peroxide if you like or used as a stand alone.
Coconut oil is antifungal and antiseptic in nature and has been shown to help with stomach ulcers, which are not unlike mouth ulcers. When done with the rinse, just spit out. It will be much thinner and foamy by then. Your teeth will be brighter and stronger with healthier gums as a result if you do this regularly.
Treat Nutritional Deficiencies/ Imbalances
Nutritional imbalances resulting from any combination of the issues above or other contributing factors like addictions or weak constitution should be investigated by a professional and treated. Some of the more common imbalances/ deficiencies involved in canker sores are:
- B1 and B12 – both have been linked to frequent mouth sores. Consuming too much alcohol decreases B1 stores and not consuming red meat regularly can lead to deficiencies in B12. Both can safely be supplemented with a little guidance.
- Iron – linked to mouth sores, low energy, and slow healing. Contact a health professional to guide testing and help you supplement or correct the reason you don’t absorb it. Poor absorption and diet account for most anemia I see and in these cases supplementing isn’t the optimal solution.
- Zinc – linked to recurring skin conditions and slow healing. Please see a professional to test and guide supplementation or suck on zinc lozenges with breakouts to determine benefit. If this helps, it’s likely you need zinc.
Other Preventive Steps:
For prevention, you may want to consider removing gluten from your diet, as so many are triggered by it. A four-week test can tell you if it’s of benefit. It may be that not all your symptoms are improved, but if any are you know you’re likely sensitive to it. You can also add fermented foods or a good quality, active probiotic into your regular diet. This helps balance the gut biome and aide in assimilation of nutrients, and helps regulate immunity and reduce inflammation overall.
It’s also beneficial to add digestive enzymes (according to your needs) with the help of a professional. This way you digest and absorb more of the nutrients from your food. Of course, if you know your diet is horrible, that’s the best place to start! Contact a professional like myself for step by step direction to turn that around for all kinds of benefit.
Lastly, there is a supplement I use for ulcers called deglycerized licorice. It promotes the protective mucus barrier in the mouth/ digestive system and is available in chewable tablets and herbal tinctures. It can be chewed or taken in water 3x per day. It can greatly help with soothing ulcers, mouth ulcers included, and reducing the time it takes for them to heal. I recommend sucking the tablets or swishing with the tincture in water for these. It often helps greatly.
As always, if readers have a health or nutrition related question, I welcome you to write to me at email@example.com. And if you’re looking for more specific health information check out my website at nonienutritionista.com, where I provide 1:1 health coaching for those who need it. There you can also access my free monthly newsletter signup. Until next week!