Canker Sores

Canker vs. Cold Sore

Canker vs. Cold Sore

Canker sores, known as aphthous ulcers to the scientific world, are painful sores that develop inside the mouth.  They can form on the inside surface of the cheeks, at the base of the gums, on the soft palate or on/under the tongue.  They are small and shallow and are round to oval in shape with the base usually covered by a white or gray membrane.  An intense red halo commonly surrounds each ulcer.

Canker sores should not be confused with cold sores.  Cold sores, also called fever blisters, are groups of painful fluid-filled blisters.  They are caused by the herpes simplex virus.  While canker sores are not contagious, cold sores are, extremely so.  They usually form on the lips and nose and sometimes on the gums.

The exact cause of canker sores is unknown.  Some people will develop canker sores after eating large amounts of citrus or acidic fruits and vegetables.  This includes, oranges, pineapple, lemons, tomatoes, strawberries, and figs.  Minor injury may also be a cause.  Injuries can be caused by overzealous brushing of the teeth, accidental cheek bite, a sharp tooth surface, or rubbing of braces/retainer.  Toothpastes containing sodium laurel sulfate (SLS) may also lead to canker sores in some people.  SLS is a chemical added to most toothpaste to create the foaming action which aids in the cleaning of teeth.

Other triggers could include:

  • Health conditions, such as celiac disease or Crohn’s disease.
  • Deficiencies in vitamins B12, zinc, folic acid, and iron.
  • Emotional stress.
  • Hormonal shifts during menstruation.

No special treatment is required for canker sores.  They will heal on their own in 1-2 weeks.  If treatment is desired, over-the-counter oral pain medication, such as ibuprofen (Motrin, Advil) or naproxen (Aleve) can be used for the pain.  Topical medications containing benzocaine, such as Anbesol, Kanka, Zilactin, and Orajel canker sore gel can be purchased without a prescription.  These medications can numb the pain and cover the open ulcer.  Prescription medications containing steroids such as triamcinolone in dental paste and Kenalog in Orabse can be used to hasten healing and decrease pain.  To prevent canker sores, avoid dietary triggers and eat a well-balanced diet.  Maintain good oral hygiene.  Protect the mouth by brushing and eating carefully.  Address problems with braces, retainers, and sharp tooth surfaces.  Reduce stress.  Avoid toothpaste with SLS, if it appears to be triggering mouth sores.

Maribeth Mulholland, MD


Are you really prepared to an Ohio State Student?

Next week you’ll be moving into the dorm or perhaps off-campus housing.  Let’s see if you prepared?

  • Schedule of classes – check!
  • Books purchased – check!
  • Map of campus – check!
  • Coordinated dorm furniture with roommate – check!
  • Purchased bedding, etc. – check!
  • Internet connection – check!
  • Plan for what to do when you get sick ???  Huh??

My guess is you ( or your parents) have been making lists of all that needs to be done, purchased, packed, etc. before you move onto campus.  That is a good thing – but have you considered what you will do if – mostly likely – when you get sick. I know, I know.  You never get sick.  But up till now you’ve been living in a fairly controlled environment.  But,  you are about to move into a living situation where the front door itself is shared with several thousand other people.  People who may or may not be quite as diligent as you at washing their hands.  And then there’s the classrooms, cafeterias, and RPAC.  That is a serious amount of door handle touching and a serious amount of germ sharing.  The odds that you will remain the person “who never gets sick” is, well pretty slim.

So, what can you to do to prepare just in case you do get sick?

  • Make sure you have the necessary information.  Any medical facility you visit will require the following items so make sure you have them with you when you come to campus AND make sure you know where you put them so you can easily access them should you get sick.
    • Medical history of both yourself and your family, here’s a link to the form we use here at Student Life Student Health Services
    • Insurance card, if it’s a copy make sure it includes both the front and back
  • Know the locations of medical facilities within easy reach of your dorm/housing
    • Student Life Student Health Services is located in the middle of campus, between the Thompson Library and the RPAC.  We are here just for students so this is a great location to know, but we are only open 8am – 6pm weekdays (Fridays 8am – 5pm).  What if you get sick outside of our business hours?  You can find a list of after hour care facilities on our website




How to Lower Your Blood Pressure

From time to time students will come to see me with mildly elevated blood pressure.  The goal is to have a blood pressure reading that is < 120/80.  I don’t typically start medications unless the blood pressure is > 140/90.

If you find your blood pressure slightly elevated, how do you go about lowering it without resorting to medications?

  • Control your weight, striving to keep your BMI < 25, through a good diet and regular exercise.
  • No smoking
  • Keep alcohol at a minimum, no more than 1 drink daily for women and 2 drinks daily for men.
  • Monitor your blood pressure, there are BP machines in the RPAC near the Sport Shop on the ground floor.

After making the above changes for 3 months, schedule an appointment with your health care provider for a re-evaluation.

Douglas Radman, M.D.

You might be a germophobe if…

  • You die a little inside when someone sneezes without covering their mouth.
  • You probably own at least 50 pocket hand sanitizers.
  • Lysol/bleach is a household necessity.
  • You hate unnecessary physical contact.
  • Handshakes make you anxious.
  • You wonder how the seven dwarfs could continue living with Sneezy.

But despite your best efforts, you may still be coming into contact with germs.  Check out this Mythbuster episode where they track the transfer of germs at a typical gathering.



Trouble Falling a Sleep – Could be your electronics

Trouble falling asleep? That could be my mantra.  I am bone tired and yet as soon as I hit the pillow I am wide awake.  I can feel myself starting to drift off and then, boom, my mind jerks me back awake and I just lie there.  Ugh!  Or I drift off to sleep only to awaken in the middle of the night unable to fall back asleep.  Oh, what I would give for even 6 straight hours of sleep.

Trust me when I tell you this – I have tried everything. Sleepy time tea, warm milk with honey and nutmeg, no liquids after 8pm, meditation, relaxation exercises, breathing sequences, Benadryl.  You name it, I have been willing to give it a try.

Blue light affects sleep

Ok, well almost everything. The experts are constantly saying that we need to turn off all devices at least 2 hours before bed.  Seriously – 2 hours?!  By the time I get home from work, do the dinner thing and whatever else needs to be done – that would mean no devices at all on the weekday evenings.  Is that realistic?  That’s when I catch up with my family on Facebook, play a couple of games, and read a chapter in a book.  I also hold online chats with students a couple of nights a week and yes, computers and laptops count as devices.

So why the insistence that we turn off devices at least 2 hours before bed? It all has to do with blue light.  According to Scientific American the blue light emitted from our devices has a higher concentration than natural light and this affects our levels of the sleep-inducing hormone melatonin.  Normally melatonin would be released naturally by our bodies a few hours before bedtime as the sun sets.  The blue light from our devices, however, resets our body’s clocks to a later schedule which in turn interferes with our sleep.

So, what to do? I don’t know about you, but not using electronics after 8pm just is not practical – especially on those nights I meet with students.  Turns out that there are several blue light filters out there that you can install on your devices, yes even your computer and laptop.  These apps allow you to essentially implement a night mode by indicating your time zone and then automatically adjust the lighting of your device as the day progresses, from a strong blue light during the day to an amber color at night.  When I get home tonight, I’m going to install one of these apps on my IPad and computer and give it a go.  I’ll let you know the results in a couple of weeks.

Mythbusters – Hand, Elbow, or Hankie

We are constantly told to COVER OUR COUGH or to SNEEZE INTO OUR SLEEVE, but does it really matter?  Is sneezing or coughing into my sleeve really any better than using a tissue, for instance?  Mythbusters decided to put it to the test.  They inhaled some dye and then sneezed, using different barriers, the hand, a hankie, and a sleeve.  The results – SLEEVE!  Not only did this result in the least amount of exposure, but the odds of passing it on to another person through a handshake or by touching another surface was infinitely less.  You can view their test cases below.





Audiology Awareness Month – Free Hearing Screenings

October is Audiology Awareness Month. To celebrate check out these free hearing screenings:

  • OSU Speech-Language-Hearing Clinic is offering free hearing screenings on Tuesday (10/11/2016) and Thursday (10/27/2016).  Please call the clinic to schedule a free screening at 614-292-6251.
  • The Ohio State Student Academy of Audiology is offering free hearing screenings to the general public on Friday (10/7/2016) 1-4 p.m. at the Ohio Union in dance room 01 on the building’s lower level. Hearing screenings require only 5 or 10 minutes to complete — and are done by audiology graduate students.

Should I have my cholesterol tested?

There are several risk factors for heart disease and stroke.  These include obesity, high blood pressure, diabetes, smoking history, high blood cholesterol levels, and family history of heart disease and stroke.  High cholesterol can build up in your blood vessels causing narrowing and reduced blood flow.  This can lead to heart disease and stroke.

The U.S. Preventive Task Force recommends that men get a blood cholesterol test at age 35 years and women at age 45 years.  This should be done every five years.  The cholesterol test may be performed at an earlier age or more frequently if you have any of the cardiovascular risk factors mentioned above.  The accuracy of cholesterol tests done at public screenings such as health fairs varies.  It is probably better to discuss this with your provider who can order more reliable testing.

Dr. Matthew Peters

The Problem with Antibiotics

There are many types of antibiotics. The most commonly used antibiotics treat bacterial infections.  Penicillin was discovered in 1928.  It was first used on a patient in 1941.  It was mass produced by the end of World War II.  There are now dozens of antibiotics on the market.  These drugs have reduced illness and death from infectious diseases.  However, bacteria have adapted resulting in these drugs becoming less effective.

These antibacterials medicines do not work on all infections. They treat bacteria but not viral infections.  Common viral infections are colds, influenza, bronchitis, and most sore throats and sinus infections.

Overuse of antibiotics contributes to more serious drug-resistant bacteria. The CDC estimates that 23,000 people in this country die yearly from antibiotic-resistant bacteria.  Reasons for overuse include pressure on healthcare providers to prescribe these drugs, patients using leftover antibiotics, and patients using antibiotics purchased overseas.

What can we do? Do not expect antibiotics to cure every illness.  Please do not pressure your provider to prescribe an antibiotic.  Most colds and coughs will take two weeks or longer to resolve.  Complete the entire course when an antibiotic is prescribed,.  Also, never take someone else’s medication.


Dr. Matthew Peters, MD

How do I know if I have frostbite?

Q: I was out in the cold in tennis shoes for a long time. When I came inside my toes were blue and hurt really bad for a few hours. Did I get frostbite?

A: Frostbite occurs when tissue freezes.  The condition mainly affects the fingers, toes, ears, cheeks and nose, but any body part can freeze – even your eyeballs!  When exposed to prolonged cold temperatures, blood flow is decreased to the extremities and diverted to more vital organs, like your heart, lungs and brain.  Unfortunately, this leaves the vulnerable areas even more at risk.

There is a spectrum of severity in frostbite.  Superficial frostbite occurs when the areas of the skin close to the surface freeze. There is often a burning sensation, numbness, or tingling.  Affected tissue becomes cold and white, but maintains some of the elasticity of normal skin.  This type of frostbite can be serious, but is potentially reversible with no loss of tissue or function.

The deeper the freeze, the more serious the disease.  When there is more extensive damage the tissue becomes white and hard, sometimes with superficial blood blisters. Sensation in the tissue is either absent or profoundly decreased. There probably will be loss of tissue, and sometimes surgery is required.

Frostnip is a cold injury to the tissues that is different from frostbite.  In frostnip, superficial tissue becomes cooled, but is not cold enough to freeze.  Skin is usually pale and numb, but recovers fully with gradual warming.

People with frostbite should be seen by a physician as soon as possible.  The area involved should be elevated and gradually warmed.  No rubbing! Clapping, rubbing, or slapping those cold frozen fingers together is only going to cause more damage to already stressed tissue.

Of course, the best way to avoid frostbite is to listen to your mother (and Dr. Vicki) and wear your hat and gloves. Minimize your exposure during severe weather. Be extra careful if you’re sick, have diabetes, vascular disease, or you smoke. Be wary of cold weather and alcohol. Stay warm out there, Buckeyes!

Victoria Rentel, MD (OSU SHS)

Reviewed by Tina Comston, M.Ed.