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


Free dental screen and X-rays

Columbus State Community College (CSCC) is hosting a Dental Hygiene Student Board Screen Day at the Ohio State College of Dentistry. As part of clinical training, the CSCC's dental hygiene students will give one complimentary dental screening and two to four complimentary X-rays, under faculty supervision, to participants who are at least 18 years old and in good health. This event takes place Monday (1/23) 5-8 p.m. and is open to the public.


For more info:

I get sores on my tongue. Could it be cancer?

Mouth sores can be painful, annoying and unsightly. Some appear inside the mouth – on the gums, tongue, lips, cheeks or palate (roof of mouth).  Others, like cold sores, can appear outside the mouth, such as on and around the lips, under the nose and on the chin.

Mouth sores can be caused by bacterial, viral, or fungal infections or oral cancer. Some other causes include:  extreme sensitivity to ingredients found in some toothpastes or mouth rinses; medication, cancer treatment side effects or reaction to therapy; or certain specific skin, oral or systemic diseases.

Some people may experience occasional discolored, painless spots in their mouth. Most are harmless and will disappear or remain unchanged.  However, some sores or spots can be serious and need attention of your dentist or physician.  That’s why regular dental checkups are so important.  Have your dentist examine any mouth sore or spot that fails to heal within two weeks.

Laurie Smith, RDH

How do I know I need to have my wisdom teeth removed?

Generally, wisdom teeth emerge in late teens to early twenties. Frequently the eruptions of these teeth are blocked by soft tissue, bone or adjacent teeth and are considered impacted.  Removal of wisdom teeth is necessary to prevent decay of adjacent teeth, possible infection, cysts or tumors, jaw pain or crowding of other teeth.  Most wisdom teeth need to be removed but a policy of watchful-waiting can be adopted for those that are not cystic, painful, or erosive to adjacent teeth.

If you have pain with your wisdom teeth or just want them evaluated, call the Dental Clinic at the Wilce Student Health Services to make an appointment with a dentist for consultation. After doing an oral exam and taking an X-ray, your dentist can evaluate your wisdom teeth and discuss whether or not they should be removed.  A referral can be sent to an oral surgeon for further evaluation.

Laurie Smith, RDH

Do I Have To Have My Wisdom Teeth Removed?

Most of our permanent teeth erupt during childhood, but the 3rd molars (or “wisdom teeth”) show up much later, usually during adulthood.  In fact, the term “wisdom teeth” originated in the 19th century because these molars don’t erupt until people are old enough to have gained some wisdom. 

If your wisdom teeth appear healthy and are in proper alignment, there is no need to remove them.  Your dentist will just monitor them throughout your lifetime.  But if they’re causing you trouble, they may need to be removed.  Symptoms of an unhealthy wisdom tooth include:

  • Pain
  • Fever
  • Inability to open mouth and/or pain with chewing
  • Toothache
  • Sensitivity to sweets, hot and/or cold temperatures
  • Bleeding and/or  swollen, painful gums
  • The sensation of crowding or pressure

If you are having any of these symptoms, come in to see one of our dentists at the Wilce Student Health Services Dental Clinic.  We will perform an exam and take a panoramic x-ray of your teeth to see what is going on.   The x-ray can tell us if your wisdom tooth is crowding the 2nd molar and causing a cavity, or if there are any cysts or tumors involving the wisdom tooth.

Any of the above signs or symptoms would lead us to recommend that you have your wisdom teeth removed.  We don’t remove wisdom teeth at the Student Health Center; if necessary, we will refer you to the oral surgery clinic at the Ohio State College of Dentistry.

If you want to learn more about wisdom teeth, the American Dental Association has a great (and short) video that you can check out here.

Julia O’Neil-Johnson, DDS
Student Health Services
The Ohio State University

Choose your stud wisely

Ha!  Made ya look.

Not that kind of stud, people – let’s try to keep our minds out of the gutter for at least one post, here. 

No, I’m talking about tongue studs.  Piercings.  Those little metal spikes that some people (of questionable sanity, IMO) actually voluntarily allow someone to poke through their tongue.  Man… just thinking about it makes my tongue hurt.

A new study in the Journal of Adolescent Health showed that out of the four most commonly used piercing materials – stainless steel, titanium, polytetrafluoroethylene and polypropylene – stainless steel had significantly more bacteria crawling around on it than the other three materials.  Researchers studied 85 people who randomly received a sterile tongue piercing with one of the four materials. 

To be fair, the researchers found that bacterial counts were pretty low for all of the materials tested and no one in the study got an infection from the piercing, so it’s safe to conclude that getting your tongue pierced under proper sterile conditions doesn’t put you at too much risk for getting a mouth infection.  But it’s probably a good idea to avoid stainless steel studs just in case because when infections do occur, they can get pretty nasty.

Even though the risk of infection wasn’t too bad, there are other problems to think of.  5% of the people in the study had chipped teeth from the piercings and about 29% had lingual recessions, or receding gums.  Both of these situations can lead to more serious problems.

If you do decide to get your tongue pierced, don’t try to do it yourself.  And make sure you go to a place that uses proper sterile procedures.  And if you are having any problems from a piercing – chipped teeth, bleeding, nasty drainage, bad taste in your mouth, swelling or pain – come in and see one of our dentists so they can make sure everything’s OK.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Kapferer I, et al “Tongue piercing: The impact of material on microbiological findings” J Adolesc Health 2011; DOI: 10.1016/j.jadohealth.2010.10.008.

When a little night-time grinding is NOT a good thing!

Q: I’ve been waking up with jaw pain and headaches lately.  What could be causing this?

A: You’re probably grinding your teeth.  Teeth grinding – or bruxism – is a very common problem. We used to think it was just caused by misalignment of the teeth or jaws, but we now know that it can also be related to stress, anxiety, depression, changes in sleeping patterns and even diet.  Sound familiar?    

So how do you know if you’re a bruxer?  It can be hard to figure out on your own since most of the clenching and grinding happens when you’re asleep.  You could ask your sleep partner or roommate if they’ve ever noticed you doing it.  If that’s a little too weird for you, you could just come in to the student health center and see one of our fabulous dentists – they can take one look at the wear and tear on your choppers and tell if you’re grinding away or not.  Other signs that may indicate you’re grinding your teeth include:   

  • Jaw pain or tightness which can lead to difficulty eating
  • Headache
  • Earache
  • Oversensitive teeth
  • Indentions in the tongue or damage to the inside of the cheek
  • Pain in your temporomandibular joint (the area right in front of your ear where your jaw hinges)

If you are a bruxer (we just love saying that word), there are some things you can do to give your jaw and pearly whites some relief:

  • Your dentist can fit you with an oral mouthpiece that will protect your teeth and decrease the amount of tension in your jaw while you sleep.  You can try one of those squishy mouth guards you find at sporting goods stores, but they don’t work as well.
  • Stress reduction can go a long way! The more relaxed you are while you’re awake, the more relaxed you will be while asleep!
  • Warm compresses applied to the jaw can help relax muscles.
  • Jaw exercises can also help to loosen up those muscles!
  • Cutting back on the alcohol and caffeine will also help.

Click here to learn more about bruxism, or make an appointment to see one of the dentists at the Student Health Center.  We’re always happy to help.

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Salvatore Paul Lowry, DDS
Student Health Services
The Ohio State University

Teeth Whiteners: Do They Work and Are They Safe?

wikimedia commons: dozenist

Dentist-prescribed overnight bleaching is the most effective method of teeth whitening, but it’s very expensive – anywhere from $400 to $900 per treatment, with multiple treatments often needed.  Over-the-counter (OTC) whitening agents are a lot more affordable, but do they measure up? 

Generally speaking, any peroxide-based product can whiten your teeth.  The ingredients in OTC kits aren’t as concentrated as the ones the dentists use, so they may take longer to work.  Tray-based products and whitening strips are your best bet – they are comparable in terms of side-effects and have been shown to be equally effective in whitening teeth.  As an aside, it’s important to note that most of the studies comparing the different products have been done by the product manufacturers, so take them with a grain of salt.

  • Tray-based: These products use carbamide peroxide as the bleaching agent. Be careful with the products that contain mouthpieces that aren’t custom-fitted. Because these mouthpieces may not fit snugly, some parts of the teeth may be covered by the bleaching agent, while some parts may not, resulting in uneven bleaching. The leaking can also lead to irritation. If the trays do not fit your mouth properly, they can irritate your gums and mess with the alignment of your teeth.
  • Whitening strips: The whitening strips use hydrogen peroxide as the bleaching agent. You typically will see results after a week. Maximum benefit occurs at 2 weeks; using it any longer than that doesn’t seem to add any further whitening effect.
  • Paint-on: These whitening agents come as a gel with a small brush, like nail polish. They use peroxide-based bleaching gel like the tray-based agents and you apply it once a day for 14 days. While the paint-on products seem to be as safe as the whitening strips, they aren’t as effective. 
  • Toothpastes: Whitening toothpastes can help the teeth remain cleaner and therefore look whiter but the stronger ones rely on abrasion to scrub off the outer layer of the teeth – the “newer” layer underneath looks whiter for a while but over time this will actually cause the teeth to lose shine and luster. Aside from the highly abrasive products, the peroxide-based toothpastes are generally safe for daily use although they’re not very effective at whitening teeth. They’re just not on your teeth long enough to do anything, even if you spend a long time brushing. Toothpastes are a decent option for if you’re trying to clean surface stains (e.g. from tobacco, coffee, etc.), but removing deeper stains and changing the color of the internal tooth structures requires professional intervention.
  • Chewing gums: There have been no clinical studies to see if these products actually whiten teeth so despite any marketing claims, we don’t really know if they work or not.

The most common side effect of dental bleaching products is tooth sensitivity.  This should not last more than a week after cessation of the whitening regimen – if it does, be sure to see a dentist.  Gum irritation is more of a problem with OTC bleaching kits, and is mostly due to the bleaching agents leaking around the edges of the mouthpieces.  This stuff not only tastes bad, but it can be dangerous if you swallow too much of it.  OTC whiteners haven’t been around long enough to say what the long term effects of sustained use are. 

If you do decide to use OTC whitening products, use them according to the package directions, stop using them if you experience bothersome irritation, and consult your dentist if you have any questions. 

Kelsi Wilkerson (OSU College of Pharmacy)
Philip Anderson, RPh
Student Health Services
The Ohio State University

Wanna keep your heart healthy? Brush your teeth!


We have learned over the years that inflammation is the ultimate culprit in many types of disease.  A recent article in the British Medical Journal has looked at a link between inflamed gums and the likelihood of developing fatty deposits in blood vessels (called atherosclerosis), which leads to lots of bad things down the road like heart attacks and strokes.  These researchers looked to see if there was a relationship between the frequency with which someone brushed their teeth and the likelihood of them developing heart disease.  Turns out that brushing twice a day was associated with less heart disease than brushing less frequently. 

Now, I am sure there are scientists out there saying, “Well, people who don’t brush their teeth probably don’t take care of themselves in other ways, too so how do you know it was the tooth brushing that helped them.”  If you thought the same thing, good logical thinking!!  The researchers took a lot of other variables – age, gender, wealth, smoking, physical activity, weight, family history of heart problems, high blood pressure, and diabetes – into account when they designed the study to help them decide if there really was a significant association between what they are studying and what they found.  And they decided that toothbrushing really did have an impact on developing heart disease.  You can read the details yourself to see if you think they really proved it – I’m sure they’d love to hear from you.

Bottom line – keep brushing those pearly whites, and you may just be around longer to use them! 

Roger Miller, MD (OSU SHS Preventive Medicine)

Let’s talk teeth!

Q: Does diet pop do as much damage to my teeth as the sugary regular pop?

A: Yes.  Even though diet pop does not contain sugar, it is made with two kinds of acid: phosphoric acid and citric acid.  Both can be very destructive to your enamel, the hard coating that protects your teeth, and cause large amounts of tooth decay, especially when you’re sipping on the pop throughout the day.

Q: Does sugar really cause cavities?

A: Sugar does not cause cavities directly.  The bacteria that normally live in your mouth use the sugar as a food source and when it digests the sugar, it produces acid.  It is this acid that destroys the enamel and leads to cavities.  

Q: What is a root canal?

A: Root canal therapy is necessary when the nerve inside a tooth dies due to deep decay, or trauma like a cracked tooth.  When this happens, the inside of the tooth becomes infected and the best way to treat the infection is by performing a root canal.  An opening is made in the top of the tooth and the pulp (or nerve) is removed and replaced with a filling inside the tooth canal.

Julie O’Neil-Johnson, DDS   Charles Schindler, DDS   Salvatore Lowry, DDS

Ohio State Student Health Services Dental Clinic