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Tag: mouth

  • Some people tape their mouths shut at night. Doctors wish they wouldn’t

    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.Doctors say don’t do it.Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.”The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.It is better to breathe through your nose most of the timeMouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.Don’t rush to use mouth tapeBut even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.And meanwhile, there are the potential dangers to be avoided.Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.Mouth breathing could be a sign of something serious — so find outThe safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.”The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.

    Doctors say don’t do it.

    Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.

    “The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.

    It is better to breathe through your nose most of the time

    Mouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.

    If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.

    Don’t rush to use mouth tape

    But even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.

    There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.

    And meanwhile, there are the potential dangers to be avoided.

    Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.

    Mouth breathing could be a sign of something serious — so find out

    The safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.

    You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.

    “The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”

    The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

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  • Some people tape their mouths shut at night. Doctors wish they wouldn’t

    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.Doctors say don’t do it.Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.”The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.It is better to breathe through your nose most of the timeMouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.Don’t rush to use mouth tapeBut even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.And meanwhile, there are the potential dangers to be avoided.Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.Mouth breathing could be a sign of something serious — so find outThe safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.”The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.

    Doctors say don’t do it.

    Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.

    “The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.

    It is better to breathe through your nose most of the time

    Mouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.

    If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.

    Don’t rush to use mouth tape

    But even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.

    There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.

    And meanwhile, there are the potential dangers to be avoided.

    Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.

    Mouth breathing could be a sign of something serious — so find out

    The safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.

    You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.

    “The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”

    The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

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  • Abandoned German shepherd found in Malibu with mouth zip-tied shut

    Abandoned German shepherd found in Malibu with mouth zip-tied shut

    After a group of hikers found an abandoned German shepherd wandering the Malibu wilderness with its mouth zip-tied shut, an animal protection group is offering a $2,500 reward to find and hold accountable the person responsible.

    Just before 8 p.m. on July 3, two hikers found the pup near Malibu Creek Canyon, according to a news release from In Defense of Animals. The dog had a zip tie around his mouth and another around his neck.

    The hikers quickly called 911 and removed one of the zip ties before police and animal control arrived. Together, they removed the second zip tie and carried him to safety, the group said.

    “Someone did this intentionally. They left him stranded, down a hill in the middle of nowhere off the side of the road,” one of the hikers who found the dog told KTLA. “Something needs to be done to find the person who did it.”

    The dog, which In Defense of Animals said was described as “sweet and gentle,” warmed up to his rescuers and eventually let them pet him. He was later taken to the Agoura Animal Care Center.

    “We are grateful for the quick actions of these hikers and law enforcement, but our efforts must continue,” said Fleur Dawes, spokesperson for In Defense of Animals. “We are determined to find the person responsible for this horrific abuse and hold them accountable since they are a danger to others.”

    Anyone with information leading to the identification, arrest and conviction of a suspect is asked to call In Defense of Animals at (415) 879-6879.

    Keri Blakinger

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  • It’s scary season for kids’ teeth. Help keep them cavity-free with these tips

    It’s scary season for kids’ teeth. Help keep them cavity-free with these tips

    As Halloween nears, you might be strategizing how to deal with your child’s annual sack of Halloween candy after a big night of trick-or-treating.

    It’s no secret that sugar is bad for teeth. But the effects of poor dental health extend far beyond a treat-heavy holiday.

    Dental issues are a leading cause of absence from school, and California ranks right near the bottom among states when it comes to kids’ oral health. However, parents can fend off sugar’s role in dental decay and infections, Venice Family Clinic dental director Dr. Jaspreet Kaur said.

    “Halloween is a reminder and a learning opportunity to set boundaries,” she said. “Teach your kids that they can enjoy the treats, but in balance.”

    Here are some tips from dentists for keeping your child’s mouth healthy at Halloween and beyond:

    Avoid chewy, sticky, hard and sour treats

    Candies that are chewy or sticky tend to stay in a child’s mouth longer than others. Soft, taffy-like candy, caramel and gummies get caught between teeth or in their grooves. Hard candies, like lollipops that children suck on, linger longer in the mouth.

    When the candy isn’t washed or brushed away quickly it produces acid, which can break down the enamel that protects teeth and causes cavities, according to Dr. Santos Cortez, a pediatric dentist in Long Beach. Sour candies are extra damaging because they not only introduce sugar to the mouth, but also acids when first eaten.

    The texture issues don’t just apply to candy either. That packet of raisins in your child’s trick-or-treat bag isn’t necessarily a better option. The sticky texture of the raisins causes the sugar to stick to the teeth in the same way as candy, making the mouth more susceptible to cavities, Cortez said.

    Juice and soda are also a problem. Like with hard candies, the sugar may stay on your child’s teeth for a while, especially if they take a long time to drink it, which means the teeth are exposed longer.

    Opt instead for sweets like chocolate — dark chocolate if you can. Chocolate, as long as it isn’t mixed with something like caramel, tends to melt in the mouth faster and is easier to brush off.

    Bring a water bottle with you on your Halloween route.

    Have your child drink water after eating candy. The water can help wash away some of the residue left behind by the sweet treat, according to Cortez. Keep a bottle handy as you trick-or-treat to have your child sip and wash off some of the stickiness as they enjoy the night. That will help reduce sugars until they are able to brush their teeth.

    Make a habit of having them drink water any time they consume sugar and can’t brush right away. Instead of bottled water, give them tap water, which should contain fluoride to help stave off dental decay.

    Of course, brush their teeth

    Make sure your child brushes their teeth as soon as possible after eating candy or anything sweet. If your child is determined to brush on their own, let them, but make sure to get in there afterward to remove plaque. Continue to brush your child’s teeth for them until they are 8 years old, using a pea-sized amount of fluoride toothpaste. Using a fluoride toothpaste helps combats the effects of sugar.

    In baby teeth, cavities tend to develop between teeth, so be sure to help you child floss once they’re ready.

    If you have a baby whose first tooth is just appearing, brush it with a small smear of fluoride toothpaste on a baby toothbrush twice a day — just enough to color the bristles. For infants without teeth, dentists recommend wiping their gums with a clean cloth after feedings.

    Remember, taking care of baby teeth is just as important as taking care of the permanent teeth. Problems that affect the baby teeth now can affect the permanent teeth later on if not addressed.

    Set rules on candy

    Set rules about how much candy your child can consume — a small amount daily. It’s better to let them eat a piece or two at once rather than allowing them to snack on sugary treats multiple times throughout the day, according to pediatric dentist Dr. Alexander Alcaraz, the program director of pediatric dentistry at USC Ostrow School of Dentistry. Constant and long exposures to sugar feed the bacteria that develop cavities. Saliva also needs time to neutralize the acids in the mouth that can break down the enamel.

    Kaur also recommends limiting the time a child sucks on hard candy such as a lollipop. Some kids will suck on candy for up to half an hour. Opt for 10 minutes, for example, she said.

    Have them eat candy with a meal

    Leave candy — or any sweets for that matter — for an after-meal snack. When kids eat, more saliva is produced, which can better wash away the goodies. It might make it easier to remember to have your kids brush their teeth soon afterward as well, since many parents have kids brush their teeth after a meal.

    Some foods also have self-cleaning qualities. Fruits and vegetables like apples, celery and carrot sticks rub into the enamel when you bite into them, removing plaque.

    Exchange the candy

    Limit how long the candy bag is available so your child does not get used to having it within reach. Remove some of the candy your child collected or trade it all for a toy or extra play time. Check if your dentist or another group is sponsoring a candy donation effort.

    You can also take part in a new tradition and invite the “Switch Witch” into your home. Have you child put aside some of their candy for the Switch Witch, who’ll visit overnight to pick up the candy and leave something fun in its place. You can leave a toy for them to find the next morning.

    “Cavities don’t happen overnight,” Alcaraz said. “It takes time. It’s not a one-day process.”

    Go to the dentist

    After the first baby tooth emerges or your child reaches age 1, it’s time to see the dentist, who can add a coat of fluoride varnish to strengthen tooth enamel. Their efforts can make the effect of sugar-filled holidays less stressful.

    A dentist will let you know early on, for example, to avoid putting an infant to bed with a bottle of milk or formula because the liquid can sit on their teeth, and the sugars cause cavities, sometimes even before the first tooth emerges.

    Developing a relationship with dentists with an appointment every six months will also help keep you better informed as they grow. For young kids, the goal is to set strategies for families to keep the teeth healthy and reduce risk of gum disease and dental decay, Cortez said.

    Ask the dentist to apply sealants to a child’s back molars around the age of 6, the Los Angeles County Department of Public Health recommends. The thin coating can protect the chewing surface of the teeth from developing cavities.

    “It’s the most common chronic disease in children, more common than asthma,” Cortez said about dental decay, which affects more than 60% of kids in California by third grade. “We need to pay more attention. And so for pediatric dentists anyway, and for all dentistry, I think that the key is to start early.”

    This article is part of The Times’ early childhood education initiative, focusing on the learning and development of California children from birth to age 5. For more information about the initiative and its philanthropic funders, go to latimes.com/earlyed.

    Kate Sequeira

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  • Seltzer Is Torture

    Seltzer Is Torture

    I do not like carbonated beverages, plain and simple. I won’t drink soda, and you’ll never catch me with a beer. Gin and tonics are a no. Sparkling water? A beast in disguise. Oh, the cocktail is not that fizzy, you say? I’ve heard that one before. And get your slushie out of my face. As I said, I do not like carbonated beverages. I do not like them at all.

    I don’t just mean that they taste bad to me, the way soap or penicillin does. I mean that they hurt me. They inflict actual, physical pain on my mouth. The sensation is prickly, like having my tongue poked with hundreds of needles. On the handful of foolhardy occasions when I’ve dared take a sip of Coke, it’s felt like what I imagine sipping static electricity would feel like, at least until the pain subsides and I’m left with nothing but the hyper-saturated sweetness of a melted freezer pop. Even after I swallow, my mouth feels raw.

    When I try to explain this aversion, people sometimes struggle to wrap their mind around it. “Even sparkling cider?” they ask incredulously. “Even cream soda?” Yes, even sparkling cider. Yes, even cream soda. Occasionally, people try to relate: “Oh, I hate carbonation too … except in champagne.” Whatever these people mean by “hate” is clearly not the same thing I mean. The specifics of the drink make no difference to me. The carbonation itself is the problem.

    Part of me wonders whether this all traces back to an incident from my childhood. When I was 6 or 7 years old, I accidentally ate a piece of sushi covered in more wasabi than I’d bargained for and, in a panic, took a big gulp of water—except the water wasn’t water; it was seltzer, and I spit it all over the table. A couple of years later, I tried root beer at day camp and spat that out too. By that point, I’d pretty much learned my lesson.

    Read: The medical origins of seltzer

    So why am I like this? It’s not as though my mouth is hypersensitive to all tastes and sensations. I pop Sour Skittles at the movies and have a pretty high spice tolerance. My issue is more specific and, given that Americans consume more than 40 gallons of soda a person each year, very rare. But apparently I’m not the only one: On Reddit’s r/unpopularopinion forum and others like it, never-fizzers find common cause. Drinking carbonated beverages is “kinda masochist.” It’s “pure agony.” It’s like “swallowing battery acid.” “I feel like I’m drinking flesh eating bacteria,” one Redditor writes. “I swear I thought I was the only one who thinks they hurt,” another replies.

    You can find dozens of posts like these online—so many, in fact, that you may begin to wonder: How many times can an unpopular opinion be posted before it ceases to qualify as an unpopular opinion? Scientists, for their part, have documented at least one instance of an anaphylactic reaction to sparkling water. That reaction was not caused by the bubbles themselves, but neither is carbonation’s distinctive mouthfeel. For a long time, people assumed that the fizzy sensation was just the tactile experience of having bubbles pop inside your mouth. Early suspicions to the contrary came from mountaineers, who reported that when they raised a toast at the summit, their bubbly champagne tasted flat. In 2013, researchers confirmed that the “bite” of carbonation is not dependent on bubbles: Even after drinking sparkling water in a pressure chamber, where bubbles cannot form, test subjects still reported feeling the slight “sting, burn, or pungency” associated with fizzy drinks, both on the tip of their tongue and at the back of their throat.

    Read: The sad truth about seltzer

    The source of that bite, scientists determined, is the carbonic acid formed when enzymes in the mouth break down carbon dioxide. (That process happens to be inhibited by a medication commonly taken by mountaineers to stave off altitude sickness.) The acid activates pain receptors, Earl Carstens, a neurobiologist at UC Davis, told me, so the experience of drinking a carbonated beverage should be sharp and irritating for everyone. In that sense, the weird thing is not that some people hate carbonation; it’s that anyone likes it at all. Social conditioning may play a role: We accept the pain of drinking soda because we’re taught that it’s okay. Or perhaps the mild pain is associated with a pleasurable release of endorphins, as can occur when people eat a spicy food. Both of those factors are likely in play, Carstens said.

    But as my experience shows, not everyone experiences carbonic-acid pain the same way. Some people feel a refreshing tickle, others a chemical assault. No one knows why. Scientists have traced other aversions—to cilantro, for example, or tannic wines—to natural variations in human taste and smell receptors. “We are not at the same place in our knowledge of carbonation,” Emily Liman, a neurobiologist at the University of Southern California, told me. The problem faced by sodaphobes may yet turn out to have a genetic explanation, but for the moment, scientists don’t even understand exactly which cells are involved in the sensation. Pain receptors (such as the ones that detect spiciness) and taste cells (such as the ones that detect sourness) seem to play a part in feeling carbonation, Liman said, but it’s unclear exactly which cells contribute.

    In short, there’s no way to know whether I’m the victim of busted mouth biology, or of some long-repressed experience that bubbles up as oral pain, or of something else entirely. In any case, hating carbonation only means that I have to do a lot of polite declining. It’s not a huge deal, yet I sometimes find myself perturbed to to be cut off from a whole sector of human experience, to dislike something that almost everyone else seems to like, and to dislike it not because of some contrarian impulse or principled objection but because of my physiology or my psychology. Best not to indulge such musings, though—they can easily give way to temptation. Last summer, after years of strict avoidance, I ordered a cider at a bar, thinking that maybe, after all these years, something had changed. Nope!

    Jacob Stern

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  • We Still Don’t Know What Fundamentally Causes Canker Sores

    We Still Don’t Know What Fundamentally Causes Canker Sores

    A canker sore—a painful white ulcer inside the mouth—might be brought on by stress. Or the wrong toothpaste. Or certain foods: tomatoes, peanuts, cinnamon. Or an iron deficiency. Or an allergy. Or a new prescription. Or an underlying autoimmune disease.

    Even though millions of people suffer from them every year, researchers still don’t know much about what fundamentally causes these sores. This leaves doctors and dentists stuck playing detective with their patients—running down a checklist, trying to figure out which of more than a dozen potential triggers could’ve set off the gnarly little lesions.

    That list is long and spans different specialties in medicine. It includes trauma to the mouth, stress, diet, genetics, hormones, allergies, vitamin deficiencies, autoimmune diseases, and gastrointestinal diseases. Diana V. Messadi, a professor at the UCLA School of Dentistry, told me that canker sores are multifactorial, which makes them hard to study. Cold sores, by comparison, offer a much tidier story: They’re viral infections (herpes simplex) and thus are treatable with antivirals. (Cold sores are pimplelike blisters that usually form around the lips, whereas canker sores are white ulcers that occur inside the mouth.)

    Read: The overblown stigma of genital herpes

    Canker sores can be loosely sorted into two buckets. In Bucket A are the smaller, more common sores, the kind a person might get two or three times a year. These sores are bright, nagging, and painful, and they make eating and talking difficult. They usually aren’t life-threatening. In Bucket B are larger cankers, usually more than a centimeter wide. (Technically, a third bucket exists that includes herpetiform, or clustered, sores—but this type is rare.)

    Big or small, some sores are linked to an underlying disease, like Crohn’s, Behçet’s, HIV/AIDS, or celiac disease. In a way, these cases are better understood: The sores are a secondary effect of something else going on in the body—something a doctor can test for and identify.

    The human mouth is a weird place. Canker sores occur in what’s called the oral mucosa, which is doctor-speak for the skin (it’s not actually skin) inside your mouth. Even though the mucosa is tucked away inside your cheeks, it gets exposed to a lot. Salsa, notes Nasim Fazel, a former professor at UC Davis who started the college’s oral-mucosal clinic, “is a chemical irritant. You don’t rub salsa on your skin.” But people do eat salsa—and chips, nuts, and other foods that are spicy or acidic or sharp, and that can damage the lining of the mouth. Some of these wounds later develop into canker sores.

    Because the mouth is dirty, white blood cells like to hang out there; Andres Pinto, a professor at the Case Western Reserve University’s school of Dental Medicine, told me that this way, they can react quickly to a potential infection. But sometimes, this surveillance system fails, and the body can actually self-injure. This is thought to be part of what causes typical canker sores, Pinto explained: Immune dysregulation is the “common denominator” behind the ulcers. Inflammation can help the body heal, but too much inflation can cause the mucosa to break down, which is what we see when we look at the oval-shaped wounds.

    Beyond that, canker sores are still idiopathic, meaning doctors don’t really know why they happen. The body’s immune system is deeply complicated; as my colleague Ed Yong wrote in 2020, it’s where “intuition goes to die.” “The problem with all these immune-mediated conditions, oftentimes, is we still don’t know why they come,” Alessandro Villa, the chief of oral medicine at the Miami Cancer Institute, told me. “At the end of the day, it’s still a big mystery.”

    Another lingering mystery is why some people get canker sores while others live in ignorant bliss, free of their specific kind of torture. Genetics is starting to help solve that one. “Using sophisticated computers, we can actually detect which genes are associated with what we see in the mouth,” Pinto told me. “What I just said is a big step,” he added. “It took probably 30 years to develop that last sentence.”

    Read: Paxlovid mouth is real—and gross

    More research is needed to better treat patients, especially those with bad or chronic sores. Topical steroids can help, but they don’t address the underlying causes. A spokesperson for the FDA told me there are no available FDA-approved prescription options specifically for canker sores.

    Comparatively speaking, the United States does not have a lot of providers that specialize in this area. Fazel, formerly of UC Davis, is a rare combination of dentist and dermatologist who sometimes sees patients with debilitating cases. “I’m kind of using the same meds as I was using 10 years ago,” she told me. “It’s kind of sad.”

    Oral-medicine specialists are dentists with extra training in such ailments. But only about 400 practice in the United States, Pinto estimated. A representative for the American Academy of Oral Medicine told me the organization currently has 281 active members (although it noted that there may be additional nonmembers practicing). Fazel, for her part, thinks dermatologists are better equipped to treat canker sores, because dentists “can’t prescribe the big guns.” (The “big guns,” in this case, are medicines that modulate the immune system to calm inflammation.) Even if a patient does manage to see the right provider, that’s only the first step. They’ll still need to go through the checklist, trying to determine what their triggers are—while the bigger question of what actually causes the sores remains unknown.

    Caroline Mimbs Nyce

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