No cure but many treatments for canker sores

DEAR DR. DONOHUE: I’ve been bothered with canker sores of the mouth for almost a year. And I’m talking about having five or six at a time. Is there a cure? — N.N.

ANSWER: A cure? No. Treatments? Yes. Canker sores are painful, shallow ulcers that appear on the tongue or the lining of the mouth. They’re probably an autoimmune phenomenon. Something in the mouth triggers the immune system to assault it. One possible explanation is that a protein part of a bacterium that belongs to one species of the mouth’s normal bacterial population is the switch that turns on the immune system. Many researchers have looked and are still looking for a viral cause.

The number of ulcers during an outbreak can be one or many. They have a gray center with a red, often slightly elevated margin. They last for a few days to as long as two weeks, and then they spontaneously heal.

A few things help prevent them or help make them less painful. Go easy on acidic foods and drinks. Citrus fruits and tomatoes are examples. Use a toothbrush with soft bristles. Hard bristles can injure the tongue and set off an outbreak. The same thing goes for very crunchy foods, like toast and potato chips. Some people have identified sodium lauryl sulfate, an ingredient in many toothpastes, as the factor provoking an outbreak. Check the ingredients of your toothpaste and switch to another if it has this material.

For an outbreak, mouthwashes like Peridex and PerioGard lessen pain and hasten healing. Aphthasol, a paste applied to the sores, does the same. Put it on mouth areas that tingle before the sore appears. If you don’t have that kind of warning, then apply it to the sore. Kenalog in Orabase is another medicine applied directly to the canker. Rinsing the mouth with Benadryl liquid and then spitting it out soothes the sores. Or you can make a mouthwash solution of equal parts of Benadryl liquid, Milk of Magnesia and Kaopectate. This, too, is spit out after swishing it around.

DEAR DR. DONOHUE: Two or three months ago, you stated that potassium brings down blood pressure.

I mentioned that to my doctor, and he wanted to read about it for himself. Will you please supply that information? — N.H.

ANSWER: Sure. One article is found in the New England Journal of Medicine, 356:19, May 10, 2007. The title is: Sodium and Potassium in the Pathogenesis of Hypertension. The authors are A.J. Adroque and N.E. Madas. The library at your doctor’s hospital either will have bound copies of the journal or can send away for the article.

The Institute of Medicine, a board of experts that develops recommendations for many nutrients, including minerals and vitamins, suggests that people get 4,700 mg of potassium a day. We are a people who take in too much sodium and an insufficient amount of potassium. Potassium blunts the blood-pressure-raising property of sodium (salt). Potassium also dilates arteries, something that lowers pressure. In people with high blood pressure, potassium can lower their reading by four points.

Sweet potatoes, tomatoes, baked potatoes with their skin, figs, prunes, soy beans, lima beans, squash, spinach, peaches, cantaloupe, kidney beans, bananas, orange juice and almonds have a generous supply of potassium. You can meet your potassium goal through foods.

Since I’m on this potassium kick, it also is reputed to decrease the risk of kidney stones and to guard muscles against the shrinkage caused by old age.

DEAR DR. DONOHUE: I have a question about how far away you should sit from a television set. I had heard, a long time ago, that a person should sit no closer than 10 feet. I am concerned because my grandchildren sit much closer. — V.W.

ANSWER: I had heard the same thing, but the current opinion is that no danger exists from watching TV closer than 10 feet. If readers have evidence to the contrary, let me know.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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