Symptoms - Causes

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Most canker sores are round or oval with a white or yellow center and a red border. They form inside your mouth — on or under your tongue (soft palate), inside your cheeks or lips, and at the base of your gums. You might notice a tingling or burning sensation a day or two before the sores actually appear.

There are several types of canker sores:

Minor canker sores. The most common type of canker sore is an oval lesion, less than 1/3-inch (7.62 millimeters) wide that clears on its own in about two weeks. Though not serious, minor canker sores can be very painful.
Major canker sores. These are large lesions with irregular margins that can last months or even years. They often heal with extensive scarring.
Herpetiform canker sores. These are clusters of dozens of tiny lesions that may merge to form a single large ulcer. Herpetiform canker sores usually develop later in life and may last from a week to a month or more.

Occasionally, you may experience other signs or symptoms along with the lesions, such as:
Fever
Listlessness
Swollen lymph nodes


Causes
The precise cause of canker sores remains unclear, though researchers suspect that a combination of several factors contributes to outbreaks, even in a single individual. These factors include:

A faulty immune system that attacks healthy cells in your mouth instead of pathogens such as viruses and bacteria

A minor injury to your mouth from dental work, overzealous brushing, sports mishaps, spicy or acidic foods, or an accidental cheek bite

An allergic response to certain bacteria in your mouth

Helicobacter pylori, the same bacteria that cause peptic ulcers

A diet lacking in vitamin B-12, zinc, folate (folic acid) or iron

Celiac disease, a serious intestinal disorder caused by a sensitivity to gluten, a protein found in most grains

Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis

Behcet's disease, a rare disorder that causes inflammation throughout the body, including the mouth

HIV/AIDS, which suppresses the immune system

Food allergies or sensitivities
Certain foods, particularly chocolate, coffee, strawberries, eggs, nuts, cheese and highly acidic foods, such as pineapple

Hormonal shifts during menstruation

Emotional stress

Toothpastes and mouth rinses containing sodium lauryl sulfate