Musician, Heal Thyself: Canker Sores

Canker sores: these minor annoyances can become an issue for brass players, and over the years I’ve dealt with my fair share of them.  First, the disclaimer: I am not a physician, and the following material is based purely on my own experience.  It is not meant to be medical advice – when in doubt consult a medical doctor!  That being said, I have found a few things that seem to help me (and my students) overcome these painful sores.

According to WebMD, canker sores are “small shallow ulcers that appear in the mouth and often make eating and talking uncomfortable.” The WebMD entry goes on to describe two different kinds of sores, simple and complex, the former being the most common.  For most people, canker sores hurt for a couple of days and then disappear.  For brass players, though, the repeated contact between the sores and the teeth/gums (depending on where the sore is located) can cause them to linger on for several days, even up to a week or more.  Since taking several days off from playing isn’t usually an option, most of us simply have to grin and bear it until the sore(s) finally heal. Canker sores can be brought on by stress, although in my case most of the sores I’ve had have developed from small cuts in my mouth, either from accidentally biting my cheek while eating or scraping my gums or cheek with a piece of sharp food like a potato chip or toasted bread. I’ve never had anything serious enough to warrant a visit to the doctor, but if you have several sores at once or a sore that lasts for multiple weeks you should definitely consult your physician.  After some trial and error, I now follow these basic rules to help prevent and treat my canker sores.

  1. Switch to a toothpaste which doesn’t contain sodium lauryl sulfate.   This common ingredient in many toothpastes can promote the formation of canker sores – for more info see this page on the Mayo Clinic’s website. I stopped using toothpastes with this ingredient over a year ago, and since then I’ve noticed a marked decrease in the frequency and duration of canker sores.  One brand that is reasonably priced and easy to find is Burt’s Bees.
  2. Chew carefully!  As previously noted, cheek biting has caused a number of sores for me, and taking a bit more care when eating has helped me prevent future injuries. What can I say, I enjoy eating, and sometimes I get in a hurry! If you do happen to bite your cheek, make sure to take extra special care that you don’t bite the same place again as this will aggravate the sore.
  3. Keep your mouth clean. This is a good rule of thumb whether you’re prone to canker sores or not.  Brush after every meal when possible, and use a good mouthwash as well.  If I get a canker sore I like to rinse my mouth with equal parts water and hydrogen peroxide.  Follow the directions for use on the bottle of hydrogen peroxide.  There are some expensive mouthwashes out there which claim to be formulated specifically for canker sores, but if you look at the bottles carefully you will see that the active ingredient is, you guessed it, hydrogen peroxide.
  4. Canker Covers: I have had success with treating canker sores using these patches, which protect the sore and dissolve over the course of 8 or so hours. They allow you to eat and drink without running the risk of further aggravating it, although I would not recommend playing with one of them in your mouth. For one it feels pretty weird, and I would imagine that parts of the patch could find their way into your horn if you aren’t careful.

That’s about it for my tips on treating canker sores – if you have run across other helpful remedies feel free to comment below.  I seem to remember there being some information on homeopathic remedies for canker sores and other minor irritations in Broken Embouchures, by Lucinda Lewis, but I have misplaced my copy at the moment so I can’t be sure.

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I used to suffer a lot from these as well, and after a lot of experimentation, have found a method that seems to work more effectively than anything else I’ve tried. Try picking up Alum, which is a spice used in pickling, and can be found in the spice aisle of most grocery stores. Put a dab of alum on the sore a couple times a day and it will quickly dry it out. Usually the pain from a sore goes away even before the sore itself disappears.

Two caveats:
1) This will burn like crazy! Try to leave the alum on for 5 minutes or so before washing it off.
2) Alum tastes utterly horrible, so do whatever you can not to let it touch your tongue or ingest it.

I stopped eating potato chips! Before playing the horn there never seemed to be a problem, but after several episodes of dealing with various nicks, decided discretion the better part of valor.

On a vaguely related note, I did a series of posts on dealing with a lip callus, and they pull in a slow but steady stream of search engine hits. Back when it happened a couple of years ago there was nothing I could find on the net. Haven’t looked lately, but since I’m getting the hits, assuming there’s not much. Certainly are trumpet, horn & trombone players looking for info.

Hi Lyle,

Thanks for the comments – I agree about the potato chip thing – but they sure are tasty!

I’ll have to give your posts on lip calluses a read through – I’ve heard of some professional players getting them, but luckily haven’t had to deal with one myself.

Thanks David – interesting stuff! I agree that the “shampoo causes cancer” bit certainly sounds like an email hoax, and the information linked to on the American Cancer Society site is very reputable. I have not, however, been able to find anywhere that debunks a link between sodium lauryl sulfate and canker sores. Perhaps it’s some kind of an allergic reaction that certain people are susceptible to? It should be noted as well that Tom’s of Maine toothpaste does contain SLS, so they have a vested interest in promoting, or at the very least downplaying any negative effects of, that ingredient. Then again, it’s always possible that my experience with an SLS-free toothpaste was psychosomatic.

James – I will admit to going with potato chips from time to time, but never within a week or ten days of a performance. I mentioned the callus issue because it seems rare, but real, and thinking that if you knew anything about it, maybe you’d do a post. I’m sort of uncomfortable with my novice’s thoughts coming up so high in search engine results.

My old horn teacher recommended to me to try taking Acidophilus – it is the enzyme found in yogurt and found in most grocery stores/pharmacies by the vitamins. I would take several (like 5) at each meal for 2 or 3 days and the cankers would be gone quickly.

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