Are Canker Sores Part Neurologically Driven?

Article in press found injection of Botox into aphthous ulcers not only gave relief of pain in three days but freedom of recurrence for more than 6 months
Eur Arch Otorhinolaryngol. 2008 Jun 27. [Epub ahead of print]
The value of local botulinum toxin A injection in the treatment of the pain of aphthous ulcer.
Yang TY, Jang TY.

abstract here

Control groups was saline injected.
Botox was diluted by TEN mls. of Normal saline (10 units/ml). ONE unit was injected as follows:

  • 30 gauge needle
  • entry 2 – 3 mm from ulcer
  • go down at 45 degrees
  • 0.1 ml = ONE unit was injected “toward the center” of the ulcer

Pain was much better after 3 days and there were no recurrences after six month (NOTE they took only people with frequent recurrences). There was faster healing compared to saline injected placebo. They commented the three days coincided with the three days Botox took to achieve anti-wrinkle effects when injected cosmetically.
One Botox bottle could do 100 ulcers.

They suggest it be done for ulcers

  • over 1 week duration
  • difficult to talk or eat
  • monthly recurrences

Comment – There has to be peripheral neurogenic inflammation as part of aphthous ulcers. This is got to be great news for canker sore sufferers as the dose is miniscule and results long lasting.

Addendum:

B12 1000mcg at bedtime sublingual for six months cuts no aphthous status from 74.1% (control group) to 32% intervention even though B12 levels were normal – now that’s a cheap aid…
In:

Effectiveness of Vitamin B12 in Treating Recurrent Aphthous Stomatitis: A Randomized, Double-Blind, Placebo-Controlled Trial
Ilia Volkov, MD, Inna Rudoy, MD, Tamar Freud, MBA, Gabriel Sardal, MD, Sody Naimer, MD, Roni Peleg, MD and Yan Press, MD
Am Board Fam Med January-February 2009 vol. 22 no. 1 9-16 free article here

Reviewed here:
Evid Based Dent. 2009;10(4):114-5.
Vitamin B12 for the treatment of recurrent aphthous stomatitis.
Carrozzo M.   abstract here

Earlier case reports here though had actual B12 deficiency:
Case Report: Recurrent aphthous stomatitis responds to vitamin B12 treatment
Ilia Volkov, MD, Inna Rudoy, MD, Unes Abu-Rabia, MD, Tawfek Masalha, MD, and Rafik Masalha, MD
Can Fam Physician. 2005 June 10; 51(6): 844–845.  free article here

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2 Responses to Are Canker Sores Part Neurologically Driven?

  1. Pingback: Chronic Back Pain Help – Forgotten B12 Injections | Pain Medical Musing

  2. Hey There Admin,
    Thanks for the info, For someone who never experiences canker sores this article will seem a waste of time but for those of you who experience the pain and irritation of canker, you will find this information extremely valuable. Canker sores, known medically as Apthous Ulcers are tiny, sometimes unseen sores that develop inside a persons mouth. They can show up just about anywhere in the mouth at any time. Most commonly however they come about because of some sort of trauma to the mouth. Even something as innocent as eating a tortilla chip and scraping the inside of the mouth cavity. What happens from there can only be best described as inter-mouth carnage. They are most likely caused by the body’s own immune system. For some unknown reason the immune system identifies an invading agent inside the mouth and then rushes white blood cells to catch and destroy the bacteria. However they sometimes also attack the healthy tissue and the result is a canker sore. Or when a secondary infection is present because of the irritation germs multiply which in turn causes the body’s immune system to over-react sending too many white blood cells.
    Keep up the good work

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