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All You Need to Know About Canker Sore on Tonsil Tissues

Updated on October 23, 2016
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Trained in dentistry, Sree is currently studying lab sciences. She enjoys researching various health topics and writing about her findings.

What is a Canker Sore?

If you've ever had a canker sore, then you know how painful they can be.

Canker sores are characterized by a yellow or whitish dot on the cheek, the tongue, or any other part of the mouth including the tonsils and their underlying tissues. The canker is often surrounded by reddish, inflamed-looking flesh.

Canker sore is the most common type of mouth lesions, which affects about 20% of the US population. It is also referred to as aphthous ulcer or aphthous stomatitis. It is more common in women than in men. Susceptibility to canker sore can be inherited.

Most canker sores are oval or round in shape, white at the center with red border.

There are three types of canker sores:

  1. Minor sores - This measures about 3 - 10 mm, oval shaped with red border. This is the more common type. The lesions may heal in 10 to 14 days. The healing process will takes place without leaving any scar.
  2. Major sores - These are bigger and deeper than the other two types. A major sore is usually round with defined red border. If it is larger, it forms an irregular shape with irregular edges. It is extremely painful. Major sores grow more than 10 mm and take six weeks to months before they heal and may even leave scars.
  3. Herpetiform sores - These are large groups of sores, from clusters of 10 to about 100. They may also merge into one large sore and have irregular edges. They appear smaller, about 2 - 3 mm. These sores may be the smallest, but they appear in hundreds simultaneously. You can expect them to heal without scarring.

If you get a canker sore on your tonsils, every time you swallow, you'll know that it is one of the most painful canker sores you can get.

Can you really get a canker sore on your tonsils?
Can you really get a canker sore on your tonsils?

What Causes a Canker Sore

Some of the main causes of canker sores include:

  • A small injury as a result of an accidental bite, bump, burn, rough brushing of teeth, or dental work–any small abrasion to the inside of the cheeks, lips, or tongue may not heal properly and may cause a canker.
  • Lack of important nutrients that promote proper growth of tissues, such as iron, zinc, vitamin B12, and folic acid (folate).
  • Allergies or sensitivities to toothpaste or food (coffee, chocolate, shellfish, strawberries, cheese, eggs, nuts, highly acidic foods like pineapple, lemon, and tomatoes, and ingredients like sodium lauryl sulfate).
  • Acidic foods, like citrus fruits can trigger the appearance or make it worse.
  • Smoking
  • Gastrointestinal tract diseases, like Crohn’s disease or Celiac disease
  • Auto-immune disorders, like Behcet’s disease or systemic lupus erythematosus IQ
  • Other immune system weaknesses, like the common cold, flue, or HIV/AIDS
  • Oral cancer
  • Stress.
  • Anxiety.
  • Poor oral hygiene.
  • An allergic response to bacteria in the mouth.
  • Hormonal changes may trigger a canker sore on a woman's tonsil tissue during the days prior to menstruation.

Unlike cold sores, canker sores are not associated with herpes virus infections. If you experience cankers chronically, you should begin keeping a record of everything you eat and drink to help determine what might be the cause. There are also more serious medical triggers for canker sores so if you get them chronically, consult your doctor.

Signs and Symptoms of Canker Sores

Canker sores are painful. Among the most common symptoms of this problem are the following:

  • There is a tingling or burning sensation, which lasts for up to 24 hours before the appearance of the sores.
  • Appearance of ulcers that resemble small craters of gray, white, or yellow, with red border.
  • Difficulty in swallowing, speaking, or eating.

The following symptoms are not that common, but these can also indicate a more serious medical condition:

  • Swollen lymph nodes
  • Fever
  • Sudden weight loss
  • A feeling of sluggishness
  • Presence of thrush infection in the throat or mouth

If you notice the following when dealing with canker sores, it is advisable to seek medical attention immediately:

  • Sores are spreading rapidly, particularly into the lips.
  • They are larger than usual.
  • You've had them for more than 3 weeks already.
  • Presence of severe pain that is not relieved by pain relievers.
  • Difficulty swallowing, even fluids, causing dehydration.
  • Pain is accompanied by high fever.
  • Recurring ulcers, with the new ones appearing even before the old ones start to heal, or there are frequent outbreaks of sores.

Risk Factors
Practically anyone may develop canker sores, though, teens and young adults are more prone to having them. Canker sores are more common among women.

People who suffer from recurrent canker sores are likely to have a family history of the medical condition. Aside from heredity, it may also be due to a shared factor environment, like allergens and certain foods.

How to Prepare for your Appointment

Your dentist or medical doctor can diagnose canker sores by performing physical examination. Here are some important information that you need to know before seeing your doctor:

Information you need:
Make a list of the following:

  • The signs and symptoms - These include the initial appearance of the sores and how they developed over time.
  • Medications - These include all your over-the-counter medications, vitamins, and supplements. Make sure that their doses are also included.
  • Other medical conditions - These include recent changes you have observed and possible causes of emotional stress.
  • Questions and other inquiries - Make sure you list down the things that you want to know about the condition. Writing them down allows you to cover everything, thereby ensuring that your visit to the doctor is more efficient.

Basic questions you might want to ask:

  • What exactly do I have? Is it a canker sore?
  • If it is canker sore, what could have been the triggering factors that led to its development?
  • If not, what is it?
  • Are there tests that I need to undergo?
  • What kind of treatment would you recommend, if there are any?
  • What self-care tips can you recommend to help alleviate the symptoms?
  • Are there anything else that we can do to speed up the healing process?
  • How soon can I expect the symptoms to subside and the sore to start healing?
  • What steps can I take to prevent its recurrence?

Asking questions will help you understand the condition more. Do not hesitate to throw in questions, even if you think they are just trivial ones.

Questions that you should expert your dentist/doctor to ask:

  • Enumerate your symptoms.
  • When did you first have the symptoms?
  • How severe is the pain?
  • Can you recall of similar conditions in the past? If so, did you notice anything that might have trigger the appearance of these sores?
  • Did you seek treatment when you had similar sores before? If you did, what treatment was the most effective?
  • Have you recently had any dental work?
  • Was there anything recent that caused you to be stressed out?
  • Did you recently undergo a major life change?
  • What do you usually eat every day?
  • Did you have other medical conditions before?
  • Are you taking medications for a particular illness? How about vitamins and other nutritional supplements?
  • Do you have other family members who've had canker sores?

How Canker Sore is Diagnosed
Your doctor or dentist will conduct a physical examination. Blood tests or a biopsy of the affected area can be ordered if there is severe breakout or if they suspect the presence of the either of the following:

  • Viral infection
  • Hormonal disorder
  • Vitamin deficiency
  • Weak immune system

It is also possible that your doctor may suspect cancer since cancerous lesions may appear like a canker sore. Oral cancer and canker sores have some similar signs and symptoms, including the appearance of painful mouth ulcers and swelling in the neck area. However, oral cancer has more severe symptoms, including bleeding from the gums, earaches and loose teeth.

It is important to see a doctor if you experience canker sores symptoms in order to rule out oral cancer.

How Long Can a Canker Last?

Even without treatment, canker sores usually heal of their own accord within a matter of days. Ten days is the longest one could expect to suffer from a canker sore but those ten days can be quite excruciating, especially if the sore is located on a highly sensitive part of the mouth like the tonsil.

There are various methods for treating a canker sore on tonsil tissues to help speed recovery and alleviate pain. Ask your doctor which of the following methods might work for you.

Prevention
Prevent canker sores from recurring by identifying then veering away from the foods that may have triggered the initial outbreak. Foods that are salty, spicy and acidic can cause the appearance of canker sores. Foods that you are allergic to can also cause the problem.

You may also establish if the sores appeared when you were under a lot of stress. Try meditation or yoga to help relieve stress.

Good oral hygiene is imperative. Consult your dentist on what additional steps to take care of your mouth.

Canker Sore on Tonsils
The cause of the appearance of canker sore on the tonsils is different from the sores that grow on the soft tissue of the mouth. When canker sores appear on your tonsils, it is usually because of an allergic reaction. Supposing you are allergic to a particular food or medication and you accidently ingest it, the appearance of sores will likely follow.

Foods that may cause allergic reactions are tomatoes and strawberries since both of these have high acidity levels. In some instances, shellfish is also a cause for canker sores on either side of the tonsils.

If a particular medication (drug) is to be blamed for the appearance of the sores, it is important to get immediate medical attention. It is not advisable to immediately cease taking the medication once canker sores appear because it can cause more harm than good on the ulcers.

Canker sores growing on the tonsil tissues may also be due to poor oral health. Not regularly flossing and brushing the teeth can lead to bacterial growth in the mouth. The food particles that get stuck in between teeth and create residue on the tongue may adhere to the tonsil tissues and create canker sores.

Also, some toothpaste ingredients may result to allergic reactions, thereby leading to ulcerations on the tonsil tissues.

Symptoms
Symptoms are similar to the symptoms on normal canker sores found on the walls of the mouth. Aside from the pain and severe discomfort, there is a burning sensation just before the appearance of the tiny ulcers. Then white ulcers begin to form with visible red edges.

Fever may also accompany the appearance of the canker sores. You can also expect to experience swollen glands, body malaise and feelings of extreme fatigue in severe cases.

Possible Related Issues
There could be a connection between the canker sore on the tonsil tissues and constant pain in your ear. This may be due to how the eyes, ears, nose and throat are connected. If you have a deep ulceration in your throat or tonsil tissues, there is a great possibility that you will also experience pain in the ear every time you swallow. The pain will usually persist until the canker sore heals.

If the pain becomes unbearable and you cannot wait out for the canker sores to heal, you should consult your doctor to make sure that you get the proper medication for the pain.

Fever and canker sores on the tonsil tissues may also be related. Fever is likely to occur when there is ulceration, however, this is a rare occurrence. If this happens, there could be viral infection. If the temperature proves to be too high, professional medical attention is in order.

Treatments

It is important to reiterate that there is no single cure available to treat canker sores. The trigger is different for every person affected.

Canker sores may be treated with prescription medications such as corticosteroids. Doctors may also recommend over-the-counter drugs, like anesthetic liquids and gels. Various home remedies may also help.

However, there are cases when over-the-counter liquids and gels and homeopathic remedies cannot do anything to treat canker sores on the tonsil tissues. For one, it will be hard to reach the tonsils to topically apply these meds. In this case, doctors will recommend mouth washes and other antiseptics.

Here are some important considerations:

  • For those who have canker sores almost regularly, it is advisable to start a food diary. Here, you will take note of everything that you eat. This will help you see a pattern when the canker sores appear after eating certain types of food. It will then be easier for you to establish the trigger factor, so you can avoid eating these and prevent the recurrence of the ulcerations.
  • If you often develop cancer sores on your tonsils, try not to use toothpastes with sodium lauryl sulfate. It is a foaming agent and identified to trigger canker sores in the mouth and tonsils. There are only certain toothpaste brands that use sodium laurel sulfate. You will just have to check the labels before purchasing.
  • The kinds of food you eat may determine the occurrence and cure of canker sores. Yogurt helps decrease the uncomfortable burning sensation because it contains Lactobacillus acidophilus. Spicy foods may worsen the pain so it is advisable to avoid them.
  • Highly recommended as cure are zinc lozenges. Experts say that zinc has a mild antibiotic property, which can kill germs growing around the ulcer. Zinc also allows the sore to heal faster.
  • Not all mouthwashes are created equal. Choose mouthwashes with antibacterial agents. If you gargle with a mouthwash that has antibacterial properties, the sores may heal faster. If you cannot tolerate the taste and sting of a mouthwash, you may gargle water with salt.
  • There are topical agents available in the market. Look for glycerin or a topical anesthetic agent to alleviate the burning sensation. It helps soothe the sore.

Conventional Treatments
Most dentists and medical practitioners recommend to let canker sores heal on their own. However, if you get canker sores more frequently than usual, you may want to get rid of the ulcers fast.

For severe cases, dentists recommend the use of mouthwash or lysine. Choose a mouthwash, which contains steroid dexamethasone that helps reduce inflammation and pain, or idocaine which is also useful in relieving pain.

Laser therapy and mucosal bandage are often the treatments of choice to get rid of canker sores quickly.

The use of pure botanical oils when brushing and rinsing helps kill the bacteria that cause the sores.

Topical products may also be prescribed, like Benzocaine, Fluorcinonide, and Hydrogen peroxide.

There are oral medications that your doctor may prescribe if other topical treatments or mouthwashes won't work. Some doctors recommend some medications that are not intended for canker sores but have been proven to be effective in dealing with these sores. One example is for intestinal ulcer, sucralfate, which is utilized as a coating agent. Colchicine is used for gout treatment, but may also be effective in treating canker sores.

Oral steroid medications may help relieve the symptoms and completely cure sores, but there are known effects so this is usually recommended by doctors as a last option.

Your doctor may explore the option of called cautery of sores. During the process, the sore is burned or seared with the use of an instrument or a chemical substance. Debacterol, a topical solution, is used to treat canker sores and other gum problems. This chemical shortens the healing process to only a week. Another chemical used to cauterize the sores is silver nitrate. It helps relieve pain.

Your doctor may give you a nutritional supplement if needed. These include folate or folic acid, zinc, vitamin B-6, and vitamin B-12.

Lifestyle Improvements
To help in relieving pain and speeding up the healing process, you may want to consider the following tips:

  • Properly rinse your mouth - You add baking soda or salt to warm water and use it as a mouthwash.
  • Apply a small amount of milk of magnesia on the sore several times daily.
  • Swallow ice chips - This helps reduce inflammation and slowly dissolve these ulcers.
  • Gently brush your teeth with a toothbrush with soft bristles. A toothpaste that is free from any foaming agent is your best choice, like Sensodyne ProNamel or Biotene.

How to Prevent the Initial Appearance and Subsequent Recurrence
Canker sores may recur if you do not make the necessary changes to prevent them from reappearing.

Consider the following:

  • Eat right - You have already identified the types of food that trigger their appearance, and worsen the condition. Take note of the foods you can and cannot eat. On your food diary, create a list of the food types you should include in your diet to ensure that the sores don't recur. Make a list of anything that you are allergic to so that you can avoid them immediately. When you dine out, make specifications to the server. If you have allergies in foods, make it a point to ask the server if the dish you are eyeing to order does not contain ingredients that you are allergic to.
  • Eat only healthy foods - Aside from ensuring that you don't suffer from canker sores, eating healthy foods can also help improve your overall health. Include more fresh fruits and vegetables in your daily meal. Switch to whole grains.
  • Good oral hygiene is important - You know the drill. Practice proper hygiene. The mouth is one of the most overused parts of the body, so you have to take extra care of your mouth.
  • Make sure your mouth is properly protected -If you have braces, retainers, or other dental improvements in your mouth, ask your dentist for its proper maintenance.

Natural Home Remedies for Canker on Tonsil

Before considering any type of treatment, it is necessary to ensure that the blister is a canker sore and is not a not a cold sore (“fever blister”) or a symptom of another condition. Canker sores that develop in any part of the mouth, including the tonsils, are traditionally given anti-inflammatory treatments.

Most of the medicines available to treat cankers will not work on your tonsils because of where the tonsils are situated, but here are a few things that might help:

Foods. In addition to avoiding spicy foods, certain foods will help in treating a canker sore, including yogurt. Its lactobacillus acidophilus helps lessen the burning sensation.

Baking Soda. A baking soda mouth rinse can be used to reduce pain and aid in healing. Mix 1 teaspoon baking soda in a half a cup of warm water, stir, then gargle a mouthful. Be sure not to swallow the mixture. Repeat once a day as needed.

Lozenges. Zinc lozenges are an effective remedy for canker sores. The antibiotic properties of zinc help it kill off germs in the tonsil area.

Hydrogen Peroxide and/or Milk of Magnesia. Mix one teaspoon of hydrogen peroxide with one teaspoon of water then dip a clean cotton swab into the mixture and apply it directly to the afflicted tonsil. Then take a new swab, dip it into milk of magnesia, then dab it on. Repeat three to four times a day as needed.

Mouthwash or Gargle. There are a few mouthwashes which contain antibacterial ingredients which can expedite the healing of canker sores. Gargling with saltwater is an ancient and effective home remedy for treating canker sores as well. Use these mouthwashes or gargles at least twice a day as needed.

Cold. Drinking something cold or sucking on an ice cube won't heal you, but it may help numb the pain. Hold a piece of ice in your mouth, as close to the canker as you can get it. Let it melt there for as long as you can stand it.

Vitamin B. Daily intake of at least 100mg of vitamin B12 supplement will help. Also, eat foods that are rich in vitamin B like shellfish, fish, and dairy.

Propolis. Propolis is a resinous mixture that honey bees collect from trees, sap, or other botanical sources which has been used for thousands of years as a treatment for canker sores. Propolis is an untested, unapproved herbal antiseptic that cleans out the sore and kills bacteria. You'll find it in the health section of any natural supermarket.

Probiotics. A daily intake of food or supplements with high levels of probiotics is also recommended for people with canker sores on their tonsils. This is especially important when taking antibiotics in order to balance out the bacteria levels in the digestive tract. Probiotics are considered 'good bacteria' and can be found in many supplements and fresh food such as yogurt and dairy products.

Alum. Alum is a chemical compound that has a wide variety of uses. In its powder form, alum can be applied to the armpits as a deodorant that attacks the bacteria that cause body odor. It can also be poured onto dirty water to purify it. Apply a few dabs of alum powder on the sore. The application of alum powder to the lesion of a canker sore can be quite painful and may induce vomiting in some people. However, the high acidity level and the antiseptic nature of the alum is very effective in helping the sore to heal rapidly.

Fever Blister (Cold Sore) vs. Canker Sore on Tonsil

Fever blisters (cold sores) and canker sores both cause a lot of discomfort and pain and it's sometimes hard to tell the difference between the two. However, there are a few major differences:

  • Fever blisters (also known as cold sores) are highly contagious while canker sores are not. Fever blisters are caused by the herpes simplex virus (HSV).
  • Fever blisters can appear elsewhere on the body (on the nose, eyes, or genitals, for example), whereas canker sores are confined inside the mouth. The tonsils are the furthest areas that canker sores reach, but there is no clear evidence or history to show that cold sores/fever blisters affect the tonsil tissue.
  • The herpes virus that causes fever blisters remains latent even when the blisters themselves are completely healed. This means that the virus is always present, even without signs. On the other hand, a canker sore can heal completely and never reappear, depending on whether or not the person comes into contact with the triggering factor.
  • It is easy to tell them apart. Fever blisters develop on firmly attached on keratinized, firmly attached oral tissues. These are often referred to as bone-bearing tissues, meaning they are tightly bound to the bone lying underneath. Bone-bearing tissue example is the skin that covers the hard palate. Another example is the attached gingiva, which is the gum tissue surrounding the teeth and bone tissue.
  • Canker sores form on non-keratinized, loose tissues of your mouth. The areas include the floor of the mouth, the soft palate, the back of the mouth, tonsils, or the tip of underside of the tongue. It is easy for doctors or dentist to come up with an accurate diagnosis just by identifying the location of the canker sore.
  • The early stages are different. For fever blisters, they appear as a group of vesicles, more commonly known as blisters. On the other hand, canker sore lesions initially appear as raised with red border. From this form, it will become an ulceration, which may grow up to ¼ of an inch. If you notice the formatting of blisters, you can rule out canker sores. However, if there are no visible blisters, it will be hard to accurately identify if it's cold sore or canker sore.
  • Fever blisters may appear different with canker sores in terms of shape. Cold often appears as a group of small sores. The outline created is like a scallop or lobed shape, whereas for canker sores, the lesions are rounded, smoot, and with red edges. To put it simply, if you see rounded lesions, then they are canker sores. If you see irregularly-shaped sores, these are herpes.
  • Another difference: fever blisters may recur on the same area, while canker sores do not necessarily appear on an area they first appeared. Most of the time, canker sores appear in different areas each time.
  • Symptoms are more specific for fever blisters, like body malaise, high fever, and joint pains. Often, the symptoms are not easily detected. As for canker sores, there are no specific symptoms to indicate the occurrence of canker sores. Except for pain, that will come a little later, sufferers often "normal".
  • The formation of canker sores come ahead of a certain traumatic act, like biting. In comparison, fever blisters' appearance is triggered by certain types of traumatic act.

Which One Will Cause More Discomfort?

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Have You Ever Faced Canker Sores?

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Take note of these:

Sores that persist for over 2 weeks could still be diagnosed as fever blisters or cold sores and canker sores.

Fever blisters and canker sores often do not need immediate medical attention since they are not dangerous conditions and there are many home remedies proven to relieve pain and heal the lesions associated with these conditions. Both canker sores and cold sores are expected to heal in just 1 to 2 weeks.

Since canker sores can occur to anyone at any point in their lives, and most of us would like to avoid them, it is a good idea to figure out what caused yours so you can avoid triggering another. Take careful note of which dietary, environmental, and/or emotional factors may have caused your canker sore and try to avoid them in the future. In the meantime, for the 1 to 10 days you'll be suffering from the canker sore on your tonsils, one or more of the above-mentioned remedies will certainly help.

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      Eric 21 months ago

      A word of warning with the baking soda mouthwash, the taste is absolutely foul. The first time gargling with it, I gagged to the point of vomiting. Use this near an empty sink, or better yet a toilet, and have a cup of clean water on hand to rinse your mouth out.

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      Sree Lakshmi 21 months ago

      @Eric: Agreed :)

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      Angela 14 months ago

      This is the first time I've ever had a canker sore on my tonsil, and it has to be the absolute canker sore I've ever had. I honestly thought I had strep or something, until I found it.

      I occasionally get them on the insides of my lips, and while they're very annoying they never bother me too much. But this one has been absolutely horrible to deal with. I never thought a canker sore could cause so much pain.

      When I first got it, I couldn't eat food harder than yogurt for days, and I even struggled to eat a banana. Honey and Cepacol lozenges were the only things that would stop the pain. I was surprised at how effective honey was at stopping the pain. I then found some Burt's Bees cough drops, and I was finally able to function normally (besides eating), as long as I had one in my mouth. Those cough drops were amazing for the pain.

      I've pretty much had lozenges in my mouth 24/7 for the last four or five days. It seems like the sore is finally healing, though, so hopefully it'll finally be gone.

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      Dalton 13 months ago

      I too have several canker sores on or close to tonsills. It is THE WORST pain i've ever felt. I'd prefer to have my two legs broken than having to deal with this!

      To top it of i was badly diagnosed 4 days ago and the "doctor" gave me antibiotics which probably worsened the cankers thinking the throat pain and fever was just flu. I was on antibiotics for 4 days.

      Now on anti-acid and anti-fungal medication along with anti-inflamatory lozenges and finding "some" relief.

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      Gina 9 months ago

      Hi...long time ago I experience the canker sore.it's so annoying and bothering me to much.then now I try to use the baking soda..I hope is working..

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      Zak 2 months ago

      Had a sore throat and some pain for about a week now and just discovered an ulcer on my tonsil. Never had one there before, but yeah definitely the most painful one I've ever had. It's bigger than any other I've ever had either. About a 1/4 inch in diameter. Have other people with tonsil canker sores also had swollen tonsils? Just asking as both of mine are a bit inflamed.

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