Canker Sores And Anxiety

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated April 27, 2022

canker sores and anxiety

Canker sores, increased frequency and prevalence, can be an anxiety disorder symptom, including anxiety and panic attacks, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, phobias, and others.

This article explains the relationship between anxiety and the frequency and prevalence of canker sores.

Common Symptom Descriptions

  • You get canker sores more often than usual.
  • The frequency of canker sores has increased, but there is no medical or obvious reason why.
  • You’re getting one canker sore after another, and it seems no matter what you do, you can’t to stop them from occurring.

Canker sores, also called aphthous ulcers, are small, shallow lesions that occur on the soft tissues in the mouth and base of the gums.

Canker sores can:

  • Occur occasionally, frequently, or persistently.
  • Precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.
  • Precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" and for no reason.
  • Range in intensity from slight, to moderate, to severe.

Canker sores can be any size, from tiny (almost imperceptible) to large. They generally go away on their own in about a week or two.

Large canker sores that persist should be discussed with your doctor or dentist.

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.

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Causes

Medical Advisory

Talk to your doctor about all new, changing, persistent, and returning symptoms as some medical conditions and medications can cause anxiety-like symptoms.

Additional Medical Advisory Information.

It’s not known why some people develop canker sores, and others don’t. However, it’s believed there can be many contributing factors, including:

Stress

Anxious behavior activates the stress response, causing many body-wide changes that prepare the body for immediate emergency action – to fight or flee.

This survival reaction is often referred to as the fight or flight response, the emergency response, the fight, flight, or freeze response (some people freeze when they are afraid, like a “deer caught in headlights”), or the fight, flight, freeze, or faint response (since some people faint when they are afraid).[1][2]

Visit our “Stress Response” article for more information about its many changes.

Since stress responses push the body beyond its internal balance (equilibrium), stress responses stress the body. Consequently, anxiety stresses the body.

Stress is thought to be a common cause of canker sores,[3] including emotional stress, such as from anxious behavior.[4]

Moreover, canker sores are thought to be also caused by hormone shifts. Anxiety stresses the body. Stress can cause fluctuating hormone levels, and hormones affect each other. Therefore, anxious behavior can indirectly cause canker sores due to stress-caused fluctuating hormone levels.

Furthermore, stress depletes vitamin B. Low vitamin B is also thought to cause canker sores.

A weakened immune system is also thought to be a cause of canker sores. Stress, including anxiety-caused stress, can suppress the immune system.

Overall, anxiety can play a role in the development of canker sores because of how anxiety stresses the body.

Consequently, chronic stress (hyperstimulation), such as from overly apprehensive behavior, can be a common cause of chronic and persistent canker sores.

Behavior

Anxious behavior can play a role in other ways, too. For instance, some anxious and stressed people chew the inside of their cheeks and lips when nervous or stressed. Lesions caused by chewing can turn into canker sores.

Furthermore, many anxious and stressed people clench their teeth. Clenching teeth can inadvertently cause canker sores if you happen to bite the inside of your cheek, and that bite turns into a canker sore.

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Other Factors

Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:

Select the relevant link for more information.

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Treatment

When this symptom is aggravated by other factors, addressing those factors can help reduce the incidences of canker sores.

Since a virus does not cause canker sores, they aren’t contagious and typically heal on their own.[5]

To reduce anxiety-caused canker sores, contain anxious behavior, and reduce stress.

As anxiety is contained and the body recovers from stress, including chronic stress (hyperstimulation), the prevalence of canker sores should diminish.

You can eliminate hyperstimulation by:

  • Reducing stress.
  • Containing anxious behavior (since anxiety creates stress).
  • Regular deep relaxation.
  • Avoiding stimulants.
  • Regular light to moderate exercise.
  • Getting regular good sleep.
  • Eating a healthy diet of whole and natural foods.
  • Passively-accepting your symptoms until they subside.
  • Being patient as your body recovers.

Visit our “60 Natural Ways To Reduce Stress” article for more ways to reduce stress.

Keep in mind that it can take a long time for the body to recover from chronic stress (hyperstimulation). The higher the degree of hyperstimulation, the longer it can take to recover.

Nevertheless, faithfully practicing your recovery strategies, passively accepting your symptoms, containing your anxious behavior, and being patient will bring results.

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The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including increased frequency and prevalence of canker sores.

References

1. Folk, Jim, and Liashko, Vitaly. “The Stress Response.” anxietycentre.com, retrieved April 2022.

2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.

3. "Canker sores (mouth ulcers): Overview." Institute for Quality and Efficiency in Health Care. 2006.

4. “Canker Sore.” Mayo Clinic, retrieved 30 Sep 2021.

5. “Canker Sores.” Cleveland Clinic, retrieved 30 Sept 2021.