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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 6021
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA, American Academy of Oral Medicine
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Three times in the last year my entire mouth has been

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Three times in the last year my entire mouth has been completely overcome with canker sores, my entire mouth, checks, top, bottom, lips, and even my tongue. I have gone to seven different doctors and each had a different idea. Some of the reasons I was told was mono, hand foot and mouth disease, allergies, herpes, stress... I did my own research as well and decided to become gluten free and still had an outbreak after. I've tried supplements, changing my toothpaste to fluoride and sodium laurel sulfate free toothpaste, I eat very healthy, I don't feel more stressed, I don't know what else to do. During my last outbreak my family took me to the ER where I was given IV fluid because it was too painful for me to even drink water, I lost 17lbs in 10 days. This is seriously the worst thing that has ever happened to me. Any ideas? Please help!

I wanted to add a few things. I had blood work done and pretty much everything was normal except I had low DHEA. I have a very extensive family history of Hashimotos disease and RA, could this be some sort of autoimmune condition perhaps?

Hello-- I'm Mark Bornfeld, DDS. Welcome, and thank you for putting your trust in me!

The issue which really needs to be resolved is whether your repeated episodes of oral ulceration truly represents recurrent aphthous stomatitis (i.e., canker sores), or whether this is really some other type of ulcerative mucous membrane condition. In fact, your narrative implies that your doctors haven't settled on a diagnosis of aphthous stomatitis at all, because neither mononucleosis, hand foot and mouth disease, herpes simplex, or allergies have anything to do with canker sores. It is my observation that medical doctors too quickly dismiss any oral ulcerative disorder as "canker sores", which is unfortunate, because accurate diagnosis is key in selecting an effective therapeutic strategy.

In fact, your history of autoimmune disorders may provide some clue to the nature of your condition, because patients with one of these conditions tend to have a significantly higher incidence of others. Many of these (for example, psoriasis, Crohn's disease, lupus, mucous membrane pemphigoid, pemphigus, and others) are known to manifest in the mouth and on other mucous membranes as multiple, recurrent ulcerations.

There are more specific tests for these conditions, but in order to implement a more rational diagnostic protocol, the clinician needs to know which tests to take. For oral conditions, your best bet would be to consult with a clinical oral pathologist, because this type of specialist is best trained and most experienced in the subtleties of diagnosis of soft tissue lesions. Your primary care general dentist would be able to recommend someone locally, or you may consult the online directory of the American Academy of Oral & Maxillofacial Pathology for contact information for an oral pathologist near you.

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