Some environmental factors that contribute to the germination of sores are stress, intake of acid or citrus foods, lesions produced inside the mouth that can leave unhealed wounds, a weakened immune system, a nutritional problem, a gastrointestinal illness or an infection due to wounds that can produce sharp instruments or orthodontics. Also, the oral temperature, slightly higher than the outside temperature, can also contribute to the germination and development of sores.
Severe changes in environmental variables such as high osmotic pressure, low oxygen tension, low or high pH, and low or high temperature interfere greatly with the germination process.