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Ouch! Understanding Mouth Sores
By Dr. Tareq Khalifeh, DDS

Everyone experiences painful sores in the mouth from time to time. We tend to ignore most of them, or try “old wives’ cures” like baking soda pastes or gargles. But I always urge my patients to pay closer attention to these sores. It’s important to know what type of sore you have, so you know whether it is contagious, whether it indicates the need for better oral care, or whether it is an early indicator of a more serious problem.

Most mouth sores are caused by abrasion, bacteria, virus exposure, or fungus. While most are not serious, any sores that last more than a week could point to underlying disease and should be seen by your dentist.


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Canker Sores.

Canker sores appear inside the mouth, on the gums, inside cheeks, or sometimes on the tongue. They are small skin ulcers with a white or grayish base and red border. You can get several of them at the same time. They are not contagious.

While noone knows exactly why canker sores appear, possible factors include immune system problems, bacteria or viruses. What is known is that you are more susceptible to these painful eruptions when you are stressed or tired. Likewise, a skin injury in your mouth, such as from an orthodontic device, from biting your cheek or tongue or from scalding yourself with hot liquid or food, can develop into a canker sore. It is also possible that you are not keeping your mouth clean enough, and should do a more thorough and regular job of brushing and flossing.

Some people with underlying digestive disorders, such as Crohn’s disease, may also suffer from more frequent outbreaks of canker sores.

There is no real treatment for canker sores, other than keeping your mouth clean, drinking plenty of fluids, and letting time heal. The sores should disappear in a few days or a week. For relief from the discomfort caused by the sores, some people put baking soda on the sore or rinse the mouth with a mixture of water and baking soda. Topical mouth anesthetics can also provide temporary relief. Avoid irritating spicy or acidic foods until the sore heals. If the sores are severe, consult your dentist to minimize risk of infection.

Cold Sores

Cold sores appear externally, usually on the lips or the skin near the mouth. They are extremely contagious, painful, pus-filled blisters caused by the Herpes Simple I virus.

If you contract the Herpes I virus, you may not ever get an outbreak of the sores. If you do experience symptoms, the first infection may seem like a bad case of the flu. You may get a fever, glandular swelling, and/or painful sores in your mouth. Some people get quite sick the first time they get a Herpes I outbreak, while others never even know they have it until they get a cold sore weeks, months, or even years after they first contracted the virus.

After the first outbreak, the Herpes simplex I virus stays in the body, usually in a dormant state. Recurrences of blisters tend to occur when your immune system is stressed from fatigue, poor nutrition, or exposure to a cold or flu virus.

Cold sores are quite uncomfortable, but there is little to be done but wait them out. Most will disappear in about 5 to 7 days. Some individuals shorten the duration of the lesions by using L-Lysine amino acid supplement or increasing intake of foods rich in Vitamin C and Vitamin B. Avoid peanuts and chocolate, which can sometimes be triggers in allergic individuals.

If you get frequent cold sore outbreaks, ask your dentist or doctor about treatment with prescription antiviral drugs. These drugs can be used upon first appearance of symptoms, to minimize the painful blistering and speed healing. Patients who suffer from frequent or particularly bad outbreaks can sometimes benefit from a prophylactic regimen of antiviral drugs to minimize or possibly eliminate outbreaks.

The Herpes Simplex I virus is easily spread from direct contact to the sore. So when you have an outbreak, avoid contact with the sore, wash your hands frequently, and isolate towels, bedding, and eating and drinking items to minimize risk of spreading the virus on your own body or giving it to others.

A Fungus Among Us

A common fungal infection, known as “Candidiasis” or “oral thrush,” occurs when the normal bacteria in the mouth are reduced, enabling the Candida bacteria to over-multiply. This problem frequently afflicts denture wearers, people with dry mouth syndrome, people who are receiving antibiotic treatment, or anyone debilitated by disease.

Good oral hygiene is essential to preventing and treating Candidiasis. Probiotics, such as Acidophilus, can be obtained at a health food store or pharmacy, and can help to maintain bacteria balance during antibiotic therapy. Denture wearers should be careful to remove orthotics at bedtime and clean them thoroughly. For other treatments, consult your dentist.

Dr. Khalifeh owns Philmont Family Dentistry, located on Rte 217 in Philmont, NY. A graduate of the New York City School of Dentistry, he completed his residency at Albany Medical Center and practiced in Albany until 2004. For more information, call 672-4077.

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