Different types of mouth sores require different treatments

Pamela Egan Practical Practitioner


By: Pamela Egan, FNP-C CDE



Different types of mouth sores require different treatments



Dear Pam,

I’ve been bothered by a sore in my mouth that makes it painful to eat and talk. Any suggestions or cures?

Many otherwise healthy people suffer from recurrent mouth sores. Two of the most common recurrent oral lesions are fever blisters (also called cold sores) and canker sores (apthous ulcers). When they occur in the mouth, it may be difficult to distinguish one from the other. Since the treatment and cause of these two sores are completely different, it is extremely important to know which is which.

Fever blisters are fluid filled blisters that commonly occur on the lips. They also can occur in the mouth, particularly on the gums and roof of the mouth. Fever blisters are usually painful. In fact, the pain may precede the appearance of the lesion by a few days. The blisters rupture within hours, then crust over. They last about seven to 10 days.

Fever blisters result from a herpes simplex virus which becomes active. This virus is latent (dormant) in afflicted people but can be activated by conditions such as stress, fever, trauma, hormonal changes and exposure to sunlight. When lesions reappear they tend to form in the same location.

Fever blisters can spread from the time the blister ruptures until the sore is completely healed. The virus can spread to your own eyes and genitalia, as well as to other people.

To prevent fever blisters, avoid mucous membrane contact when a lesion is present. Do not squeeze, pinch or pick at the blister. Wash hands carefully before touching your eyes or genital area or another person.

Despite all caution, it is important to remember that it is possible to transmit herpes virus even when no blisters are present.

Treatment consists of coating the lesions with a protective barrier ointment containing an antiviral agent, for example 5 percent acyclovir ointment. Presently, there is no cure, but there is much research activity under way in this field.

Canker sores are small, shallow ulcers occurring on the tongue, soft palate or inside the lips and cheeks. They are painful, and usually last five to 10 days. The best available evidence suggests that canker sores result from an altered local immune response associated with stress, trauma or local irritants, such as eating acidic foods such as tomatoes, citrus fruits and some nuts.

Canker sores cannot be spread locally or to anyone else since they are not caused by bacteria or viral agents. The treatment is directed toward relieving discomfort and guarding against infection.

A topical corticosteroid preparation such as triamcinolone dental paste is helpful. Unfortunately, no cure exists at the present time.

For any mouth lesion that does not heal in two weeks, you should see your dentist or healthcare provider.

This article was originally published February 16, 2004 in The St. Tammany News.


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