Canker sores, Cold Sores and Other Tissue Issues

The last thing anyone wants to experience is a painful sore in or around their mouth.  I suffer from canker sores a couple times a year and know how much they hurt and count the days until it is over.  But sometimes I wonder, how did I get this and what can I do about it?  What's the difference between a canker sore or other problem and should I be worried?

Canker Sores (Aphthous Ulcers) can show up on the cheeks, lips, tongue or other soft tissue areas in the mouth.  Rarely they occur on the palate (roof of the mouth).  It usually appears as a white, flat sore...and can be very painful.  Many patients that get canker sores ask what they can do to prevent them, or to make them go away.  Canker sores last 7 - 10+ days, whether you "treat" them or not.  Although the cause is not known (they are not bacterial, viral, fungal or otherwise), potential triggers include fatigue, some foods, emotional distress, abrasion of tissue with a sharp object or food, or another reason.  My personal trigger seems to be orange juice, or other acidic fruit juices...and stress.  They are thought to be mostly immune related or due to physical trauma (a cut or abrasion in the mouth.)

So, what can you do?  Avoid irritating the soft tissue.  When a canker sore is present, don't irritate it further by aggressive brushing, or eating hot/spicy foods.  There are over-the-counter products that can help numb, dry or protect the area and relieve discomfort.  One product that we recommend is called Colgate Orabase.  

​Cold Sores can show up on the lips or in the mouth.  Most patients know this type or sore as a "fever blister."  This type of lesion is caused by the herpes virus and can be passed from person to person or other parts of the body.  Unfortunately, these can show up due to various conditions including, stress, drying of lips, sunburn, hormonal changes, or high fever.  Many sufferers often can tell when a cold sore is coming on due to a tingling feeling...which we call the "prodrome."  It is important to act fast at the first tingle!  Dr. Jones can prescribe an anti-viral medicine that when applied at the earliest sign can help prevent the sore from developing.  However, sometimes that time frame is missed because it is typically a very short window, and the sore appears.  If you don't have a medication available, apply ice to the area during the "prodrome" stage.  The cold can help reduce/prevent viral replication.

So, what can you do once a cold sore appears?  Topical anesthetics (like the one mentioned above), various sealers or protectants can be bought over-the-counter.  Ice placed on the lesion provides some relief.  However, healing cannot be accelerated.  We can prescribe antiviral medications and ointments, but once the sore appears, it is mostly about keeping it comfortable and being careful not to spread the virus.

To prevent the spread of cold sores, be sure to avoid sharing things like cups, food, kisses, etc. when the sore is present.

Oral Cancer

If you have a sore or odd lesion in your mouth that does not seem to be going away, or changes shape, please call our office to schedule an appointment with Dr. Jones.  Often, cancerous lesions do not hurt and can start out small and unoticable in the dark corners of your mouth.  In many cases, these sores are benign, but in the rare incidents that a mouth cancer is present or cellular change is starting, the best course of action is early detection (as with all types of cancer.)   

You will notice that Dr. Jones does a very thorough "soft tissue exam" at the beginning of every hygiene appointment with you.  You may recall that she makes you stick your tongue out and she moves it all around to check the back and sides, the top and bottom and all other areas of tissue in and around your mouth. She looks at every area of tissue with good lighting and magnification, as well as feels around all your tissue.  This is called an "oral cancer screening," but she is also looking for any and all changes in the soft tissue, including benign or unremarkable, common conditions.  She will educate you on what is "normal" for you so that if you look in your mouth and notice you have bumps on the roof of your mouth or under your tongue, you will remember, "oh yeah, Dr. Jones said that is just normal extra bone called tori."  She may give you recommendations to keep your tissue healthy and prevent and/or treat any soft tissue conditions you may experience.  

There are many more conditions that can present in and around the mouth.  Many of them are also related to systemic conditions.  Dr. Jones is trained to look for and be able to diagnose and treat (or refer when appropriate) soft tissue conditions.  

So, the next time you get a canker sore or other issue in your mouth...call us!  We will be happy to see you or make a recommendation over the phone, when possible.