Update on Oral Sores

The November,  2012 issue of the American Dental Association Journal included an update on common oral sores and irritations that I thought I would share with my blog readers.  Sores and irritations can develop in and around the mouth but fortunately oral sores and irritations usually heal on their own within a couple of weeks.  Four common mouth sores are canker sores, cold sores, leukoplakia and oral candidiasis.

Canker sores are small white sores with a red border that develop inside of the mouth.  They are not contagious.  The cause is often not known but can be due to trauma.  Canker sores heal in a couple of weeks but they can be painful. Topical anesthetics and antimicrobial mouthrinses may be soothing.  The sores may be irritated by spicy, acidic or salty foods.

Cold sores (fever blisters) are clusters of raised, red blisters that usually occur around the lips, under the nose or on the chin.  These are fluid filled blisters that can break open and the fluid leak out.  Scabs can then form until the cold sores heal.  Cold sores are cause by the herpes simplex virus and are very contagious.   The infection may be initially accompanied by flu or cold symptoms.  Cold sores typically will heal by themselves in about a week but there is no cure for the herpes virus.  Once you have been infected, the virus remains in the body and flare-ups can occasionally occur.  Topical anesthetics provide some relief from discomfort.  Antiviral drugs may be prescribed to reduce the healing time.

Leukoplakia is an overgrowth of cells resulting in a rough patch of white or grey tissue.  It can occur anywhere inside of the mouth.  The patches are not painful and are not contagious.  Leukoplakia may result from irritation from an ill-fitting denture or from chewing the inside of the cheek.  Tobacco users are also be prone to leukoplakia.  Treatment involves identifying the irritant.  Once the irritant is eliminated, the patches should disappear.  But leukoplakia can also be associated with oral cancer so a biopsy may be indicated if the leukoplakia looks suspicious.

Candidiasis (oral thrush) is a yeast infection that occurs on the soft tissues inside of your mouth.  It is a smooth white patch with a red base.  It can be sore or it might bleed.  It is caused by a fungus and usually develops when the immune system is weak.  People in poor health, old people, the very young and people with systemic diseases are at risk of oral candidiasis.  Steroids, antibiotics and cancer therapies can increase the risk of candidiasis.  Treatment consists of controlling the cause of the outbreak.  Candidiasis is common among denture wearers so daily cleaning of dentures is important.  Also  if dentures are removed at night, the denture-bearing tissues are allowed to regenerate.  Anti-fungal medication is also helpful.

If you see a lesion – make an appointment so a dentist can do a thorough oral examination,  make a diagnosis and take a biopsy, if necessary.

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