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Welcome to our health education library. The information shared below is provided to you as an educational and informational source only and is not intended to replace a medical examination or consultation, or medical advice given to you by a physician or medical professional.

Mouth Sores

Also called aphthous stomatitis, mouth sores are blisters or lesions that appear anywhere within the mouth – including the inner cheeks, gums, tongue, lips or palate.

What causes mouth sores?

In most cases, mouth sores are caused by:

  • Accidentally biting the cheek, tongue or lip
  • Chewing tobacco
  • Irritation from ill-fitting braces, dentures or other dental appliances
  • The presence of a sharp or broken tooth
  • Hot food or drinks

Mouth sores, however, could also be cold sores, which normally appear after a person has had a fever.

Mouth sores can also be canker sores. Unlike herpes simplex virus, canker sores are not contagious and can appear as a single pale or yellow ulcer with a red outer ring or as a cluster of such lesions.

The cause of canker sores is not entirely clear but may be related to:

  • A virus
  • A temporary weakness in the immune system (for example, from cold or flu)
  • Irritation caused by friction
  • Stress
  • Low levels of vitamin B12 or folate

Women have been observed to get canker sores more often than men. This may be because of hormonal changes such as those experienced during menstruation.

Mouth sores can also be a symptom of an underlying illness, tumor or reaction to a medication.

Do I have a viral infection if I have mouth sores?

The presence of mouth sores could also be an indication of oral herpes simplex virus infection. Herpes simplex is highly contagious disease that does not immediately show symptoms when it is dormant. The sores usually start as blisters and then crust over.

Herpes simplex virus can lie dormant in the body for years, appearing only when something provokes it. These triggers may include another illness, especially if there is a fever, stress, hormonal changes (such as menstruation) and sun exposure.

What can I do at home?

Mouth sores can last from a little more than a week to two weeks. Sometimes it can stay for as long as six weeks. But generally, the sores go away.

To alleviate the symptoms an infected person can observe the following:

  • Gargle with cold water or eat popsicles. This step is particularly helpful for mouth burn cases.
  • Keep away from hot beverages and foods, spicy and salty foods and citrus.
  • Take pain relievers like acetaminophen.

For canker sores:

  • Rinse with saltwater.
  • Apply a thin paste of baking soda and water.
  • Mix one part hydrogen peroxide with one part water and apply this mixture to the lesions using a cotton swab.

For more severe cases, treatments include:

  • Fluocinonide gel (Lidex®)
  • Anti-inflammatory amlexanox paste (Aphthasol®)
  • Chlorhexidine gluconate (Periden®) mouthwash

Nonprescription preparations like Orabase® can protect a sore inside the lip and on the gums. Blistex or Campho-Phenique may provide some relief of canker sores and fever blisters, especially if applied when the sore initially appears.

For cold sores or fever blisters, these additional steps may be taken:

  • Apply ice to the lesion.
  • Take L-lysine tablets.

Antiviral medications for herpes lesions of the mouth may be recommended by your doctor. Some experts feel that they shorten the time that the blisters are present, while others claim that these drugs make no difference.

When to seek medical attention

Seek help from expert healthcare providers when:

  • The sore begins soon after starting on a new medication
  • Large white patches on the roof of the mouth or tongue appear.
  • The mouth sore lasts longer than two weeks.
  • The infected person has a condition such as HIV or cancer.
  • The condition is accompanied by other symptoms like fever, skin rash, drooling or difficulty swallowing.

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