Oral lesions (mouth sores) make it painful to eat and talk. Canker sores and fever blisters (also called cold sores) are two of the most common of these recurrent oral lesions. Though often similar in presentation, they do have some important differences. Other types of common oral lesions are hairy tongue, and torus palatinus or mandibularis. Oral cancer, leukoplakia, and candidiasis are discussed in our website Patient Education section. The other lesions mentioned above are covered in more detail within this section for the benefit of our patients. As mentioned previously, it is important to be able to distinguish between different types of oral or mouth lesions as treatment will vary based on the type of lesion present.

Fever blisters:
Fever blisters are fluid filled blisters that occur most commonly on the lips but can also more rarely occur on the gums and roof of the mouth (hard palate). Canker sores (also called apthous ulcers) are small, red or white, shallow ulcers that occur on the tongue, soft palate, or inside the lips and cheeks. They are quite painful, and usually last 5-10 days. Fever blisters are also usually painful and the pain may precede the blisters by a few days. They may rupture within hours of appearing then crust over. They usually last 7-10 days. Fever blisters are caused by the Herpes Simplex virus that becomes active. This virus can lay dormant (latent) within the body for years in afflicted people. It is activated by stress, fever, trauma, hormonal changes, and exposure to sunlight. The lesions often appear in the same location if infection reoccurs. The time between when the blister ruptures until the sore is completely healed is when there exists the greatest risk for transmission and spread of infection. The virus can spread to the afflicted person's eyes and genitalia, as well as to other people. Fever blisters are treated by coating the lesion with a protective barrier that contains an antiviral agent such as 5% acyclovir ointment. At present there is no cure for the Herpes virus but scientist are making great headway in developing newer, more effective antiviral medications.

Canker sores:
Canker sores are not contageous and cannot be spread locally or to anyone else. Treatment is limited to relief of discomfort and guarding agiainst infection. Topical anesthetic ointments and steroid cremes (Kenalog in Orabase 0.1%) is helpful. 
If a canker sore fails to heal within 2 weeks, see an ENT physician as bacterial infections can enter the body thru the open sore. People who regularly consume alcohol, smokers, smokeless tobacco users, chemotherapy or radiation patients, or patients with weakened or compromised immune systems are most susceptible. Remember that the first sign of oral cancer is often a small sore that does not heal soon after onset.

Another abnormal finding within the mouth is hairy tongue which is a rare elongation of the taste buds on the surface of the tongue. If a superficial yeast infection is also present, this can appear dark brown or black. It can also be caused by poor oral hygiene, smoking, or chronic oral irritation.

Torus palatinus or mandibularis is a benign boney outgrowth from the surface of the roof of the mouth (hard palate) or the inside ridge of the lower jawbone (alveolus of the mandible). It occurs more commonly in females over 30. These rarely need treatment unless there is irritation or ulceration of the mucus membrane that covers these areas or prevents denture fitting or dental implant placement.

Tips to Avoid Mouth Sores:
1. Stop smoking or using smokeless tobacco.
2. Avoid injury to the mouth caused by hard tooth brushes, hard foods, braces, or dentures
3. Do not eat or drink very hot food or beverages.
4. Eat a well balanced diet and follow nutritional guidelines for multivitamins or supplements.
5. Chew your food slowly and completely and drink plenty of water.
6. Practice good dental hygiene and see your dentist regularly.


For more information about mouth sores/lesions 

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Suite #200
Hoover, AL 35244