Mouth Sores: Large or Small, No Fun at All!
Here’s a guide to the most frequently encountered types of mouth sores.
Canker Sores: The Most Common Mouth Sore
Canker sores burn and sting. Even though scientists call them big names like Aphthous Ulcers and Aphthous Stomatitis, we still don’t know what causes these sores. It’s clear that they show up more frequently when we’re tired, stressed or sick. And people with autoimmune diseases like Crohns or Lupus get them more frequently than others.
Canker sores can show up on our lips, tongue, gums, cheeks or the roof of the mouth and usually last around 10 days. If a canker sore lasts more than 2 weeks or is larger than 1cm in diameter, it’s important to have it checked by a dentist because it could be infected or it could be a sign of something more serious.
Tips and Home Remedies for Canker Sores:
- Eat bland foods: Spicy, sweet & sour foods can irritate the canker sore and make it hurt worse. Abrasive foods like tortilla chips can injure the sore.
- Rinse with a salt or baking soda rinse: Use 1 tsp of baking soda or salt in ½ cup warm water.
- Milk of Magnesia: Dab a small about on the sore several times a day.
- Pain relieving gels or creams: Use them as soon as the sores appear. Commonly used products contain Benzocaine such as Anbesol, Kank-A or Orabase
- Use a Hydrogen Peroxide rinse: Oragel Antiseptic Mouth Sore Rinse and Peroxyl are both great.
- Brush gently: Avoid jabbing or injuring the sore.
Also called Fever Blisters or Herpes Simplex, cold sores are caused by a highly contagious virus that passes from person to person through personal contact, touch, or saliva as well as behaviors like sharing eating utensils, razors & towels, or kissing. People most commonly catch the virus as small children and, once infected, have it all their lives.
Cold Sores typically show up around the lips, though they can occur under the nose and on the skin as well. In young children, cold sores can show up in the mouth and are frequently mistaken for canker sores. Cold sores are fluid filled blisters that typically show up after several days of tingling and itching in the blister area. Blisters will pop, ooze and crust over before going away. They usually appear in the same area every time and can last up to two weeks. Like canker sores, cold sores tend to pop up when the immune system is weak or stressed due to stress, fatigue, emotional upset, illness or even sunburn. See a dentist if the cold sore lasts more than two weeks, if you have frequent cold sores or if symptoms are severe.
Cold Sore Tips and Home Remedies:
- Apply Medicated Cold Sore Ointment: Healing time can be up to a day shorter with frequent application of Docosanol (Abreva).
- Apply Cold Sore Creams: There are many creams at the store that contain alcohol and effectively dry out the sore. For some people, these speed healing time.
- Use Lipbalm and Sunblock: Since sunburn clearly stresses the skin and can cause cold sore outbreaks, keeping your lips moisturized and protected from the sun helps prevent cold sores Choose a moisturizing lipbalm with a powerful sunblock such as zinc oxide.
- Try a Cool Compress: A cool, damp cloth can help inflammation and reduce redness. This can also speed crusting and healing.
- Use Pain Relieving Gels or Creams: Topical creams or gels that contain Benzocaine or Lidocaine help with temporary “numbing” for pain and irritation.
Mouth Abrasions and Leukoplakia:
Sharp edges of broken teeth, stray wires from braces and anything else scratchy, sharp, pokey or rough can cause uncomfortable white or gray mouth sores called Leukoplakia.
These sores (doctors call them plaques) are dangerous because they increase your risk for oral cancer. It’s important to smooth or remove whatever is irritating the tissue before it causes permanent damage. White and gray patches need to be looked at by a doctor to insure that they are cancer free.
If you have braces, use your orthodontic wax to cover irritating brackets or wires and protect yourself from cancer later on.
Mouth Abrasions and Leukoplakia
Dentures sores are painful sores on the gums that make using and wearing a denture miserable. Denture spots usually occur for one of three reasons:
- First, the denture is too large.
- Second, the denture isn’t molding to the gums evenly.
- Third, the denture hasn’t been properly cleaned and is causing a fungal infection.
Let’s look at each one of these and what you can do to fix it:
The denture is too large.
If the denture is too large, it needs to be adjusted and polished. Help the sores heal by eating a soft diet, rinsing with salt water or baking soda water, and cleaning the denture with nightly soaks in denture cleaner.
The denture doesn’t mold evenly to the gums.
If your denture doesn’t “fit” the gums, then either your bone has changed or the denture “bite” is uneven. Either way, the inside of your denture is going to be uneven on your gums and that makes denture sores. To fix this problem, a dentist will usually reline your denture, giving it a new lining to sit on the gums that fits your gums and bone in their new shape.
The denture isn’t clean enough.
If a denture isn’t completely cleaned on a daily basis, fungus builds up and can cause a mouth infection called thrush (or candidiasis). To get rid of the fungal infection, you’ll probably need prescription anti-fungal medication as well as new denture cleaning techniques. Some people’s mouths are more sensitive than others’.
To Prevent Thrush:
- Brush or rinse dentures after every meal.
- Soak dentures every night in denture cleaning solution.
- Brush both the denture and your gums nightly.
- Use antiseptic mouth rinses (with alcohol or hydrogen peroxide) to help keep your mouth clean and infection free.
- If you have frequent mouth sores or dry mouth, DON’T use a rinse with alcohol and try an alcohol free or dry mouth specific rinse like Biotene.
Chemotherapy works for cancer because it targets rapidly growing cells. Unfortunately, it doesn’t know the difference between a cancer cell and a mouth cell. That’s why it’s common for chemotherapy patients to get burn-like sores in their mouths. These sores can make eating, talking, swallowing and even breathing painful. Chemo mouth sores usually show up within two to three days of starting chemotherapy. They’re the worst around seven days and go away after two to three weeks.
There is no way to prevent these sores 100%, but we can take steps that make them better or worse. Sores are definitely more miserable if they get infected. Getting your mouth as healthy as possible before beginning treatment can help reduce chemo sore intensity and complications.
Having a healthy mouth is also important because mouth sores provide a gateway for infection to enter the body when the immune system is weakened from chemo. Keeping the mouth clean is critical to preventing chemotherapy complications.
Here are some steps you can take to get a healthy mouth:
- See Your Dentist. Make sure your dentist looks in every crack and cranny for infection. Treat any infections present in your teeth or gums. Eliminating infections lowers your body’s stress load and helps it heal more efficiently. Getting rid of infection reduces your risk for complications once you start chemo.
- Stop Smoking. If you smoke, stopping will not only improve your overall health, it will improve your mouth’s ability to heal, which means a quicker recovery from mouth sores.
- Eat Well! Eating a diet rich in fruits and vegetables will give your body the nutrients it needs to heal and stay strong.
- Use the Right Tools. Care for your teeth and gums daily using non-alcohol mouthwashes, soft flosses and soft toothbrushes or foam cleaners. This insures that you keep bacteria in the mouth under control and prevent painful infections.
If you’ve already started chemo and have painful mouth sores, here are some tips to get you comfortable and eating again:
- Keep up your home care: It can be painful to brush and floss; however, there are special types of brushes and floss that make it easier. Keeping teeth clean is critical to keeping infections from forming and allowing sores to heal.
- Rinse your mouth: Frequent rinsing with warm salt water or baking soda water helps keep things clean and can speed healing.
- Magic Mouthwash: This prescription rinse contains coating agents that form a protective layer over the sores as well as numbing agents to help with pain. An alternative to Magic Mouthwash is asking your dentist about Coating Agents and Pain Killer Rinses with similar ingredients to help cover the sores and numb pain to ease eating and talking.
- Avoid Foods that Cause Pain: Acidic foods, spicy foods, sharp or hard foods and alcohol containing foods or drinks can irritate already irritated mouth tissue (mucosa). Mouth sores are extra sensitive to hot and cold temperatures. Room temperature foods and drinks are often the most comfortable.
- Use a Straw: Using a straw helps you keep liquid off of painful sores.
Oral Lichen Planus
Oral lichen planus is a weird name for a funny looking mouth sore. These spots look like lacy white patches on the tongue or cheeks. More serious cases are painful and interfere with eating, drinking or talking.
Scientists think that these lacy patches are a kind of autoimmune or allergic reaction because they seem to be happen because of mouth irritation, emotional stress, dental procedures, or trauma. They are also more common for people with Hepatitis C and diabetes.
Treatment can involve prescription corticosteroid rinses, immune response medications, light therapy and aloe vera. Although these patches don’t always hurt, it’s important to treat Oral Lichen Planus because it increases the risk of getting oral cancer.
Since oral lichen planus is related to mouth irritation, preventing it means keeping your teeth and mouth clean with careful home care and regular dental cleanings. It means using soft toothbrushes and soft floss, and it also means avoiding irritating foods and alcohol.
Oral Lichen Planus
Candidiasis or Thrush:
If you have white spots on your cheeks or tongue that won’t brush off, then you potentially have Candidiasis, which is a big name for an overgrowth of yeast fungus. Besides the white patches, Cadidiasis can also cause a sore throat, difficulty swallowing and cracked skin in the corners of the mouth called “cheilosis.”
Candidiasis can occur whenever the immune system is weakened. Antibiotics, steroids and cancer treatment increase the risk of developing this infection. It’s also a common problem for denture wearers.
This infection is treated with antifungal medication and careful home care.
Candidiasis or Thrush
Dry mouth occurs when we don’t have enough spit or saliva in our mouths. This can occur for a variety of reasons. It can be the side effect of a medication, of a disease, of radiation therapy, of chemotherapy, of menopause or of smoking. Dry mouth can make your mouth feel parched and cause difficulty swallowing. It contributes to more frequent dry lips, mouth sores and cavities, causes bad breath and can make it difficult to talk sometimes. Dry mouth can be miserable and it can also cause a lot of damage in the mouth.
Treating dry mouth means treating whatever is causing it. When changing the underlying cause (medication, disease, etc) isn’t possible, then it becomes important to develop habits to minimize the damage.
Tips for Managing Dry Mouth:
- Drink Water: Continually sip on water or sugarless drinks
- Avoid Caffeine: Caffeine is a diuretic that causes us to lose water and it can contribute to dry mouth.
- Chew sugarless gum or suck on sugarless sweets: This can stimulate saliva flow if the saliva glands still function.
- Choose Xylitol: Xylitol is a sugar free sweetener that makes your mouth cleaner. It helps stop bacterial growth in the mouth because bacteria in the mouth are not able to digest it.
- Avoid Tobacco and Alcohol: These further dry the mouth.
- Get a Humidifier: Nighttime humidifier use can help minimize the effects of dry mouth while you sleep.
For Dry Mouth, Consider Implants:
Without saliva, teeth decay very quickly. People with dry mouth may have multiple new cavities at every dental appointment and keeping the teeth repaired eventually becomes a full time job. I’ve seen patients with full mouth restorations who had to re-do their mouths AGAIN after just a couple years because of dry mouth.
When the underlying cause of dry mouth is something that can’t be changed, getting dental implants is the best way to get healthy, functional teeth to chew with and to eliminate the hassle and expense of constant cavities. Dental implants can’t decay. They don’t depend on saliva to stay healthy. If you find yourself facing a lifetime of dry mouth, consider replacing decaying teeth with dental implants for long term success.
People rarely pay much attention to their mouths unless they hurt, but oral cancer is a killer that doesn’t always hurt at the beginning. If you notice any of the following symptoms, get it checked out right away!
Warning signs of oral cancer include the following:
- A mouth sore that just won’t heal
- Lumps or thickening tissue on or in the cheek
- A white or red patch on the gums, tongue or anywhere in the mouth
- Persistent mouth pain
- Numbness in the mouth
- Oral cancer can also disguise itself as jaw problems or mis-fitting dentures
We perform an oral cancer screening at every cleaning and we always want to know if you’ve noticed anything changing. You know how your mouth normally feels so please never feel embarrassed to bring something to our attention. It’s always better safe than sorry!
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