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What Is a Mouth Sore or Canker Sore and What Are the Causes?

People often use the terms "canker sores" and "cold sores" interchangeably. While both are very painful, a canker mouth sore is found on the inside of the mouth and is not contagious; cold sores are located on the inside or outside of the mouth and are contagious.

Canker Sores:

These sores are found inside the cheeks, on your tongue or the bottom of your mouth, and sometimes on your gums. They range from the size of a tiny pinhead to a penny. The sores are grayish-white in the center and circled with a red inflammation. Since it's an open mouth sore, it hurts when touched by anything, including saliva. They can burn and itch, too.

Canker sores might be called the "stress sores," because they are caused by different types of stress:

• Emotional stress;
• Physical stress, such as biting your tongue, burning your mouth, or an abrasion from braces or loose dentures; or
• Chemical stress producing changes in your body, perhaps resulting from an illness or change in eating habits (such as medications, or too much of acidic foods such as tomatoes, grapefruit, or lemons).

About one in five people get them. Women in the 20-to-50 year age group get them more often. Once you get them, you're likely to experience them again. However, they usually go away after seven to ten days, although some can be longer-lasting.

An antimicrobial mouth rinse may lessen the irritation. Temporary relief can be provided by over-the-counter topical anesthetics. Pain relief varies with different products. Some medications provide a protective film that physically blocks contact with food and saliva, lessening irritation.

Good oral hygiene and a healthy diet are preventive measures for reducing the frequency of outbreaks.

Cold Sores

Also known as fever blisters, cold sores are caused by the virus herpes simplex. These are painful blisters that usually break out around the lips and sometimes under the nose or chin and normally heal within one week. They are very contagious. The virus stays in the body, causing recurrent lesions prompted from a fever, sunburn, skin abrasions, or stress.

They can be treated by your dentist with the same topical anesthetics to relieve pain and irritation as for canker sores. Prescription antiviral drugs can be effective in reducing viral infections that cause flare-ups.

Additionally, there are new topical medications (ointments) now available that shorten the duration of a breakout, when applied immediately after the cold mouth sore is noticed. All antiviral medications work best in the prodromal or early stage of the lesion. If the wound is open and sore, these medications are of little use as the healing time is still the same.

Be sure to consult with your dentist when any mouth sores do not heal.

By Brian J. Gray, DDS, MAGD, FICO

Women's Dental Care FAQs

Q. Why is it important that women be concerned with their oral health?

A. For many women, oral health changes throughout the different stages of their life, due to surges in sex hormone levels. The dentist may request to see the patient more frequently during hormonal surges.

Q. Gum disease tends to run in my family. What's the best way to prevent and treat it?

A. To prevent periodontal disease, dentists recommend the basics to all their patients: Brush at least twice a day, and floss once a day to remove plaque. Most people should see a dentist twice a year. Because of family history, some women may need to brush and see their dentist more often. There are also new medications that help fight gum disease. Recently, the Food and Drug Administration approved an oral drug, Periostat, which may improve tooth attachment and stop tissue destruction. Two other new products, Atridox (an antibiotic) and PerioChip (an antibacterial), are applied to the gums by your dentist. These medications are to be used in conjunction with traditional gum disease treatments, such as scaling and root planing.

Q. What problems occur for girls during puberty?

A. The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation. Herpes-type lesions and ulcers also can develop. They also may experience sensitive gums that react more to irritants.

Q. What gum problems may occur during menstruation?

A. Women may experience red, swollen, tender gums (gingivitis) a few days prior to their menstrual period because of increased levels of progesterone in their bodies. These changes occur because of an exaggerated gingival (gum) response to bacterial plaque and generally resolve toward the end of the menstrual period or shortly thereafter. To combat these symptoms, a dentist may recommend more frequent cleanings, fastidious home care, and possibly an anti-microbial mouth rinse or special toothpaste.

Q. Can women develop cold sores related to the menstruation cycle?

A. Yes, a few days before menstruation begins, some women may experience an activation of cold sores (herpes labialis). These sores occur on the lips and usually heal by themselves within 10 to 14 days. A dentist and/or physician may prescribe a topical medication for treatment.