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Sores in the Mouth

by Linh Cao-Chan, DDS on 01/22/19

Sores in the Mouth

I get a fair number of patients complaining of sores in their mouth, so here's a list of some common lesions found intra-orally.

Canker Sores

Also known as apthous ulcers, these are probably the most common ones seen. They appear as small, flat sores inside the mouth such as the palate, the inside cheek area and by the gums. Unlike cold sores, they don't appear by the lips' outside region and are not contagious. They tend to be round or oval, white or light yellow center, with a red border. They can be quite painful, and usually go away after a few days to a couple of weeks.

Causes can include food irritation (hot pizza, sharp tortilla chips), trauma (cheek biting or dental work), toothpastes and mouthrinses containing sodium lauryl sulfate (SLS), reactions to foods (spicy food, coffee, chocolate (that's a bummer!)), and stress. 

Anyone can get canker sores, but they occur more commonly in teens and young adults, and more in females. For those who get them repeatedly, it could be hereditary- check your family history.

There's no definitive treatment for canker sores. You can rinse with warm salt water to promote healing of the tissue. Some people like using Orajel, which is a numbing gel that numbs the pain for 15 minutes. I've read an article that claims eating yogurt daily decreases the recurrence thanks to the help of the good bacteria (probiotics). Watch what you eat (avoid spicy, salty and acidic foods), and try to reduce your stress.

Cold Sores

Also known as fever blisters, they are common viral infections. They occur around the outer lips in small clusters that blister and crust, then heal without a scar after a couple of weeks. Cold sores are contagious, and are caused by a herpes virus (HSV-1). You may feel a tingling or itching around your lips before the sores appear,

Cold sores are most contagious when when oozing blisters are present, so don't share utensils, food or drinks. Once you've had an episode, it can be re-triggered in the same area by sun exposure, fever, stress, and hormonal changes.

You can use Abreva cream (buy over the counter) to help speed up healing of the sores, or use anti-viral medicine like Zovira and Valtrex (both prescription) to help shorten the course of the sores, most effective when taken within the first 48 hours of the outbreak.


Leukoplakia are thickened white patches that cannot be rubbed off that appears on the gums, the inside of the cheek, the floor of the mouth and sometimes the tongue. It is caused by irritation from tobacco- smoked or chewed. It can also be caused by irritation from rough edges like broken teeth, ill-fitting dentures or partials. These lesions go away once the offending factors are fixed or tobacco use is stopped.

Most leukoplakia are harmless (non-cancerous), though lesions at the floor of the mouth may be associated with the beginning of cancer (those usually needs biopsy to confirm). White lesions with red patch inside may also indicate pre-cancer. Let me know if you have lesions in the mouth that haven't resolved after 2 weeks, or are getting bigger.

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