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Cold/Canker Sores - Two Different Conditions, Two Different Sets of Remedies

Mouth sores can be a pain, especially when it affects your eating and talking. Two common mouth sores we may hear are cold sores and canker sores. These terms may be confused as being the same condition but in two different names, but they are not. In fact, after you know the difference, telling them apart is quite easy.

Cold sores often occur outside of the mouth; they are fluid-filled and caused by a virus. Canker sores occur inside the mouth; they are small, shallow ulcers and not caused by a virus. In fact, the cause of canker sores are unknown. However, we do know that citrus or acidic fruits and vegetables like lemons, oranges, pineapples, apples, figs, tomatoes, and strawberries attribute to the formation of canker sores. Injury to the gum tissues can also trigger a canker sore, i.e. by a sharp tooth or misfitted denture.

Cold Sores

Cold sores, or Herpes simplex labialis (HSL), can be very painful for some people, while some people infected with the virus may not experience any symptoms at all. Cold sores are caused by the herpes simplex virus I, actually both herpes simplex I and II can cause cold sores. Once infected with this virus, the virus stays with the affected person for life. To prevent from catching this virus, it is best to avoid contact with fluids of the infected person, for example, kissing, sharing utensils, drinking cups, and anything else the person with a cold sore may have used.

Cold sores usually go away after a few days on their own, but there are remedies over the counter to help relieve the symptoms of cold sores. Abreva is the only FDA-approved over-the-counter treatment of cold sores that can reduce the duration of cold sore symptoms, the number of occurrences of cold sores, as well as relieving the pain. Abreva contains the active ingredient docosanol 10%, that's used to treat cold sores. Other remedies that you may try to relieve the pain from cold sores are topical analgesics, like benzocaine; you can find products containing these ingredients at your local pharmacy over-the-counter. There are also natural lysine-containing products that you can use to prevent the spread of cold sores. You can also look for the common ingredients types: analgesics (menthol, camphor, phenol), and skin protectants with sunscreen (dimethicone allantoin; dimethicone being the sunscreen ingredient).

Canker Sores

There are two types of canker sores, or Recurrent Aphthous Stomatitis (RAS): simple and complex. Simple canker sores are the most common type of canker sore. Complex canker sores occur more often in people who have had them before, and may be an indication to a bigger underlying problem such an impaired immune system, nutrition deficiency in vitamin B-12, zinc, folic acid, iron, etc., or gastrointestinal tract disease like Celiac disease and Chrohn's disease.

Canker sores are characterized by one or more painful sores inside the mouth, either on the tongue, soft palate (the posterior region of the roof of the mouth), or inside the cheeks in the mouth. You may experience a tingling or burning sensation before the appearance of a canker sore. These painful sores are round , white, or gray in appearance, and have a red border. In cases of severe canker sores, the person may experience a fever, feel sluggish, and have swollen lymph nodes.

There are over-the-counter remedies to relieve canker sores, including oral debriding (plaque removing), wound cleansing, pain-relieving (topical oral anesthetics) products, as well as topical oral protectants and rinses. Cleansing and debriding agents contain the active ingredients: carbamide peroxide, hydrogen peroxide, or sodium bicarbonate. Beware that the prolonged use of these agents can lead to tissue irritation and tooth enamel decalcification. You can also look for analgesics (benzocaine), and use that with an antiseptic (benzalkonium chloride).

Your doctor may prescribe Magic mouthwash for your canker sore, but there is no standard formula for this treatment. The most popular formulation includes an anesthetic such as lidocaine, an antihistamine such as diphenhydramine, plus maalox. The person may add antifungals, corticosteroids, and antibiotics for treating infections or inflammations. You can find these ingredients over-the-counter in your local pharmacy and mix your own mouthwash. You will need diphenhydramine, maalox and ibuprofen liquid, and mix together the same amount of each ingredient and make a 1 to 1 to 1 mixture. This formulation should be used 4 times a day, by swishing 5 ml (1 teaspoon) of the mixture in the mouth for 1 to 2 minutes, then spitting out. Do not eat or drink for 30 minutes after use.

If these remedies do not relieve your symptoms in a few days, please consult your doctor before taking the next step.

 

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A Registered Pharmacist providing resources to help people cope with their everyday health-related illnesses and symptoms.

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My daughter has my weak enamel and love of acidic foods, when can she start using fluoride toothpaste?

Like me she loves oranges, pineapple, lemonade, and tomatoes. She just turned two and we try to have her brush after every meal and snack or at least rinse out with water at restaurants. I'm actually on prescription toothpaste with a higher amount of fluoride than they can sell in stores until I have dentures.

You should take her to the dentist if you are convinced that she has enamel like yours and ask his advice. Generally children shouldn't use floride containing products until they are old enough to spit them out as opposed to swallowing. My daughter is 4 and uses the same toothpaste as me (she refuses to use children's toothpaste) and mouthwash and has never swallowed any of it.

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