Ouch! How to manage Cold and Canker Sores

Two very common painful afflictions in the mouth are cold sores and mouth ulcers.

Cold sores, also known as fever blisters, tend to appear outside the mouth along the border of the lips. Cold sores are initially caused by exposure to herpes simplex virus (HSV) Type 1. Almost everyone has been exposed to this virus as a child and have the virus living dormant inside their nerves. Only some are unlucky enough to have the virus sporadically flare up causing sores.

Sores that appear inside the mouth are commonly known as canker sores or aphthous ulcers and are typically not related to any virus. There are some known triggers for both types of painful sores which can contribute to flare ups.

Here are some tips to help prevent and treat cold sores and ulcers:

  • Use sunscreen and lip balm with SPF: and reapply as directed! Not only will this prevent harmful UV ray damage to your skin and lips, it can lessen the frequency of cold sores. Many people find sun exposure is a trigger. Lip balm will also prevent dryness and chapping, another known trigger.

  • Avoid trigger foods: Trigger foods for many people include spicy foods, acidic food and drinks, and very hot foods and drinks. These can trigger both cold sores and mouth ulcers.

  • Prevent spreading infection: Cold Sore lesions are contagious from the initial “tingling or itching” phase until oozing stops and the lesion is completely crusted over which typically takes 7-10 days.

    • Avoid touching the lesions or immediately wash your hands after.

    • Avoid direct contact with other persons and sharing drinks or silverware during this time.

  • Immediately treat the area: The best time to treat a cold sore lesion is as soon as the itching or tingling can be felt. There are many helpful over the counter topical products that can be applied, keep these handy so you can apply as soon as possible.

    • In many cases you can also take a systemic or pill form of an antiviral medication. Talk to your doctor or Dr. Berry about whether a prescription is appropriate. These medications can usually reduce the duration and pain involved with cold sores.

    • Dissolving ½ teaspoon of salt in a glass of warm water and rinsing several times a day can help alleviate discomfort from mouth ulcers.

    • Dr. Berry can use a laser to immediately reduce discomfort from these sores.
  • Stay healthy and active: A healthy diet, regular exercise, and a good night’s sleep will help prevent some of the biggest triggers for mouth sores: fatigue, a weakened immune system and stress! Eat a well balanced diet and talk to your doctor about taking supplements as needed to help prevent vitamin deficiencies.

  • Avoid trauma: If involved in contact sports, wearing a sports guard can help prevent trauma to the lips and teeth. Habitual lip biting or picking can also cause irritation to trigger an outbreak.

  • Check your products: Some ingredients found in toothpastes and mouth rinses can irritate the mouth tissues and increase outbreaks of sores.

    • Typically these can be found in whitening or tartar control formulations.

    • Sodium Lauryl Sulfate, or SLS is also a common ingredient that may irritate the mouth. Sensodyne Proenamel is SLS free.

    • Alcohol is mouthwashes may trigger a sore, use alcohol free mouthrinse such as any ACT brand rinse or Crest Pro Health.


Make sure Dr. Berry is aware of any abnormal mouth sores inside or outside near the mouth that last for more than two weeks, or appear suddenly with a fever, as these could be serious infections that require more attention.


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