Mouth Sores & Spots
Mouth sores can be annoying, painful and unsightly.
Some sores appear inside the mouth — on the tongue, gums, cheeks, lips or palate (roof of our mouth). Others sores(like cold sores), can appear outside the mouth also, such around the lips, on the chin & under the nose.
Mouth sores can be caused by bacterial, viral or fungal infections & oral cancer. Some other causes include:
- Irritations, such as caused by old dentures that no longer fit properly and rub against oral tissues.
- Extreme sensitivity to ingredients found in some mouth rinses or toothpastes.
- Loose orthodontic wires.
- Sharp edge of a broken tooth or filling.
- Certain specific oral, skin or systemic diseases.
- Medication side effects
- Side effect of cancer treatment or reaction to therapy.
Although there are many types of mouth sores, the most common are cold sores, canker sores, leukoplakia (a thick gray or white patch) and thrush (a fungal infection) or candidiasis.
Some people may experience occasional painless, discoloured spots in their mouth. Most are harmless & will disappear or remain unchanged. However, some sores can be serious and need immediate attention of your physician or dentist in India. For example, oral cancer may not be painful in the beginning, but it can become deadly. That’s why regular checkups with your dentist are important. Have your dentist examine any mouth spot or sore that fails to heal or disappear within a couple of weeks.
Aphthous ulcers appear inside the mouth. They usually are small ulcers with a yellow, white or gray center with a flat red border. Rarely, aphthous ulcers can be very large (major canker sores) with a raised border. There may be several ulcers & they re occur at varying periods of time.
An aphthous ulcers usually begins as a red spot or a bump. It can produce a burning or tingling sensation before other symptoms appear. Fortunately, most aphthous ulcers heal spontaneously in 6 to 10 days.
The exact cause of aphthous ulcers is not known. Genetics do play a role. White cells (lymphocytes) in the immune system can affect the lining of the mouth causing these irritating, but harmless sores. Emotional stress, Fatigue & certain foods can increase the possibility of a ulcers for some people. Even biting the inside of the cheek or tongue or chewing any sharp piece of food may trigger an aphthous ulcer .
Aphthous ulcers are not precancerous or contagious. There is no permanent cure for Aphthous ulcers; therefore, treatment is for pain or discomfort. Over-the-counter topical medications (such as protective ointments or numbing agents) and antimicrobial mouth rinses may offer temporary relief. Avoid spicy, hot or acidic food and beverages that can irritate the ulcer. Treatment for an attack involves Prednisone, corticosteroids like medications that control troublesome lymphocytes. The medication may be systemic (taken as a tablet or capsule)or in a topical form (applied to the skin).
Cold sores are a group of painful, fluid-filled blisters. These grotesque sores usually erupt on the lips, and sometimes around the lips on the skin. Clusters of small blisters may also occur on the gum tissue near the teeth as well as on the bony roof (palate) of the mouth.
Cold sores — caused by herpes virus are contagious. The initial infection, which often occurs before adulthood, may be misunderstood with a cold or the flu. The infection can cause painful lesions to erupt in the mouth, and some patients can become quite ill. Most patients who get infected with herpes do not get sick. However, once a patient is infected with herpes, the virus stays there in the body, where it may stay inactive. Unfortunately, in some people, the virus gets activated periodically, causing the cold sores to appear on and around the lips. A variety of irritants (sun, wind,stress, fever) can cause a flare.
Cold sores usually heal in about a week. Once the blister breaks, an unsightly scab forms. Over-the-counter topical anesthetics and protectants, anti-inflammatory agents or topical antiviral agents may provide temporary relief for the discomfort but do little to speed healing. As with the common cold, there is no cure for these viral infections. Topical or systemic antiviral drugs can be prescribed by your dentist, but they are ineffective after 3 to 4 days of blister formation and usually are not recommended in otherwise healthy patients.
Leukoplakia (loo-koh-PLAY-kee-ah) is a white or gray patch that develops anywhere on the inside of the mouth. It is caused by excess cell growth of the lining of the mouth. It is often a response to chronic irritation, such as smoking or smokeless tobacco (snuff, chewing tobacco), certain foods, cheek biting, irregular dental restorations or broken teeth. In some instances, a cause cannot be determined. Leukoplakia patches develop slowly over a period of time. The patch may eventually become rough. It typically is not sensitive or painful.
Leukoplakia generally is harmless, but there is a risk that it can become cancerous. To be certain that a spot or sore is not a threat, your dentist may do a biopsy to determine if any potentially dangerous cells are present. If the leukoplakia is sensitive, cancer must be ruled out by biopsy.
Erythroplakia (e-ryth-ro-PLAY-ki-a) is a red patch that may be found in any part of the mouth but is most common in the floor of the mouth or on the gum tissue behind the back teeth. The cause is unknown but is most likely associated with smoking or other tobacco use and alcoholic beverages. Chronic irritation and poor nutrition may also be contributing factors. Although erythroplakia is less common than leukoplakia, most of these lesions are found to be precancerous or cancerous when biopsied. Red lesions that do not heal in a week or two should be evaluated by your dentist. This applies even if you do not smoke or drink alcohol.Lichen Planus
Lichen planus (li-ken PLAY-nus) is a disorder that involves a chronic, itchy, inflammatory rash or lesion on the skin or in the mouth. The lesions may consist of white spots or “lacelike” white changes. Lesions on the sides of the tongue, insides of the cheek and on the gums, may be tender or painful. Its cause is genetic and related to a chronic immune system reaction.
Lichen planus generally occurs during or after middle age. Lichen planus is not contagious and does not pose a high risk for becoming cancer. There is no cure, so treatment is for discomfort or pain. Rinses, ointments, or pills can be prescribed by your dentist, if needed. The diagnosis can be confirmed by biopsy and clinical characteristics.
Candidiasis (can-di-DI-a-sis), also known as oral thrush or moniliasis, is a fungal infection. It produces creamy white and red patches that form on surfaces of the mouth. It can be painful and may cause bad breath and difficulty tasting and/or swallowing.
It occurs when the yeast Candida albicans reproduce in abnormally large numbers. For example, Candida may flourish after antibiotic treatment, when normal bacteria in the mouth have decreased, when the immune system is suppressed or when the mouth is dry (xerostomia). Dry mouth is a common side effect of many prescription or over-the-counter medications.
Candidiasis most often occurs in the very young, the elderly, and those debilitated by disease, such as diabetes and AIDS. It also frequently occurs among people who wear dentures.
Treatment consists of controlling conditions that cause the outbreak. Cleaning dentures to remove Candida is important in preventing denture-induced problems.
Saliva substitutes or prescription medications are also available to treat dry mouth. Antifungal medications may be used when the underlying cause cannot be treated or eliminated. Good oral hygiene is essential.
Oral or mouth cancer may appear on the lips, tongue, cheek lining, gums, palate (roof of the mouth) or floor of the mouth. Cigarettes and other tobacco products, including smokeless tobacco, are associated with 70 percent of oral cancer cases. Drinking alcoholic beverages can also increase your chances of having oral cancer.
Oral cancer may appear as a white or red lesion, lump or ulcer. It is usually small and painless at first, but can grow and spread quickly. Many oral cancers are discovered during routine dental examinations. Control of erythroplakia & leukoplakia may prevent some oral cancers from developing. Some oral cancers can resemble benign (non-dangerous) changes, so may delay early diagnosis. Early diagnosis and treatment greatly increase the chances of survival and a good quality of life.
- Schedule regular dental checkups. See your dentist for mouth sores that persist longer than two weeks, even if they are not painful. A biopsy (tissue sample taken for testing) can usually determine the cause or rule out cancer. Your dentist can recognize and often diagnose the type of mouth sore or spot based on its appearance and location.
- Keep a diary of what you eat and drink.
- Keep a list of oral hygiene products (toothpaste, mouth rinse, etc.) you have been using.
- Avoid all tobacco products.
- If you drink alcoholic beverages, do so in moderation.
- See your dentist if you notice any change in your mouth, including pain or discomfort, or the presence of sores in the mouth, even if they are not painful. For oral cancer, early diagnosis and treatment can increase your chance of cure.