Smiles Online - Gustafson & Morningstar, D.D.S

The Recurring Problem of Cold Sores
Do You Get Cold Sores? You’re Not Alone

A cold sore is a common occurrence, but knowledge about it is not as widespread.

Last year, 40 million Americans suffered an outbreak of cold sores. For most people, cold sores are little more than an annoyance. But for others ― for example, those who are malnourished, who are being treated for cancer, or who have a weakened immune system ―- cold sores can cause unusually severe illness.

They are common, for sure. Dr. Steve Gustafson says each month he sees about two to three patients who have cold sores.

When that’s the case, Dr. Steve says the first thing he does is talk to the patient about getting on a prescription medication.

“If people have the virus in their system, sometimes just routine dental work is enough stress to cause an outbreak.

If the patient already has a cold sore, he’ll usually prescribe medication in a salve form to help heal the area.

But if a patient simply feels that tingling sensation around the mouth this indicates a cold sore is coming on, he’ll prescribe a pill that can help prevent the onset. Then his office will reschedule the patient’s appointment for a later date when the cold sore will be gone.

What Causes Cold Sores?
Cold sores are caused by the herpes simplex virus 1 (HSV-1). Most people carry this virus in their bodies because they have been infected at some time in their lives, usually before the age of 5. After this initial infection in childhood, which might occur without symptoms or may mimic teething in an infant, the virus lies dormant in the nerves near the affected skin area.

Herpes recurrences, or secondary episodes, produce fever blisters or cold sores. Many factors can trigger a cold sore outbreak:

Stress
Fatigue
Some foods
Sun exposure
Fever
Excessive heat or cold
Menstruation
Pregnancy
Trauma or injury to the mouth or lips, even that caused by dental work or shaving

What's the difference between a canker sore and a cold sore?

Canker sores are often confused with cold sores. Dr. Steve says that an easy way to distinguish between the two is to remember that canker sores occur inside the mouth on soft tissue, and cold sores usually occur outside the mouth on hard tissue.

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A canker sore is a small ulcer with a white or gray base and red border. There can be one or a number of sores in the mouth. Canker sores are very common and often recur. Unlike cold sores, there is usually no hint that there is a canker sore coming on such as the tingling you get with a cold sore, Dr. Steve says.

If you do get a canker sore, Dr. Steve suggests rinsing your mouth with warm salt water. He usually prescribes a product called Orabase Oral Protective Paste that covers the sore while it heals.

Some who have cold sores even try alternative health methods such as eating yogurt, which some say helps heal the canker sore.

A cold sore, which is also called fever blister or herpes simplex, is composed of groups of painful, fluid-filled blisters that often erupt around the lips and sometime under the nose or under the chin. Cold sores are usually caused by herpes virus type I and are very contagious.

Canker sores usually heal in about a week or two.

Rinsing with anitmircobial mouthrinses may help reduce the irritation. Over-the-counter topical anesthetics can also provide relief. Cold sores usually heal in about a week. Over-the-counter topical anesthetics can provide temporary relief and prescription antiviral drugs may reduce these kinds of viral infections.

Although the edge of the lip is the most common place for cold sores to appear, they can form inside the mouth, including the gums and hard palate.

What Happens During a Cold Sore Outbreak?
The first sign of a cold sore is a slight tingling and itching in the affected area. This period is called the prodrome. Next, the area becomes swollen and red. Within one to two days, blisters appear. When the blisters break open, they leak fluid (which can spread the infection) and form painful cold sores. The sores are eventually covered with crusts and scabs.

An outbreak of cold sores usually lasts from 7 to 14 days.

Are Cold Sores Contagious?
Absolutely. Cold sores can be spread very easily from one person to another by direct contact with the sores or saliva of an infected person. If you have a cold sore, it’s important for you to wash your hands frequently, not share drinking glasses, eating utensils or lipstick with anyone, and avoid kissing until the sores have healed.

Can Cold Sores Be Prevented?
Because cold sores are caused by a virus lying dormant in your system, prevention isn’t always possible. But there are a number of steps you can take to keep outbreaks to a minimum and to shorten the duration of an outbreak. Here’s what Dr. Steve suggests:

Wear a lip balm that includes sunscreen protection of at least SPF 15.
Wear a brimmed hat to protect your face from the direct rays of the sun.
Avoid physical contact with people who have cold sores.
Take vitamin C. Avoid any foods or activities that have caused outbreaks in the past.
Be aware that stress can cause an outbreak and take measures to reduce stress or cope with it successfully.

What’s the Best Treatment for Cold Sores?
Cold sores generally clear up on their own without any special treatment in 7 to 14 days. To ease discomfort and to speed healing, Dr. Steve recommends a a number of steps you can take:

Keep your lips and the area around your lips clean.
Apply an over-the-counter topical that will shorten the healing time and duration of symptoms. Ask your pharmacist which medication is best for you.
Wash your hands frequently during a flare-up. Good hygiene will keep you from spreading the infection to other parts of your body, for example your eyes.
Apply an ice cube to the affected area at regular intervals over an hour period during the initial outbreak to reduce the swelling. For example, 10 minutes on, 10 minutes off.
Drink cool liquids or suck frozen juice bars to reduce discomfort.
Avoid picking at the cold sore or scab.
Apply petroleum jelly to the area to prevent cracking, bleeding, and spread.
If your cold sores don’t clear up after 14 days or if they recur frequently, talk to your physician or dentist. Call your physician immediately if the cold sores and fever blisters make it hard for you to talk or swallow or if you develop a fever or severe headache. Also, you should notify your physician immediately if you think that you have gotten the infection in your eye. Herpes in the eyes has led to blindness.

Your Dentist Can Help With Recurrent Outbreaks
In general, people who limit stress and follow a healthy lifestyle have the fewest number of outbreaks. But even the best intentions to avoid stress and other triggers can’t totally eliminate outbreaks for some people.

If you suffer from frequent or severe outbreaks, feel free to discuss the problem with your dentist, or give Dr. Steve a call and he'd be happy to help.