Taking 1,000 micrograms daily of vitamin B12 reduces the frequency, pain, and duration of canker sores, according to a study in the Journal of the American Board of Family Medicine. 

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Canker Sores and Cold Sores – What’s the Difference and What to Do?

This is a question that arises quite often, and is usually followed by “how did I get them?” and then “how do I get rid of them?”  Sores in the mouth can be painful and annoying, and generally come at the most inopportune time – and for a reason as you’ll see. 

Canker Sores

Canker sores are mouth ulcers, or apthous ulcers, that are commonly seen on the cheeks and inside portion of the lower lip, but may also be observed on the floor of the mouth and soft palate.  The exact cause is unknown, but genetics plays a role along with certain triggers, such as fatigue, stress, trauma, and hormonal changes.  You can see why the fatigue and stress of final exams makes this a great time for these to show up.  Also, the trauma during a dental appointment from all the cheek pulling and lip tugging can elicit this response.  Other contributors may include citrus fruits, vitamin deficiency, food allergies, chocolate, and nuts.  Some research studies claim that sodium laurel sulfate (SLS), the “foaming” ingredient in toothpaste, may increase the occurence of mouth ulcers.  Follow this link for a list of SLS-free toothpaste.

Canker sores usually last 1-2 weeks and will heal on their own.  Treatment with gels can help with the pain, but usually has a minimal effect on healing time.  Topical products contain the active ingredient benzocaine and include Zilactin-B, Orabase, Kanka, and Tanac, all of which can be purchased over-the-counter.  Vitamin B12 has been found to be effective in treating recurrent apthous ulcers, regardless of whether a vitamin deficiency is present.  Laser treatment is the most effective by giving immediate relief and speeding healing time to 2-4 days.  Research has also proven that lasers therapy can decrease the recurrence rate.  In severe cases, steriods may be needed. 

If the lesion lasts for over two weeks, see your dentist. 

Cold Sores

Cold sores are blisters that are most commonly seen on the lips, but may also be seen on the gums and roof of the mouth.  Cold sores are caused by the herpes virus, either type 1 or type 2, and are highly contagious.  Transmission is by direct contact with the lesion or by exchange of body fluid with an infected individual.  The herpes virus cycles between periods of active disease, and usually last 1 - 2 weeks.  A variety of irritants may cause a flare up, including wind, sun, fever, and stress.  Over-the-counter topical anesthetics and protectants (Zilactin) or anti-inflammatory agents (Aspirin) or topical antiviral agents (Docosanol) may provide temporary relief for the discomfort, but they do little to speed healing.  Systemic antiviral medications (Acyclovir) may be needed in patients whose immune system is suppressed - but remember, there is no cure.  Once infected, the virus remains in the body forever. 

Summary:

Ways they’re alike:  both are painful sores in the mouth, both last 1-2 weeks, both have no cure, both are caused by irritants – stress, trauma, both have medications that help to alleviate pain but have no influence on healing time (except for laser treatment on canker sores)

Ways they’re different:  Canker sores are not an infection, occur on moveable tissue in the mouth (cheeks, inside of lips, floor of mouth), are actual ulcers, and are not contagious.  Cold sores are a viral infection, occur on attached tissue in the mouth (gums, roof of mouth), are blister-like, and are highly contagious. 

Remember – if lesions last longer than 2 weeks or if you have questions, see your dentist.

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