Considerations: Many diseases and conditions begin with sores (lesions) on the mucus membranes of the gums and inner cheeks.

Origins of lesions can be grouped into several broad categories including infection, autoimmune diseases, mechanical irritation, bleeding disorders, and malignancy. The majority of mouth lesions result from mechanical irritation (such as biting the cheek or from braces) and minor infections (hand-foot-mouth syndrome, herpangina, herpes stomatitis, cankers).

Mouth sores may be the first sign of AIDS with lesions such as hairy leukoplakia and opportunistic infections such as oral Candida.

The herpes virus often resides in the body for years, manifesting itself as mouth sores only when another illness causes a rise in body temperature (fever) or following an injury (accidentally biting the inside of the lip or tongue).

While it is not known for sure, canker sores may not be caused by a virus, but may be the result of a temporary malfunction of the immune system. Women are more likely to get cankers than men, but anyone can get them for no apparent reason.

Common Causes:

• fever blisters and cold sores caused by the herpes virus
• canker sores (common in children, especially those wearing dental braces)
  • may be related to a virus or mucosal injury
• Coxsackie virus (usually accompanied by spots on the hands and feet)
  • sometimes called hand-foot-mouth syndrome
• syphilis (transmitted by oral sex)
• trauma
• drugs such as chemotherapeutic agents
• drug allergies including reactions to aspirin, barbiturates, gold, penicillin (Penicillin V), phenytoin, quinine, streptomycin, or sulfonamides

Home Care: Mouth sores caused by viruses heal by themselves. Canker sores can take up to 2 weeks to disappear regardless of how they are treated.

Pain relievers (such as Acetaminophen - oral) and lots of fluids may help relieve symptoms such as pain and fever. Cold liquids are usually soothing to the lesion (popsicles are often helpful).

Orabase, a nonprescription preparation, may be applied for protection of a sore inside the lip and on the gums. Blistex or Campho-Phenique may provide some relief of canker sores and fever blisters, especially if applied when the sore initially appears.

Call If:

• the problem is possibly caused by medication.
• there are large white patches on the roof of the mouth.
• mouth sores persist longer than 3 weeks.

What To Expect: The medical history will be obtained and a physical examination performed.

Medical history questions documenting mouth sores in detail may include:

• type
  • Is it an open sore (mouth ulcer)?
  • Are there deep, hard-edged cracks?
  • Are there large, white patches on the roof of the mouth?
• location
  • Are the sores on the lips?
  • Are the sores on the gums?
  • Are the sores on the tongue?
  • Are the sores on the lining of the cheeks?
• time pattern
  • How long have you had the mouth sores?
  • Have they been persistent for longer than 2 weeks?
  • Have you ever had sores of this type before?
• other
  • What medications do you take?
  • What other symptoms are also present?
  • Is there a fever?
  • Is there a sore throat?
  • Is there a breath odor?