Cold sores, also known as fever blisters or oral herpes, strike at least 500,000 Americans each year, says Surgeon General David Satcher, M.D., Ph.D. in a 2010 report entitled "Oral Health in America." Although cold sores are common, dermatologist Christina Cernik, M.D. explains in the June 9, 2008 edition of "Archives of Internal Medicine" that cold sores inside the mouth are not, accounting for fewer than 5 percent of cases. Medicines for cold sores inside the mouth differ from medicines for cold sores outside the mouth.
Antiviral Drugs
Although cold sores usually resolve on their own within 10 to 14 days, Cernik says that doctors usually recommend antiviral drugs for cold sores inside the mouth because they are often numerous and can interfere with activities such as eating and drinking. Common choices include acyclovir, valacyclovir and famciclovir. Topical medicines such as penciclovir and docosanol generally aren't recommend for cold sores inside the mouth because the medicines wash away before they have a chance to work.
Pain Relievers
Cold sores inside the mouth can cause extra pain and discomfort, compared to cold sores on other surfaces. While antiviral drugs shorten the duration and severity of symptoms, they offer little interim relief. FamilyDoctor.org recommends over-the-counter oral acetaminophen or ibuprofen. For severe pain, HealthyChildren.org from the American Academy of Pediatrics recommends asking a doctor about topical anesthetics such as lidocaine, benzocaine or tetracaine that are safe for use inside the mouth. Common forms include a liquid that is painted on the sores or a mouth wash that is used to irrigate the sores.
Antiseptics
The 2008 edition of "Fitzpatrick's Dermatology in General Medicine" explains that cleanliness is key to cold sore healing. Keeping cold sores clean prevents irritation from food debris and secondary infections from mouth bacteria. An article by Paolo G. Arduino and Stephen R. Porter in the Feb. 2008 issue of the "Journal of Oral Pathology and Oral Medicine" says that normal oral hygiene activities such as toothbrushing and flossing should not be performed on mouth surfaces with cold sores because it can increase irritation and tissue damage. Instead, Arduino and Porter recommend the use of an over-the-counter antiseptic mouthwash with active ingredients such as eucalyptol, menthol, methyl salicylate and thymol that can help flush away food debris and kill bacteria without making the sores worse.
References
- National Institute of Dental and Craniofacial Research: Oral Health in America -- A Report of the Surgeon General
- "Archives of Internal Medicine"; The Treatment of Herpes Simplex Infections; Christina Cernik, M.D., et al.; June 9, 2008
- "Journal of Oral Pathology and Oral Medicine"; Herpes Simplex Virus Type 1 Infection; Paolo G. Arduino, D.D.S., M.Sc. and Stephen R. Porter, D.D.S, Ph.D.; Feb. 2008
- "Fitzpatrick's Dermatology in General Medicine, 7th Edition"; Klaus Wolff, M.D. et al.; 2008
- FamilyDoctor.org: Herpes
- HealthyChildren.org: Oral Herpes
