Doctor's Notes | Published October 4, 2011 | Written by James Freije, MD, MPH, FACS

When to Be Concerned About Mouth Sores

Did you know that approximately 25 percent of patients who develop mouth cancer are non-smokers? Understanding mouth sores is an important step in preventing more serious oral conditions. The two most common mouth sores are canker sores and cold sores.

Canker sores are shallow painful ulcers that develop on the inside of the lips and cheeks, tongue, or on the back portion of the roof of the mouth (soft palate). Canker sores are probably caused by a local immune response to stress or a focal irritation. Acidic foods and digestive problems (gluten sensitivity) are also possible causes. Canker sores are not contagious and usually heal in five to 10 days.

Cold sores are painful blisters that form on the lips, gums and the bony roof of the mouth (hard palate). They are caused by the herpes simplex virus (type I) and are very contagious. The blisters rupture, crust over and heal within seven to 10 days. In severe cases, cold sores can be treated with antiviral medications.

Any sore that lasts for more than two weeks should be evaluated by a physician.

Early mouth cancer can resemble canker sores but do not heal. Though less common, mouth sores such as leukoplakia (thick white patches) and mouth cancer are curable if treated early.
Leukoplakia is caused by chronic irritation such as a jagged tooth or prolonged tobacco use. In some cases it can progress to mouth cancer, which is why a biopsy is taken to look for abnormal cells. Risk factors for mouth cancer include tobacco use, excessive alcohol consumption, ill-fitting dentures and contraction of the human papilloma virus (HPV).

James Freije, MD, MPH, FACS is an otolaryngologist (ear, nose and throat specialist) and head and neck surgeon with Mount Nittany Physician Group. He is on staff at Mount Nittany Medical Center.

This article was originally published in the June 2011 issue of State College Magazine.