- https://www.medicinenet.com -Reviewed By: Charles Patrick Davis, MD, PhD
Cold sores don’t come from colds. And although they’re also called fever blisters, fevers don’t cause them either. So, what are they? Cold sores come from a virus, and that virus can be shared by kissing, or by sharing eating utensils, or any other form of close contact between individuals. You may find over-the-counter creams and ointments helpful in easing the pain and discomfort they cause, and these treatments may also hasten healing. If you get them often, you may want to look into prescription remedies.
Cold Sore Treatment
When a cold sore outbreak develops, you may notice a tingle. Ice or a cold compress can help at these times. Prescription medicines are available as well, including antiviral pills and creams. Talk to your doctor about a choice that might work for you. Nonprescription options for pain include aspirin (not in children) and acetaminophen.
Babies and older adults are the people most likely develop thrush, which is caused by Candida yeast. But other causes can bring this out in anyone, including antibiotics, a weak immune system, medications like inhaled corticosteroids, and diabetes. If you try to wipe the patches away, you could experience painful soreness.
Also called candidiasis, babies less than a month old and older adults are most likely to develop thrush. It is also more common in those with cancer, HIV/AIDS, and those who smoke, take antibiotics, or medications that cause dry mouth. People who wear dentures are at greater risk as well. For a diagnosis, see your doctor.
Black Hairy Tongue
This one is rare, and, fortunately, painless. But it’s not pretty. Black hairy tongue occurs when the tiny bumps on your tongue seem increase in size, trapping bacteria. This gives your tongue a black, hairy appearance. These “hairs” can be over ¾ inch long. Antibiotics, smoking, neglecting good oral hygiene habits, and drinking staining beverages like tea or coffee can cause black, hairy tongue. Sometimes the problem is a lack of saliva. If you brush your tongue along with your teeth, and perhaps by trying a tongue scraper, you can usually rid yourself of the condition. However, some people need special medication.
Canker Sores (Aphthous Ulcers)
The cause of canker sores is mysterious. But there is no mystery if you have one—these painful mouth blisters can be hard to ignore. They can appear nearly anywhere on the flesh of the mouth, including your gums, lips, tongue, and inside your cheek. Infections, hormones, stress, and a lack of essential nutrients can be cold sore triggers. Dehydration and some medications may cause them, too. It is possible that small injuries inside your mouth can also cause them, such as when you bite your cheek while chewing.
Also called aphthous ulcers, canker sores usually last a week or two. They are not contagious. You can help prevent cold sores in several ways. Keep your mouth clean of debris by brushing and flossing between meals. Avoid toothbrushes with firm bristles. Work on reducing stress. Also note that alcohol-based mouthwash may make them irritated. If your canker sores are long-lasting and severe, you may need more intensive treatments, and these may include prescription medications, dental lasers, or creams that numb the sores.
If you see painless, white patches in your mouth that can’t be scraped away, you may have leukoplakia. It usually occurs when your mouth is irritated, for example from rough patches on teeth, ill-fitting dentures, or tobacco use (both smoking and chewing tobacco). Be careful, as leukoplakia can be precancerous. If these patches persist, ask your dentist for an evaluation.
If you see white, lacy patches or shiny, red bumps on your tongue or cheeks, you may have lichen planus. The cause of this condition is unknown, although in some cases it may be related to an autoimmune disorder, hepatitis C, or certain medications. When lichen planus is mild, you don’t need treatment. However, it can cause pain and ulcers, and may lead to an increased risk of oral cancer. If you have a painful, ulcerous case, ask your doctor about medications available for lichen planus treatment. This condition can also affect your nails, skin, genitals, and scalp.
Depressions in your tongue that look something like islands or continents on a map are known as “geographic tongue.” This condition may last and last (chronic), or come and go. The depressions lack the usual tongue bumps, and can shift in size, area, and pattern within minutes. The good news is that geographic tongue is harmless. But about 1 in 20 have extra sensitivity to hot and spicy foods. Most people don’t need treatment for this condition, but anti-inflammatory medicine and over-the-counter pain relievers can help with any pain it may cause.
Oral cancer can show up in many different ways. It may cause unexplained face, mouth, or neck numbness. Or it may take the appearance of a mouth sore that never heals. Some people discover oral cancer after experiencing problems swallowing, chewing, or speaking, bleeding, pain, voice changes, or jaw swelling.
Tobacco use, heavy drinking, sun exposure, and a genetic predisposition can all cause oral cancer. HPV (human papillomavirus) may also cause it. Although cancer is frightening, it is absolutely crucial that you see your doctor if you suspect oral cancer. This condition can be cured if it is caught early on.
TMJ pain is common, and affects an estimated 12% of the population in any given year. It may be even more common, though; one study of university students found that 40% to 60% had some TMJ symptoms. TMJ (temporomandibular joint) syndrome is a problem with the tiny, sliding hinge joint just in front of your ear. Signs of TMJ syndrome include severe facial pain that may resonate from your ear, neck, or jaw. Causes include tooth grinding or clenching, as well as injury. You may hear clicking when you open your mouth, or find that your jaw locks in a certain place. You may experience dizziness, headaches, or difficulty swallowing. Having a doctor diagnose TMJ is important, as there are other conditions that can cause similar symptoms. Your doctor may recommend a mouth guard, medication, surgery, the application of moist heat, or rest.
Every chip a tooth? Each year there are roughly 5.5. chipped teeth for every 100 adults. More than 75% of these chipped teeth are molars, the back teeth that grind down your food. You can chip a tooth by chewing things you shouldn’t, such as ice or hard candy. Those who clench or grind their teeth are vulnerable to chipped teeth, too. If the chip is tiny, you may not need treatment. But pain and permanent tooth damage can be caused by larger chips or cracks. Talk to your dentist about treatments, which may include porcelain veneers or crowns, tooth contouring, or dental bonding.
That blue-gray spot in the soft tissue of your mouth is probably not a tattoo—but it could look a lot like one. So-called amalgam tattoos aren’t true tattoos, but they give the appearance of faded body ink. The cause is typically a small bit of amalgam filling that embeds into your soft mouth tissue. These are harmless, but can resemble more harmful conditions. If you notice that your blue-gray spot grows or that its color changes, ask your dentist for an evaluation.
Gum Disease (Periodontal Disease)
Gum disease is an infection of the soft tissue that helps to hold your teeth in your mouth. Gum (periodontal) disease allows the bacteria found in plaque to develop along your gum line. The first stage of gum disease is known as gingivitis, and it is extremely common. By adolescence, 70% to 90% of people have it. The telltale signs of gum disease are bleeding gums that may be puffy and red. It can lead to tooth loss. Follow your dentist’s instructions on caring for your mouth to keep periodontal disease away. Also, avoid stress, smoking, and poor nutrition, as each of these can exacerbate the problem.
After gingivitis, gum disease can develop into its second stage—periodontitis. Nearly half of American adults over age 30 have some amount of periodontitis, according to the CDC. In this gum disease stage, inflammation leads to receding gums. Pockets develop in between your gums and teeth. And these pockets are the perfect spots for bits of food, plaque, and tartar to accumulate. This can cause infection, as well as tissue to swell around accumulated pus (abscesses). Periodontitis is serious—it’s one of the main reason adults lose their teeth. If you suspect your gums are receding, tell your dentist.
An old remedy for an aching tooth is to set an aspirin inside your cheek. But it’s not a good idea. The acid from the aspirin can cause a white burn against the soft tissue of your mouth, which may leave your skin tissue with a rough feeling (do not attempt such use in children). This one is easy to avoid—simply swallow the aspirin if you want to relieve a toothache. Time is the treatment—wait a week or two and aspirin burn should go away naturally.
Cavities, Abscesses, Discoloration
It’s easy to ignore subtle mouth problems. But when you do, they can get worse. Make sure to keep up with good, basic oral hygiene. That means daily brushing, flossing, and rinsing, along with twice-a-year dental checkups. Tell your dentist if you see tooth discoloration, or think you have an abscess or a cavity. And if you have extreme toothache, don’t mess around. These infections can spread, causing problems in your face, your skull, or your bloodstream. Watch out particularly for toothaches that are accompanied by earaches or fever. If opening your jaw wide causes pain, this is another thing to discuss with your dentist.
What happens when you don’t brush your teeth? Tiny bits of food attract bacteria, and that can lead to smelly breath. Bad breath may be persistent. When it is, you may need to think more widely about potential causes, which may include:
- Dry mouth
- Continuous breathing through your mouth
- Tooth decay
- Gum disease
When you brush your teeth, be sure to brush your tongue, too, and floss and rinse everything down so you don’t have anything left in your mouth for bacteria to feed upon. You may consider an antiseptic mouthwash, too. And make sure you drink plenty of water. Of course, some stinky foods can cause bad breath too, and you may want to avoid ripe cheeses and garlic, for instance. If your bad breath just won’t go away, ask your dentist for further tips.
“Lie” Bumps (Transient Lingual Papillitis)
Painful, swollen bumps go along with an old wives’ tale; supposedly if you tell a lie, a bump will form on the tip of your tongue. That’s how “lie bumps” (transient lingual papillitis) got their common name. But even if you always tell the truth, the truth is, you may develop these. In fact, more than half of all people will get them at some point. They appear most often in young women, perhaps because women have more bumps on their tongue (fungiform papillae) that hold taste buds and temperature receptors.
Lie bumps are small and harmless, but they may be painful. They usually go away anytime from a few hours to a day or two after they first appear, only to reappear eventually. Their cause is a mystery—it could be a reaction to a food or a minor trauma like biting your tongue. One theory holds that they may be caused by a virus similar to herpes simplex virus, which causes cold sores. You don’t need to treat them, as lie bumps are harmless. Some people report that antiseptic mouthwash, topical steroids, salt water rinses, or cool, soothing foods help relieve them. However, most people who get these find that no treatment helps ease symptoms or prevents them from coming back.