Mouth Sores

There are a variety of sores that can occur in or around the mouth. Most are benign, but some may be indicative of cancer.

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Understanding Mouth Sores and When to Seek Evaluation

Mouth sores are a common condition that can develop inside or around the mouth for many different reasons. While many sores are harmless and resolve on their own, others may cause discomfort, interfere with eating or speaking, or indicate an underlying health issue. Conditions such as canker sores, cold sores, fungal infections, and irritation from dental appliances can all lead to oral sores. In some cases, persistent or unusual sores may also signal precancerous changes or oral cancer. Understanding the different types of mouth sores and when to seek medical evaluation is an important step in protecting your oral and overall health.

Canker Sores

These small, creamy white ulcers have a red border and always appear inside the mouth. Canker sores can be painful, but they are not contagious. They usually heal in one to two weeks. Prescription drugs and over-the-counter topical treatments can help reduce the pain.

Cold Sores

Also known as fever blisters, cold sores are fluid-filled blisters that form on the lips or around the mouth. Cold sores are usually caused by the herpes simplex virus, and are both contagious and painful. Fever, sunburn, trauma, hormonal changes or emotional upset can trigger their appearance. While there is currently no cure, cold sores can be treated with prescription ointments to help alleviate the pain. It is also important to wash your hands frequently and avoid sharing personal products to help prevent the spread of the infection to other people.

Candidiasis

Also known as oral thrush, this mouth sore is caused by a fungal infection. Painful red and cream-colored patches form on moist areas of the mouth. Candidiasis can cause difficulties with swallowing and taste. It is most commonly seen by denture wearers or people who have problems with their immune systems. Sometimes it occurs as a result of an unrelated antibiotic treatment, which can decrease normal bacterial development in the mouth. Saliva substitutes and antifungal creams are used to treat candidiasis.

White Patches

Chronic irritations inside the mouth, such as cheek chewing, dentures, or braces, sometimes cause benign white patches to form inside the mouth. The treatment is to alleviate the irritation to allow for natural healing.

Leukoplakias

Leukoplakias are thick, white lesions that commonly form beneath or around the tongue, cheeks, or gums. Leukoplakias are painless but can become cancerous over time. These mouth sores are most often seen in tobacco users. A biopsy may be needed to diagnose leukoplakias accurately.

Oral Cancer

Oral cancers appear as red or white patches of mouth tissue or small ulcers that look like canker sores but are painless. Oral cancers usually form on the tongue or floor of the mouth, but can occur on any tissue in and around the mouth. This includes cancers of the tonsils, adenoids, uvula (soft palate), roof of the mouth (hard palate), inside the lining of the cheeks, the gums, teeth, lips, the area behind the wisdom teeth, and salivary glands. Some of these lesions may be benign, others may be malignant, and others may be precancerous. The most common type of precancerous cells in the mouth is:

Leukoplakias: Leukoplakias consist of thick, white lesions that most commonly form beneath or around the tongue, cheeks or gums. These mouth sores are most often seen in tobacco users.
Erythroplakias: These lesions appear as a red, raised area in the mouth and have a higher incidence of becoming malignant than leukoplakias.

A biopsy is often needed to diagnose leukoplakias and erythroplakias. Squamous cell carcinomas are the most common type of oral cancer. Less common are lymphoma and salivary gland cancers. Most oral cancers occur in people aged 45 and older. When cancers of the mouth metastasize, they are most likely to spread to the lymph nodes in the neck. If you have a mouth sore that won't heal, please contact Coastal Ear Nose & Throat and schedule an appointment with one of our otolaryngologists.

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