Many individuals have experienced a cold sore at one time or another. In fact as about a third of the US populations suffer from the virus that causes cold sores, but it may not have been properly diagnosed or treated by a dentist or doctor.
Cold sores (or fever blisters) occur when the herpes simplex virus (HSV1) inside nerve 
tissue is activated by a trigger such as stress, sunlight, trauma, fever, or illness. Not to be confused with canker sores (which are caused by bacteria and occur inside the mouth), cold sores are viral and occur outside the mouth (around the lips). Rarely, a cold sore can occur inside the mouth, but usually only on non-moving areas such as the roof of the mouth.
Most people are first infected with HSV1 during infancy or childhood by contact with an infected family member or friend. However, only about 10% of those infected actually develop cold sores. Other symptoms are flu-like, such as sore throat, high fever, swollen glands, and mouth soreness.
Cold sores occur in 5 stages:
Day 1: Prodrome (tingle) stage- Before a cold sore develops; one may experience a tingling, itching, or burning feeling underneath the skin around the mouth.
Days 2-3: Blister stage- The first visible sign of a cold sore is an outbreak of a fluid filled blister.
*Take medicines before Now (see below)*
Day 4: Ulcer (weeping) stage- When the blister ruptures, it leaves a shallow, red, open sore. This is the most painful and the most contagious time during the outbreak.
Days 5-8: Crusting stage- The blister dries up after a few days and forms a yellow-brown crust, which will eventually shed. It is important to care for the scab so that it does not crack or break.
Days 9-12: Healing stage- A series of scabs will form and flake off, each one smaller than the one before until the sore heals completely.
Cold sores can be treated with topical anti-viral medications to reduce the duration and the severity of the sore, and are most effective when used early before a blister forms. Over-the-counter creams containing docosanol (Abreva®) inhibit the herpes virus and numbing ingredients such as benzyl alcohol relieve burning and itching. Applying a moisturizer like aloe-vera can reduce cracking and enhance healing. If these at-home remedies are unsuccessful, a dentist can prescribe anti-viral drugs, such as Acyclovir which inhibit the virus’s growth thereby shortening its duration and severity. An examination by your dentist ensures that the cold sore is accurately diagnosed and your treatment is appropriate for your age, medical history, overall health, and any allergies or drug tolerances you may have.
Like other viruses such as the common cold, cold sores are highly contagious. To prevent transmission of cold sore (HSV1) to another person, wash hands thoroughly and often and avoid intimate physical contact, sharing utensils, sharing toothbrushes or towels, and touching the blisters. To minimize the recurrence of an outbreak, eat a diet rich in lysine (an amino acid found in red meat, fish, and dairy products), apply sunscreen to the face and lips before sun exposure, throw away your toothbrush and razor following an outbreak, and participate in relaxing, enjoyable activities to reduce stress.
Drs. David and Janna Civils
1114 Magnolia Street
Greensboro
336-272-4177
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Doctors David Civils and Janna Civils are husband and wife Greensboro dentist who provide comprehensive family and cosmetic dental care to people of all ages. Drs. David and Janna Civils offer a wide range of dental services for everyone from the pediatric to the geriatric patient, including cosmetic dentistry and emergency dentistry.
