Canker or Cold Sore

Where it is tells you what it is and what to do about it

In or out? That's the first question to ask when you're trying to figure out whether you have a canker sore or a cold sore. If it's inside your mouth it's most likely a canker sore; outside, probably a cold sore.

The two may seem similar, but the similarity ends with the fact that both are connected with the mouth and both cause pain and discomfort. So knowing which one you have is the first step to knowing how it's caused and how to treat it, according to an article in the February 2003 issue of AGD Impact, the monthly newsmagazine of the Academy of General Dentistry (AGD).

Canker sores (or mouth ulcers) generally occur inside the mouth and are bacterial in nature. They often are triggered by trauma such as biting your cheek, jabbing your gum with your toothbrush or even overzealous tooth cleaning. Cold sores are tiny, clear, fluid-filled blisters that form around the mouth and are caused by the herpes simplex virus living inside your nerve tissue. (It is not the same virus that causes genital herpes.)

Diligence is key when dealing with your oral health, says AGD spokesperson Eric Z. Shapira, DDS, MAGD. "You need to be aware of any kind of lesion in the mouth or around the mouth, then report it to your dentist so he or she can play 'detective," says Dr. Shapira. "It is important to know what it is and what caused it before it can be treated properly."

Question:
1. Where does it strike?
Cold sore: Outside the mouth
Canker sore: Inside the mouth

2. What does it look like?
Cold sore: Tiny, clear fever blisters usually on the lips or under the nose
Canker sore: Small ulcer with a white or gray base and red border

3. What triggers it?
Cold sore: Flare-up of herpes simplex virus
Canker sore: Trauma-Biting your cheek or jabbing gum with toothbrush

4. How long does it last?
Cold sore: About a week
Canker sore: One or two weeks

5. Is it contagious?
Cold sore: Yes
Canker sore: No

6. How do I treat it?
Cold sore: Aloe Vera or over-the-counter topical anesthetics to cut pain and discomfort, Over-the-counter medications or, if needed, prescription antiviral drugs to prevent outbreak
Canker sore: Rinse with antimicrobial mouthwash or warm water and salt,
Over-the-counter oral anesthetics