Cold Sores. A high proportion of infants and young children suffer from primary herpes virus infection of the lips and oral mucosa. Many of these infections are subclinical and the patient presents no symptoms. Such subclinical infections can lead to a resistance to future infection. However, the virus can remain latent in the lips and in later life can give rise to cold sores, a condition known as recurrent herpes. Such recurrences appear spontaneously or may be precipitated by trauma (e.g. accidental cut of lip when shaving), sunlight and menstruation.

There is also a suggestion that stress can lead to these cold sores, though this has not been proven. Cold sores begin with a burning sensation on the affected area of the lips which is usually followed by the development of a painful blister (vesicles) which eventually become ulcers (pustules) and then heal gradually in 7 – 14 days. Cold sores are contagious and strict hygiene measures should be adopted when a family member is infected.

Prevention is problematical though the use of sun barrier creams will help reduce attacks in those holidaying in the sun. Also a well established product on the market (contains 5% w/w acyclovir), if applied during the early burning phase, has been shown to be very effective in reducing the length of the blister stage and can get rid of the pustule stage.



What is dry mouth or xerostomia?

Dry mouth, also called xerostomia, is a persistent feeling that there is not enough saliva in your mouth, making talking and eating difficult or embarrassing. Saliva lubricates and protects your mouth from infection by bacteria, from chemicals in the atmosphere and from hot food and drinks. Saliva coats your teeth and protects them. Reduced saliva flow, which causes dry mouth, can cause dental decay and contribute to bad breath.
Do I have dry mouth?

The effects of dry mouth may be severe, moderate or mild. Mild sufferers of dry mouth are unlikely to even know they are affected. Maybe you’ve noticed food sticking to the roof of your mouth and food just won’t go down? You probably see your dry mouth symptoms as normal, and simply try drinking more.

If you’re a moderate dry mouth sufferer, you may also be unaware of it, even though you’re licking your lips constantly and finding that your mouth feels sticky or dry. You might be avoiding certain foods, and denture-wearers will find that their dentures don’t stay in place. You probably try to alleviate symptoms of dry mouth by drinking more, sucking sweets or applying lip balm.

Severe sufferers of dry mouth will find that dry mouth symptoms have a serious impact on their quality of life. As a severe sufferer of chronic dry mouth, you may experience a sore mouth or tongue when eating, cracked lips, blisters and mouth ulcers. Your dentist may be seeing rampant decay, serious plaque levels and food debris, fungal infections, a “pebbled” tongue and red and shiny tongue and cheeks.
What are the symptoms of dry mouth?

Dry mouth sufferers often don’t notice that they are suffering from dry mouth until their saliva flow has already dropped by 50%. Symptoms of dry mouth include: a feeling of soreness in the mouth; stickiness to the touch and cracking at the corners of the mouth; a red and parched mouth or pebbled look to the tongue; difficulty eating dry or spicy foods; food just not tasting like it used to; difficulty speaking; a tendency to wake up more often during the night; bad breath.

What are the causes of dry mouth?

Reduction in saliva flow, which results in dry mouth and throat, may have one or more of five underlying causes:

  1. Medicines.
    The more medicines you take, the more likely you are to suffer from chronic dry mouth. Many everyday medicines cause dry mouth, including over-the-counter cold remedies and antihistamines. Anti-depressants, some beta-blockers, anti-hypertensives and diuretics can also be common dry mouth causes.
  2. Age.
    As people get older, they tend to take more medicines. This is the primary reason why older people are more likely to suffer from chronic dry mouth. Older people are more likely to suffer from cancer and Sjögren’s Syndrome.
  3. Sjögren’s Syndrome
    This chronic condition, in which the body’s immune system malfunctions and attacks the body’s own tear and salivary glands, is a major cause of dry mouth.
  4. Diabetes.
    All types of diabetes can cause increased urination or an underlying metabolic or hormonal problem, which results in dry mouth.
  5. Cancer and Its Treatment.
    Neck and head cancer patients who have been surveyed ranked dry mouth as one of their most distressing symptoms. Radiotherapy is the worst culprit, affecting the salivary glands and causing a near-total reduction in saliva flow. Many never regain their full flow.

Treatment of dry mouth

  • Chewing sugar-free gum
  • Drinking plenty of water to help keep your mouth moist
  • Protecting your teeth by brushing with a fluoride toothpaste, using a fluoride rinse, and visiting your dentist regularly
  • Breathing through your nose, not your mouth, as much as possible
  • Using a room vaporizer to add moisture to the bedroom air
  • Using an over-the-counter artificial saliva substitute such as Biotene.
  • In severe cases certain prescription medications may be necessary.