Patient's Query
Hi doctor,
I got canker sores when I bit my cheeks a few days ago. The first time a sore popped up was when I was around 15 and under the same condition. As far as I can recall, the sores have only popped up after excessively biting my lips and not using my chapstick. I thought they were cold sores, but I do not know for sure. Also, I am taking Sprintec, a birth control pill.
Would it be possible to get a sore on my lip from excessive biting?
Kindly suggest a solution.
Hi,
Welcome to icliniq.com.
Thank you for contacting us at icliniq.com.
I went through your query and understood your concern. A canker sore or an aphthous ulcer is a small, shallow sore inside the mouth or at the base of the gums. A canker sore usually does not occur on the lips and is not contagious. The most common causes are a local injury like accidentally biting the inside cheek, using toothpaste containing sodium lauryl sulfate, stress, a side effect of certain medicines being taken by the patient, vitamin B, and iron deficiencies.
Rarely, oral contraceptives and menstruation also cause a canker sore. Most canker sores are self-limiting and resolve in one to two weeks. The treatments include mouth rinses, locally applicable pastes, and anesthetic medications.
Recurrent aphthous stomatitis (RAS) or recurrent canker sores are common ulcerative inflammatory conditions of the oral cavity. They typically start in childhood or adolescence as small, recurrent, painful, round ulcers with well-defined reddish margins, like a halo, and a central yellow or gray floor.
The factors that cause RAS include nutritional deficiency, immunologic factors, psychological stress, dietary allergies, and repeated injury in individuals with genetic susceptibility to RAS. Topical corticosteroids are the mainstay of treatment. However, if RAS does not respond to local measures, systemic immunomodulators may be required.
I suggest these measures be taken for ulcers.
1. Brush non-traumatically with a small-headed, soft toothbrush.
2. Avoid eating hard or sharp foods like toast and potato crisps.
3. Avoid foods that you are aware of that can cause such sores.
4. Correct deficiencies, and I suggest you take a vitamin B complex and oral iron tablets.
5. Allergy testing, like patch testing, can be done to reveal allergies.
6. Also, I suggest local or systemic therapies like
a) Lidocaine or other local anesthetic-containing gels applied locally to relieve pain and accelerate healing.
b) Corticosteroids like Hydrocortisone can be taken.
c) Triamcinolone (corticosteroid), Betamethasone L.A. (corticosteroid) injections, or steroid-based mouth rinses about three to four times a day can be used.
d) Vitamin B12-1000 μg of sublingual vitamin B12 daily for six months.
e) Vitamin B complex with vitamin B1 (Thiamine), vitamin B6 (Pyridoxine), vitamin B12, and folic acid can be taken.
7. Pain-relieving nonsteroidal anti-inflammatory drugs (NSAIDs), including Acetaminophen, Aspirin, Diclofenac, etc., in case pain relief is required.
8. I suggest you get a complete blood count (CBC) and erythrocyte sedimentation rate (ESR) test done.
9. I suggest you consult a local gynecologist to change oral contraceptives and get an opinion on the correlation with menstrual cycles.
Please get this above prescribed by a local practitioner. And kindly share if you have any history of herpes, HIV (human immunodeficiency virus), immune deficiencies, or drug treatments. Kindly follow up.
I hope it helps.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
I do not know if I have the herpes virus that causes cold sores. However, I wondered if the same canker sore logic could be applied to the lip when overbitten. I know they are not canker sores, as canker sores do not exist on the exterior of the mouth as cold sores do.
But overall, I wondered if excessive lip biting could cause cold sores to appear. Or if I am simply creating a sore on my lip that is not caused by the herpes simplex virus, but by breaking down the defenses of my lip skin constantly.
Kindly suggest your opinion.
Thank you.
Hi,
Welcome back to icliniq.com.
Thanks for contacting us on icliniq.com.
Excessive lip biting may cause repeated local trauma and is likely to cause local ulcers. However, as stated earlier, aphthous ulcers are usually not caused on the lips. Therefore, I suggest you apply a local anesthetic and healing gel that contains Choline salicylate (an anti-inflammatory pain reliever) with or without Benzocaine (a topical anesthetic agent) on the site. Avoid local trauma.
Additionally, considering there is no herpes as per your history, I suggest you take a multivitamin B complex consisting of vitamin B1, vitamin B2, vitamin B6, and vitamin B12 daily for about three months. Please get it prescribed by a local practitioner.
In addition, I suggest you get a CBC (complete blood count) and ESR (erythrocyte sedimentation rate) test.
Kindly follow up after 15 days.
I hope it helps.
Thank you.
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