Dr. Jacqueline Gerhart: Mouth Sores
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I keep getting little sores in my mouth. I think it's an allergy, but I can't seem to relate it to any specific foods. How can I get tested for food allergies?
Dear Reader: First off, we need to figure out what those sores are. There are many reasons for people to get mouth sores. Causes include stress, mouth injury, an infection, an allergy or an immune disorder. Sometimes mouth sores can be a sign of something deeper, such as an underlying problem in the rest of your body.
Some of the most common mouth sores include: canker sores, cold sores, herpes sores, hand-foot-and-foot-mouth disease, thrush (fungal infection) and strep throat - but there are many others. Rarely, mouth sores can be a sign of cancer or HIV.
Regardless of the cause, mouth sores often are aggravated by caffeine, citrus or other acidic foods. So sometimes people may feel they have an intolerance or an allergy to certain foods when, in reality, their sores are just irritated by those foods.
There are multiple tests to determine the cause of the sores. The first thing is to go to your doctor and have them look at your mouth. Sores often can be distinguished from each other based on where they are in the mouth and what they look like.
Canker sores, for example, are usually white or yellow, surrounded by red. They are painful and occur inside the mouth. They are not contagious.
Cold sores, on the other hand, are usually clear fluid-filled dots with red around them, but are located on the outside of the mouth or on the lips. These are caused by a herpes virus and are contagious.
Just like canker sores and cold sores, many other oral sores can be diagnosed - and treated - simply by having your doctor look at them. However, in more complicated cases, you may need further testing. Your doctor may use a cotton swab to touch the sores and then send it for "culture" to look for viruses or bacteria. Or they may order other tests, such as blood tests, to look for underlying problems.
If symptoms persist despite testing and treatments, you may be asked to try altering your lifestyle. Changes such as decreasing stress, brushing teeth regularly and keeping a diary of how symptoms relate to the food you eat can help offer further clues.
If it seems your sores might be caused by a food, an "elimination diet" might be suggested. You will be asked to avoid many allergen-producing foods, then slowly add them back, one at a time, to try to pinpoint the culprit.
If this isn't revealing, allergy testing or a visit to an allergist might be ordered. Often, allergists will start with a "skin-prick test," where they put a small amount of different plants, foods and other possible allergens on your skin to see if you react. Then treatment can be directed toward any allergies, or you can simply work to avoid what you are allergic to.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 05/22/2013