That cold sore needs to stay home

Cold sore, fever blister, or herpes.  Whatever name you want to give this common viral outbreak, it should be taken seriously… especially at the dental office.

What is it?

The herpes simplex 1 virus affects more than 3 million US people every year. It is considered a sexually transmitted disease. (Not to be confused with HPV) According to the World Health Organization, an estimated 3.7 billion people under age 50 (67%) have HSV-1 infection globally!  It causes little fluid filled lesions that most of us refer to as cold sores or fever blisters.  The reason they have those nicknames is because many people have a trigger or condition that causes them to break out.  Stress, a common cold and the sun are commonly blamed for their sudden appearance and they are often found around the mouth and on the lips.  (Not to be confused with the canker sore that usually shows up inside the mouth)

How do you get it?

This highly contagious virus is usually transferred from one person to another through kissing, sharing of cups,  utensils, and chap stick or lipstick.   The problem is once you get it, this virus is yours forever.  Since most people don’t feel sick or notice symptoms, they can carry HSV-1 for years without knowing they have it.  A common misconception is that you are not contagious if there is no visible lesion.  Although it can be spread most rapidly from a fluid filled outbreak, it is still possible to give others the herpes virus without one.

Should I cancel my dental appointment?

The CDC recommends that “only emergency treatment for dental conditions and treatment of the actual lesion should be performed. No other treatment should be rendered.” Read the article here.

Although we use standard precaution for every patient and every dental procedure, the chances are very high that the lesion would be aggravated, allowing the virus to spread quickly.  The HSV virus can survive for hours in fluids and on surfaces around the dental office including counters and chairs. It’s just not worth the risk of having the lesion triple in size or spreading to your eyes or other people.

It is possible to some dental offices who have a dental laser to “zap” the lesion which kills the virus and shortens its lifespan by quite a few days.

And just in case you don’t want to take my word for it yet, here is a leading magazine geared toward my fellow dental professionals published more than a year after I wrote this: Why Hygienists Should NEVER Treat Patients with Active Oral Herpes

How is it treated?

Although you never get rid of the virus (it stays dormant in your system), the best advice is to use caution when you have  a visible blister.  Because this lesion is highly contagious, you should avoid direct skin to skin contact in the affected area.  There are prescriptions and over the counter medications that will speed healing and reduce the discomfort. These breakouts usually take 7-10 days to heal on their own.  If you get fever blisters often, it’s best to see a doctor and see which oral or topical treatment is best for you. Some dental office can treat your cold sore with a laser…

 Cold sores and dental appointments

If you are scheduled for a dental visit and you have a cold sore, please understand that they should reschedule any elective treatment until the sore is no longer visible.  If your dental office has a laser, they can obliterate the lesion and reschedule fillings or cleanings etc.

The benefits of using a dental laser are :

  • Destroys the virus quickly
  • Takes just a few minutes
  • Feels better right away
  • “Dries” up the lesion so that it can heal faster
  • Can be done without anesthetic
  • Affordable and usually covered by insurance

***There are over 80 types of herpes viruses.  Typically the medical world would diagnose HSV-1 and HSV-2 by their location.  Now they are identified by the proteins on their surfaces and both viruses can be found both orally and on the genitals.  For this blog post, I kept my focus on the oral type viral condition.

If you are in the market for cold sore treatments:


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