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What you need to know about oral herpes


They’re annoying, painful, and ruin your best family photographs. They’re cold sores — and once you’re infected with herpes simplex virus 1 (HSV-1), which causes them, you’ll have it for the rest of your life. But you can take steps to reduce outbreaks and keep from spreading the virus to others.

Infection Develops at an Early Age, Endures

You probably think of herpes as a disease for adults. But infections with HSV-1 usually begin in childhood or infancy. The virus is typically passed from an infected friend or family member by kissing or sharing utensils or towels.

The first infection — called primary herpes — can cause a cold- or flu-like illness that lasts about a week. Infected people might also develop cold sores during that time period.

After primary herpes, the virus stays in the body. From time to time, recurrent flares or outbreaks of cold sores can occur. These fluid-filled blisters usually develop on the mouth, lips, gums, and sometimes under the nose or around the chin.

Outbreaks can be triggered by:

  • Fever or other illness

  • Excessive sun exposure or sunburn

  • Stress

  • Skin abrasions

  • Surgery or other trauma

  • Menstrual periods

  • Medications, such as corticosteroids, that weaken the immune system

Treatment Can Ease Pain and Prevent Virus Spread

Cold sores usually heal by themselves within seven to 10 days. The blister breaks and a scab forms. Over-the-counter pain relievers can help ease discomfort, but usually don’t speed healing. Some prescription antiviral medications can reduce outbreaks.

Talk with your doctor or dentist if you have developed cold sores for the first time, or for any type of mouth sore that lasts longer than one week. He or she may want to do a biopsy to rule out other diseases, such as cancer.

While there’s no cure for HSV-1, you can take steps to prevent getting the infection. Change your toothbrush every three to four months, or sooner if the bristles are frayed. Have two or more brushes so you can rotate their use. Allow each brush to dry out between uses. The virus has been found on old bristles and handles. Avoid kissing or other contact with people who have visible outbreaks. Don’t share cups, lip balms, or other personal items with others.

Once you’re infected, you can spread the virus even between outbreaks. If you feel tingling, burning, itching, or tenderness around your mouth, limit contact with others. Call your dentist before arriving at an appointment with active cold sores. He or she may want you to reschedule.



“Canker Sores and Cold Sores.” Journal of the American Dental Association. March 2005, vol. 136, no. 3, p. 415. Accessed 2013.

“Mouth Sores.” Mouth Healthy, American Dental Association. Accessed 2013.

“Herpes Simplex.” American Academy of Dermatology. Accessed 2013.

“Herpes Simplex.” Medline Plus, U.S. National Library of Medicine and the National Institutes of Health, February 4, 2013. Accessed 2013.

“Proper Brushing.” American Dental Hygienists’ Association, 2012. Accessed 2013.

“Toothbrush Care, Cleaning and Replacement.” American Dental Association. March 2006. Accessed 2013.

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