Dentist Doi's Talking Story

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Spring 1998 Edition - Dr. Doi's Talking Story

About Cold Sores & Natural Relief

I hope this spring edition finds you appreciating the Waimea "winter" weather with the much-needed rain. This cold spell has brought about an increase in colds and cold sores (oral ulcers). If you suffer from cold sores, this information may be helpful to you.

Oral ulcers, next to dental caries and periodontal disease, is the most frequently encountered oral disorder. Of the variety of different ulcers, the 2 most common are recurrent apthous ulceration (RAU) and the herpes-caused ulceration. Of the 2, RAU is the more common, affecting about 20% of the general population. Both herpetic ulcers and RAU can be brought on by stress and trauma to the oral mucosa.

Although no single cause has been identified for RAU, many feel the causes center on the immunological theme. Although most RAU lesions heal within 10 days, about 10% may last longer and appear in larger sizes. RAU lesions have a yellow-gray center and a reddish halo and are small in size. Another way to distinguish this lesion from a herpes lesion is its location. It occurs on the tongue, floor of mouth, soft palate, cheeks or lips.

A double-blind study showed that brushing with a non-sodium lauryl sulfate toothpaste significantly reduced the incidence of RAU. SLS is a strong denaturant (sudsing agent that is found in most toothpaste). As a palliative treatment, Zilactin ointment, a nonprescription topical medication, seems to work well. Chlorohexadine, a prescription mouthwash with antibacterial properties, also works well. Although topical steroids have been proven effective, caution should be used. If the lesion is viral, the condition may worsen. I almost never prescribe a steroid ointment.

Herpes simplex virus infections are preceded by vesicles before becoming ulcerated. The lesions tend to erupt on the hard palate and thick gum next to the teeth. Oral medications (Zovirax) and topical ointments (Viroptic and ViraA) are available. As the virus sheds from the lesion, the patients should keep in mind that they are contagious and should limit activity that place others at risk. There is another type of ulcer, angular cheilitis, which I frequently encounter in my practice. This ulcer is found in the corners of the mouth. These lesions are covered by a mixture of fungal and bacterial organisms and can persist unless dealt with. I would prescribe an antifungal ointment or an essential oil to be rubbed on 4 times a day for 10 days to 2 weeks

Besides prescription drugs, our office has had some success with essential oils. Oils from different plants have healing properties, if the oil is pure and extracted properly. For the treatment of angular cheilitis, we have offered patients a blend of oils with successful results.

EMPLOYEE RECOGNITION

JANELLE CARDOZA...Celebrates her 9-year anniversary with us! JANELLE is the receptionist who confirms, schedules and reschedules your appointments and fields questions during the evenings, many times up until 10:00 p.m. She is part of the reason we can say we have exceptional accessibility and service.

The following article is taken from Dr. Andrew Weil's newsletter. Although he is targeting mainly viral caused cold sores, ice, zinc and lemon balm remedies could probably work for apthous ulcers as well.

For their tiny size, cold sores can cause a great deal of misery. These itchy, painful blisters flare up on lips or inside the mouth, lasting for a week to 10 days before crusting over and disappearing. They are as common as they are uncomfortable. Ninety percent of us are destined to have at least 1 attack at some point in our lives.

The first occurrence is usually the worst, often accompanied by fever, malaise and enlargement of the regional lymph nodes. Some people develop antibodies, but 40 % will have repeated outbreaks of these angry lesions, sparked this time of year by exposure to cold weather as well as fatigue, emotional stress, skin irritation and other viral infections.

Caused by the herpes simplex virus, cold sores can't be cured, but a number of self-care measures can help reduce the frequency and severity of outbreaks. Here are some natural methods I recommend to keep cold sores at bay:

To relieve pain, apply ice to the affected area for 15 minutes at a time.
A number of holistic practitioners swear by zinc. For a cold sore inside the mouth, suck on zinc lozenges (5 to 10 mg 4 or 5 times a day). For sores outside the mouth, take oral zinc supplements (up to 60 mg a day).
If you are suffering more than a couple attacks a year, take the amino acid, Lysine, as a preventative. I recommend a dose of 500 to 1,000 mg on an empty stomach. Lysine can also be applied topically to the sore. Commercial cream preparations (such as Super Lysine Plus by Quantum) are available at natural health food stores for this purpose. On the other hand, the herpes virus thrives on another amino acid, arginine, so cut down on foods rich in it, including seeds, nuts, peas and chocolate. In German studies, an extract of the herb lemon balm (Melissa officinalis) was found to reduce symptoms and speed healing of cold sores when applied topically. One German-made cold sore remedy containing Melissa extract that's available in the U.S. is called Herpalieve. Call Herbal Resources, Inc., PO Box 147, Hutchinson, KS 67504; (316) 663-6220.
If your cold sores are resistant to natural measures, you might ask your physician about a new prescription drug called Denavir. In 2 large clinical trials, this topical antiviral cream was shown to heal cold sores in an average of 4.5 days. The most commonly reported side effect was headaches, occurring in approximately 5 % of subjects.

Remember that cold sores are highly contagious. To avoid infecting yourself or others, don't kiss someone with a cold sore or use the same towels, razors or utensils. Replace your toothbrush after an attack and be sure to wash your hands carefully after touching the blister.

TESTIMONIALS

Last year while staying in Hawaii for the winter, I developed a severe toothache and gum infection. Far from my regular dentist, a pioneer in holistic dentistry, I lived with pain while I searched for a "top notch" dentist here in Hawaii. Dr. Doi was recommended and with great reluctance, I visited his office. An extraction was required (my first) and Dr. Doi gently and painlessly pulled the tooth...only to reinsert it 6 weeks later! I wish to let readers know of this innovative and remarkable procedure.
Since then after I had suffered a wave accident and loosened my front teeth, Dr.Doi has performed this procedure twice again - this time, removing and reinserting my tooth in the same visit. The psychological value of having your own tooth reinserted is great, not to mention, for those of us allergic to many dental materials, one's own natural tooth serving as a replacement is trauma free.
Dr. Doi's flexibility and willingness to employ the procedure best suited to the individual (rare in most "professionals") has both touched and impressed me.

Marri Parkinson
Honaunau, HI

I am a person who has experienced great relief from the removal of all my mercury amalgam fillings by Dr. Doi. I had been experiencing severe problems for the past few years with my whole system-gastrointestinal as well as autonomic nervous system. I suffered from headaches, blood-sugar imbalances, extreme fatigue, and many other symptoms also. I was so weak and sick all of the time, my mind was in a state of mild dementia. I was very depressed, nervously worried and in pain constantly with my teeth and body. I must say the amalgam removal procedure was quite comfortable and painless under Dr. Doi's expertise. I now feel 100% better, and I can attribute this only to the amalgam removal. My teeth do not hurt anymore at all, to my great relief! Also most of my other health problems have diminished to a great degree. Thank You Dr. Doi

Aloha, Bob
Kau, Hawaii