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Mark Bornfeld
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5995
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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cold sore on the top gum of my two front teeth..anxiety it comes back

Customer Question

I already asked the question and I am bothered by the Dr not understanding my question. I have a cold sore on the top gum of my two front teeth. I notice when ever I am nervous or have anxiety it comes back. I used valtrex not regularly because I have gential herpes. Which only comes around my cycle. I wanted to know if the cold sore on my gum is from my stress and anxitey?
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Owen replied 5 years ago.
Hello, and I am pleased to help, use of my answers are for educational purposes only.
Well, most cold sores are due to a herpes infection, such as HSV1 usually, sometimes HSV2.
And, YES, stress/ anxiety can cause the herpes virus which sits in your body dormant, can re-activate when you are stress and/or anxious.
And, you can use medications such as Valtrex (valacyclovir) or Acyclovir to help you with this.
I hope this helps....
Expert:  Mark Bornfeld replied 5 years ago.
Welcome to JustAnswer, and thank you for putting your trust in me!

Secondary or recurrent herpes simplex lesions can be provoked by almost anything that causes transient suppresses the immune system. This can include stress of any sort, either psychological (e.g., anxiety) or physiological (acute viral syndrome, common cold, menstrual cycle, physical exhaustion).

These lesions tend to consistently return in the same area, because the causative herpes simplex virus remains localized to the sensory nerves that serve the area, and the localized distribution of those nerve endings does not significantly change over time.

A localized recurrent herpes simplex lesion would not be any indication of a more significant immune suppression, such as that which occurs in severe debilitation or AIDS. This can cause activation of herpes simplex, but in this case the herpes infection manifests much differently-- in a manner similar to a primary herpes infection (herpetic gingivostomatitis), as well as disseminated herpes and herpetic encephalitis.

You should know that the gum tissue above the central incisors is a relatively unusual site for recurrent herpes infections, which can sometimes be confused with other issues or disorders, such as apthous ulcers or a fistula from a chronic dental infection. If there is any uncertainty as to the identity of your lesions, you should consider having them examined by your dentist-- preferably while the lesions are active, and most characteristic in appearance.

Hope this helps...
Customer: replied 5 years ago.
so this means that it could be more of a dental issue?
Expert:  replied 5 years ago.
Without diagnostic data, it's uncertain what the probabilities are. However, if you have exhausted your other treatment possibilities, dental disorders is an area that definitely should be explored. For example, if the lesion is located high up under the lip rather than lower down on the gum, adjacent to the teeth, this could be a fistula (a draining path from a chronic dental infection), or an apthous ulcer. An x-ray of the area would be very useful in this case...
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5995
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
Mark Bornfeld and 2 other Health Specialists are ready to help you
Customer: replied 5 years ago.
The sore is right above the two front teeth
Expert:  Mark Bornfeld replied 5 years ago.
Is there any way you can provide a photograph of the area? You can use the "paper clip" icon on the text entry form toolbar to upload your graphics file, or post a photo at a photo hosting site such as Flicr or Photobucket.

This might allow me to get a better idea of what you're dealing with...
Customer: replied 5 years ago.
I will try
Expert:  Mark Bornfeld replied 5 years ago.
I will await your response...
Customer: replied 5 years ago.
I have a camera phone which isn't making the picture come out to clear. I will try again
Customer: replied 5 years ago.
I have been trying to send it to you. I can't fingure these things out
Expert:  replied 5 years ago.
Don't sweat it-- I was just wondering whether I could gain some flash of insight from a photo, but you will really have more valuable information if you get an x-ray of the area.

There really can't be too many things that it could be--- either a fistula, a recurrent herpetic lesion, or a recurrent aphthous ulcer. Intermittent lesions of this sort would be encompassed by this differential diagnosis. The collection of more information by formal diagnostic session will be more enlightening, and will point the way to an appropriate means of management.

Good luck! If my answer has been helpful, please don't forget to click the "accept" button so that I may be given credit. Thanks!
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5995
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
Mark Bornfeld and 2 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Thank you, XXXXX XXXXX very knowledge and helpful. I truly appreciate your help.
Expert:  replied 5 years ago.
You're welcome. Good luck!
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5995
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
Mark Bornfeld and 2 other Health Specialists are ready to help you