Are all Mouth Sores Caused by the Herpes 1 Virus?

Dear Dr. Tom:

My boyfriend and I were debating about the transmission and origin of herpes. He thinks that the everyday mouth sores that people get (like canker sores) aren’t the same as oral herpes sores. Also, he thinks that the only reason someone would have oral herpes is because they have genital herpes, and the virus travels through the bloodstream to the mouth. I, on the other hand, thought that all mouth sores were caused by the herpes 1 virus, and that you could have them regardless of whether or not you had genital herpes, since genital herpes is a completely different form of the virus. We would be very thankful if you could clear this up for us!
Thank you, K&M

Dr. Tom’s Response:

Dear K&M:

Oral herpes sores and canker sores are not the same, so your boyfriend is correct on that issue. However, oral herpes sores can be the result of familial casual contact during the early years (birth to about 18 months) of life and may remain asymptomatic or may flare as childhood cold sores. Such herpetic infections are mild and are often herpes virus type 1. Mouth sores can be aphthous or the canker type, possibly resulting from several non-infectious causes, e.g., vitamin deficiency, or they can be herpetic, hence transmissible. Oral herpes infections are viral, transmissible and can be non-genital. Oral herpes lesions can also result as transmissions from a sexual playmate’s mouth to genital contact, cunnilingus or fellatio. Whether these are type 1 or 2 viruses, and they can be either, they must be considered genital herpes infections. The transmission is direct, from genital to the moist tissues of the mouth, tongue, or lips. The herpes simplex virus group have a liking for nerve tissues where they hide away during their dormancy. HSV is not considered a bloodborne infectious agent, although much still needs to be learned about the shedding mechanisms.


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