Does canker sores increase the susceptibility of STD Risk?

[michaelsocal]

Hi Doctor. You have mentioned these two activities are relatively low risk for catching STD's (Except for oral herpes)
1.Kissing
2.Oral sex on a girl

What about doing these activites with canker sores in your mouth? Since a canker sore is kinda like an open wound in your mouth, would this increase the susceptibility of catching an STD? or is this just theoretical speculation?

Also, would this significantly increase the chances of catching HIV? or would these activities still be considered relatively safe?

[gracefromHHP]

If you have ANYTHING going on in the oral area - canker sores or cold sores or even just cuts in the mouth from trauma of any sort - it's just plain common sense not to perform oral sex on your partner without some sort of barrier in between your mouth and their genitals!!!  First of all is the eeeeeeeeeeeeeeewwwwwwwww factor!! 2nd of all yes indeed anything like that is an open portal into the body for bacteria to get into. As Dr Hook has tried to tell you in his numerous replies - it's a lowered risk because of the mouth's own natural defenses against disease but it's still not a good idea to take that risk - for your sake or for your partner's sake.  The friction of oral sex could also delay healing of the oral sores which I'm sure isn't something you want to take any longer than it has to anyways.

So any open lesion in the oral area - no matter what the cause - either avoid performing oral sex until they are healed or utilize barrier protection to perform oral sex on your partner.

If you are wondering if you have hsv1 orally - go get a herpes blood test to see what your status is.  

grace

[Edward W Hook, MD]

You are looking for absolutes.  Sorry, this is the real world--there are not absolutes.  There is nothing that is 100.0000% safe.  If the chances are 1 in 10 million and you are the one--so what.  I have given you the best advice I have.  One lat time- an open sore is a potential entrance, an open sore caused by herpes carries with it a higher risk than an open sore due to a canker sore because of the biology of the two processes.

No further responses EWH

[michaelsocal]

Thanks Doc. I've intended this question to be brief. It just always seems that I receive confusing information.

On your last reply you say that it's best not to practice giving oral sex with sores in my mouth.

But you say that cold sores are rarely in the mouth. You also said that my previous statement is correct, which basically says: giving oral sex is relatively safe regardless of sores or not.

So, these answers leave me confused. For example, If all sores in mouth were herpes and *significanly increased chances of catching STD, then I'd understand your statement regarding avoiding oral sex when you have sores in the mouth.

Didn't mean to ask so many questions, but It seems this subject matter is confusing, VS solving a math problem which is straight forward.

Mike

[Edward W Hook, MD]

We need to finish this up.

1.  Symptoms of cold sores inside the mouth (which are rare) are highly variable.  since everyone is different, it may be difficult to differentiate the two but statistically, if you get both, sores inside the mouth are more likely to be canker sores.
2.  the best practice would e to not give oral sex when you have any sores in your mouth.
on the second follow-up post, both statements are correct, as is your summary statement.

EWH

[michaelsocal]

Actually, here is a better question:


1.So oral sex is relatively low risk.
2. And oral sex with oral herpies is slightly higher risk.

However, regardless of having oral herpes or not, *is oral sex still ultimately low risk for catching STD's? And *HIV risk is still almost zero correct?

[michaelsocal]

Thanks Doc.
The sores are inside my mouth so they should be canker sores. Although I think what confused me was that you said:
"(as long as the "canker sores" are not oral herpes)."

according to most information on canker sores such as
http://www.ada.org/public/topics/mouth_sores.asp
and this forum as you have stated in your last anwer:

Cold sores are usually outside of the mouth but may also appear inside the mouth. When I read the descriptions of canker sores vs cold sores, the ones in my mouth match the description of canker sores. There were only two incidences where I had a cold sore outbreak outside of my mouth (Completely different symptoms, itching, pain etc).

1.So what kind of symptoms would a cold sore inside of a mouth feel and look like?

2.And as long as I make sure that the canker sores inside of my mouth don't match these descriptions, I should be relatively good to go with giving oral sex?

[Edward W Hook, MD]

Sorry if my answer is confusing to you.  Canker sores and cold sores are different processes.  True canker sores are not herpes, cold sores are caused by herpes.  Do you know which you have?  Herpes cold sores occur on the lips and not within the mouth.  Canker sores occur inside the mouth, sometimes on the gums or the palate.   The biological effects of cold sores (oral herpes) act to increase ones risk for acquiring STDs more than canker sores which are not infections.

Dr. Handsfield and I do not interact on the same threads.  It is inefficient and we nearly always feel similarly about our responses although we sometimes articulate our answers differently (I think he is more entertaining than I am).  EWH

[michaelsocal]

Thank you for answering my questions Doc. Although I'm actually more confused right now as to:

Why a canker sore wouldn't increases the chances of catching STD's
VS
A canker sore that is oral herpes (inside the mouth) would increase the chances of catching an STD.


Could I also get some feedback from Doctor HHH? I would really appreciate hearing from Doctor HHH.

[Edward W Hook, MD]

You are correct.  EWH

[michaelsocal]

"My comment referred mostly to your risk of giving oral herpes to a partner if you have it."

Thanks Doc. You used the word "mostly." Which concerns me. What I'm hearing from you is that you are indirectly implying that:
(Please correct me if I am wrong)

*if I had canker sores that were in fact oral herpes, my chance of getting STD's would increase slightly.

*Therefore I should be more concerned about giving oral sex with canker sores in my mouth, if they were in fact oral herpes.

Am I correct when I state this?

Thanks Doc.

[Edward W Hook, MD]

My comment referred mostly to your risk of giving oral herpes to a partner if you have it. EWH

[michaelsocal]

Thanks Doc. Although can you elaborate on your last comment. You said:

"Thus, oral sex, even with canker sores is safer sex (as long as the "canker sores" are not oral herpes)."

So what if the canker sores are oral herpes. Does that increase the risk of me catching STD's? (Or are you talking about my oral herpes infecting my partner...which is what I'm guessing your stating)

[Edward W Hook, MD]

An open sore could theoretically increase one's risk of getting HIV and other STDs.  Interestingly however, the mouth is relatively resistant to infection, perhaps because of the enzymes and other antibacterial and antiviral substances present there.  As a result, to get HIV through oral sex is virtually unheard of (I have never seen or heard of a case who performed only oral sex on partners and got HIV that way).  The other disease which is more easily caught through open sores is syphilis but that disease is very uncommon and is acquired through direct contact with infected sores.

Thus, oral sex, even with canker sores is safer sex (as long as the "canker sores" are not oral herpes).

Hope this helps.  EWH