Monkeypox in the Mouth: How To Deal with Painful Mouth Ulcers

What is Monkeypox? Can You Get Monkeypox in the Mouth?

Monkeypox has made recent headlines in the news – but what is it? Is it contagious? How can I prevent myself from getting infected? A whirlwind of questions for something seemingly harmless – or is it? Let’s start with the basics regarding monkeypox and monkeypox in the mouth.

Image of a woman thinking wondering whether or not you can get monkeypox in the mouth.

What exactly is monkeypox? Monkeypox is, in short, a rare disease that is caused by the monkeypox virus itself, which is part of the variola virus. Now, you’re likely wondering what the variola virus is – and that is the same virus responsible for smallpox.

Dating back to 1958, two outbreaks of a pox-like disease occurred among monkeys that were quarantined for research – hence the name monkeypox, although the exact source of the disease still remains unknown.

When was Monkeypox Discovered in Humans?

The first known human monkeypox case dates back to 1970 – and was discovered in the Democratic Republic of the Congo. Before the most recent disease outbreak, however, nearly all monkeypox cases were linked to several central and western African countries. If you weren’t living in Africa, then the source of infection was likely international travel.

If The Same Virus That Causes Monkeypox Also Causes Smallpox, How do I Know I have Monkeypox in The Mouth or Other Areas?

Image of a person's back. Monkeypox is caused by the smallpox virus and can be found anywhere on the body-monkeypox in the mouth is also common.

The most significant difference in knowing whether you have monkeypox in the mouth or anywhere else versus smallpox is lymphadenopathy or swollen lymph nodes. Enlarged, swollen lymph nodes can be localized to a single area, such as the armpit or neck, or in many different areas of the body.

Although monkeypox in the mouth (or anywhere else) tends to have a very distinct appearance, it can look similar to a cold sore, which forms as a result of HSV or the herpes simplex virus.

How Long After Exposure Do Symptoms Appear If I Am Infected with Monkeypox in The Mouth or Anywhere Else?

Image of a lady holding her cheek. Monkeypox in the mouth can be very painful leading to inflammation and our dentists in Lincoln, NE can help.

Just as with many other infectious diseases, there is a “period” of time in which you will go through various stages of infection. If you’re wondering what to look for, we’ll break it down for you:

Stage 1: Infection

You came in contact with the monkeypox virus in one of two ways:

1. You touched something that had been used by someone who was infected.
2. You were in direct contact with someone was infected.

Stage 2: Incubation

This is a period lasting roughly 1 to 2 weeks. You will likely feel completely fine during this period and may experience no symptoms

Sage 3: Prodrome (Early Signs and Symptoms)

The prodrome stage is the stage in which you will begin to develop the initial symptoms of monkeypox, including but not limited to malaise (general feeling of unwellness), fever, weakness, headache, cough, swollen lymph nodes (lymphadenopathy), sore throat, etc.

Stage 4: Rash

A rash will appear after the initial signs or symptoms appear. With the rash, you will likely notice lesions occurring simultaneously and together on an area of the body. 

What do monkeypox lesions look like?

Once you notice monkeypox bumps or lesions, they will develop and progress. The stages of monkeypox lesions include: 

  1. Macular – beginning stage of the rash in which the rash will typically spread to all areas of the body within 24 hours – mainly on the arms, legs, and face.
  2. Papular – stage in which lesions have gone from flat in appearance to raised or papular.
  3. Vesicular – lesions of the rash have become raised and are filled with a clear fluid.
  4. Pustular – the stage in which lesions remain for approximately 5-7 days and will become very raised, filling with an opaque fluid – they will also gain a depressed center (known as umbilication)  – these lesions are typically deep and are firm to the touch – this is the last stage before lesions start to scab over and resolve.

Monkeypox generally lasts 2 to 4 weeks, and the severity of the illness depends upon any preexisting conditions and the patient’s overall health before contracting the disease. Once scabs have fallen off, pitted areas or lighter/darker skin areas may remain – at this point, you are no longer contagious.

What about monkeypox and dentistry?

So, you’re to this point in the article, and as you continue reading, you’re likely wondering why this is on a dentist’s website, which is an excellent question!

The answer is that monkeypox can affect the mouth. How so, you might ask? As your dentist in Lincoln, NE, we’ve recently started getting more questions about monkeypox in the mouth. The fact is that sometimes it’s hard to know whether your discomfort is from an abscess, a cold sore, or something else. Easing dental pain can be tough, and our dentists in Lincoln, NE, at Nebraska Family Dentistry are here to help.

Monkeypox in the mouth: How can it affect me?
Our dentist in Lincoln, NE, says

Image of a man thinking about monkeypox in the mouth. Because monkeypox is becoming more common, there are many questions patients have regarding the disease.

When someone is infected with monkeypox, it tends to affect their extremities and face rather than their torso. Lesions on the face occur in approximately 95% of cases, according to the World Health Organization (WHO).

The hands, specifically the palms and the soles of the feet, are affected in about 75% of monkeypox cases. In 70% of cases, the skin within the oral cavity (mouth) is involved. Other areas can include the genitals, approximately 30% of cases, and 20% of cases include the eyes.

Monkeypox in the mouth can occur simply by touching something infected with the monkeypox virus and then touching your face. Initially, monkeypox on the face can be confused with cold sores caused by the herpes simplex virus or even acne. 

Mouth lesions caused by monkeypox can be very painful. On occasion, there have been some reports of individuals having mouth lesions that kept them from properly eating and drinking due to the inability to open or close their mouth and chew properly.

However, things can help the discomfort of mouth sores and ulcers such as those caused by monkeypox in the mouth. One form of relief is magic mouthwash for painful mouth ulcers, a prescription-only mouthwash that can relieve discomfort from intra-oral monkeypox ulcers. This same mouthwash also aids in relieving pain caused by mouth sores from chemotherapy and radiation treatment in cancer patients.

What are the symptoms of monkeypox in the mouth?

Image of a man holding a Kleenex. While there are many monkeypox symptoms some of the more common ones include cough, nasal congestion, chills and sore throat.

Symptoms of monkeypox in the mouth or on other areas of the body can include but are not limited to:

  • Headache
  • Fever
  • Swollen lymph nodes
  • Exhaustion
  • Sore throat
  • Nasal Congestion
  • Cough
  • A rash appears “pimple-like,” or blisters appear inside the mouth, on the face, or other areas of the body, including the chest, hands, feet, anus, or genitals.
  • Chills
  • Backache and Muscle Aches

What do monkeypox lesions look like in the mouth?

Image of a woman's mouth who is wondering what monkeypox in the mouth looks like.

As previously stated, lesions from monkeypox can look similar to cold sores that occur in the mouth, which are caused by HSV (Herpes Simplex Virus) or even genital herpes.

If you have monkeypox lesions, you’ll likely be able to distinguish them by the very characteristic central indentation. Also, monkeypox lesions tend to be a bit bigger than those of cold sores caused by HSV.

If you think you might have monkeypox lesions in your mouth, don’t attempt to “pop” what you think might be a blister, cold sore, or even acne. The best way to know if you have monkeypox is to see a doctor and receive the appropriate testing. Our dentists in Lincoln, NE, can help guide you in receiving an accurate diagnosis.

Image of examples of monkeypox rashes.

Photo credit: UK Health Security Agency

More Examples of Monkeypox Rashes

How do Monkeypox Ulcers in the Mouth Look?

A rash may first appear on the face with intra-oral lesions. Monkeypox is a known disease caused by infection with the monkeypox virus, which is closely related to smallpox. However, it tends to causes milder symptoms. And, unlike smallpox and COVID-19, is rarely fatal. Monkeypox often presents first in the mouth as enanthem — a rash on the tongue and mucous membranes:

Image of a mouth sore caused by monkeypox in the mouth.
Image is courtesy of Dr. Bradley Shepard, a CDA member dentist who practices in San Francisco.

The rash then evolves sequentially from macules to papules, vesicles, pustules, and lastly, crusts that dry and fall off. The painful rash of one or multiple painful deep-seated vesicles or pustules are typically more concentrated on the face and extremities. 

Fever, headache, lymphadenopathy, muscle aches, and exhaustion are common early symptoms typically appearing before lesions develop. However, many cases now present without early flu-like symptoms, and instead, they have lesions only that appear in specific areas of the body.

How can I deal with mouth ulcers from monkeypox? Your dentist in Lincoln, NE, answers

Image of a woman's mouth. Monkeypox in the mouth can cause painful sores and ulcers and our dentists in Lincoln, NE can help.

If you have been unlucky enough to become infected with monkeypox and have mouth ulcers, a few things might help.

First and foremost, don’t touch your face. We all know that our hands are germ-covered, and touching our faces is a great way to spread additional illnesses. And, if you have monkeypox lesions elsewhere on your body, you could have touched an infected sore.

If you have a rash anywhere on the body, keep it dry and uncovered. If you must be in the same room with someone else, which sometimes is unavoidable, be sure to cover any rash or lesions that are present. And, you guessed it, don’t share anything. This includes drinks or eating utensils if you have mouth lesions – even things like Chapstick® could prove infectious.

If you have the dreaded mouth lesions from monkeypox, saltwater rinses could help ease your discomfort. In addition, you can apply oral lidocaine to lesions in and around the mouth.

If you aren’t sure what to use, seek the advice of a medical professional or a dentist in Lincoln, NE. Whether a spray, a liquid, a lozenge, or a prescription, we’re here to help you find relief.

What treatment is available for monkeypox in the mouth?

Image of a woman's nose and mouth. Monkeypox in the mouth can cause painful ulcers and sores. Thankfully, however, our dentists in Lincoln, NE have ways they can help.

Is there a cure for monkeypox? Your dentist in Lincoln, NE, answers

Currently, there is no cure for smallpox or monkeypox ulcers in the mouth. There are, however, things you can do to help care for painful ulcers from monkeypox in the mouth.

To relieve a dry mouth from monkeypox in the mouth:
  • Drink plenty of liquids, especially water, throughout the day using a straw (using a straw will allow the liquids to bypass painful mouth sores).
  • Suck on sugar-free candy.
  • Chew sugar-free gum.
  •  Help your lips retain moisture – use oil-based lip moisturizers such as Vaseline® or Chapstick®.
  • If you have open sores on your lips, other water-soluble moisturizers such as Surgilube® and K-Y Jelly® might be helpful.
Tips for keeping your mouth clean if monkeypox in the mouth is present:
  • Using a toothbrush or disposable mouth sponge from Toothette® (or another similar brand), gently rub the tongue, gums, and other soft tissues within the mouth.
  • If your gums are sore or bleed, or if you have a low platelet count, avoid flossing temporarily until these conditions subside.
  • Be sure to avoid smoking of any kind – Cigarettes, cigars, and pipes all include tobacco substances, which can further irritate a sore mouth.
For denture wearers who have monkeypox in the mouth:
  • Stop wearing dental plates or dentures while sleeping.
  • When cleaning dentures, be sure to use an effervescent denture cleaner such as Efferdent®, which is also an anti-bacterial cleaner.
  • Rinse dental plates or dentures extremely well before wearing them.

Commonly Asked Questions About
Monkeypox in the Mouth and
Magic Mouthwash for Painful Mouth Ulcers

Can you get monkeypox from kissing? Your dentist in Lincoln, NE, answers

Image of Dr. Kathryn Alderman explaining monkeypox in the mouth to a patient.

YES! Monkeypox transmission, from human to human, occurs through respiratory droplets, sores, scabs, and oral fluids of an infected person, generally, through close, intimate contact, which, if you’re wondering, does include kissing.

Monkeypox can also be transmitted by coming in contact with contaminated items of clothing, bed sheets and blankets, and other linens such as towels that an infected person may have previously used.

And if you’re thinking of borrowing the toothbrush of a person who has monkeypox in the mouth, or even around the mouth (or anywhere else) – you’ll want to hold off because you, too, could catch monkeypox!

Monkeypox can also be transmitted in the following ways:

  • Scratches or bites from an infected animal.
  • Eating meat from an infected animal.
  • Contact with contaminated items such as bed linens or towels.

Do I need a prescription for magic mouthwash? Your dentist in Lincoln, NE answers…

Image of a young woman wondering about monkeypox in the mouth.

Yes. As previously stated, magic mouthwash is a prescription-only medication that can help relieve pain associated with mouth sores, such as those from monkeypox in the mouth. If you feel you would benefit from this product, be sure to discuss it with your dentist in Lincoln, NE, or with another healthcare provider.

If you have been prescribed additional medication for monkeypox in the mouth, such as an antibiotic, be sure to take it as directed.

How do I use magic mouthwash? Your dentist in Lincoln, NE answers…

Image of a middle-aged woman wondering about monkeypox in the mouth and the use of magic mouthwash to help alleviate the pain.

Typically, the most commonly used instructions for magic mouthwash are to swish for approximately two minutes, spit, and swallow – repeating the process about every four hours. After using the mouthwash, it is recommended that eating and drinking be avoided for about one-half hour to allow the medication to remain on the affected areas within the mouth.

Do know, however, that your specific instructions for magic mouthwash could vary depending upon the targeted treatment and reasons for use.

Is there an over-the-counter magic mouthwash? Your dentist in Lincoln, NE answers…

Image of a man covering his mouth because he is embarrassed by the sores from having monkeypox in the mouth. Although he is covering his mouth it's important to remember not to touch monkeypox sores - as that's a great way to spread them.

Because magic mouthwash has different uses and can be formulated specifically for an individual patient, no OTC (over-the-counter) option is available.

In addition, there are ingredients in magic mouthwash that can’t be obtained without a prescription. Some common ingredients used in this special mouthwash formulation include:

  • Mylanta/Maalox can aid in keeping the medication on any affected areas/sores much longer.
  • Nystatin is a common antifungal.
  • Lidocaine is an anesthetic commonly used topically to numb the throat and mouth, thus reducing pain.
  • Hydrocortisone is a known steroid that works well in reducing inflammation.
  • Diphenhydramine is an antihistamine that reduces pain and inflammation – this is well-known in an OTC option such as Benadryl.
  • Tetracycline is an antibiotic that treats infection.

Be sure to talk with your Lincoln, NE dentist or another medical provider if you feel you might benefit from magic mouthwash for monkeypox in the mouth or another condition. If it is after hours, perhaps you might benefit from seeking out an emergency dentist or an emergency room.

What are other alternatives to magic mouthwash?

While there is no substitute for magic mouthwash, it’s well-known that mouthwash, along with some of the top dental products, are excellent for your oral hygiene. However, when it comes to monkeypox in the mouth and your teeth, a mouthwash that contains alcohol can cause serious stinging and dryness.

If you don’t have magic mouthwash, a better option would be to consider using an OTC mouth rise called, Biotene™. Biotene™ is an alcohol-free mouthwash.

If necessary, you can make your own mouthwash. There are three different ways:

  • 1 cup (8 oz.) of water mixed with1 tsp of baking soda
  • 1 cup (8 oz.) of water mixed with 1/4 tsp of table salt
  • 1 cup (8 oz.) of warm water mixed with 1/4 tsp of baking soda and 1/4 tsp of salt

If you do, however, choose to make your own mouthwash, make a new rinse each day. And, be sure to shake it well before using it. And, do know that it is important to still seek medical advice to ensure you receive the proper diagnosis and treatment.

The Takeaway About Monkeypox in the Mouth from Your Dentist in Lincoln, NE:

Image of Dr. Christine Bergman, a dentist at Nebraska Family Dentistry, showing a patient x-rays. It is important to tell your dentist in Lincoln, NE if you have monkeypox in the mouth.

Remember that monkeypox is spread through close contact, which does include kissing. Even though monkeypox is rarely deadly, it can still cause extremely painful sores and other complications that could result in death, such as encephalitis or sepsis.

Nobody wants mouth sores or monkeypox, and although you might think that what you have is just a cold sore, a canker sore, acne, or something else, if you aren’t feeling well, do everyone a favor and see your local physician to receive the proper testing. 

If you are one of the “lucky” ones and have monkeypox in the mouth or on another area of the body but don’t feel that sick, which means you’ll still need to self-isolate, use it as an excuse to catch up on your favorite tv show or put your feet up and read a good book!

The bottom line is you must still do your part and keep your distance from others. You don’t want to infect your loved ones – and they don’t want to be infected. They say “sharing is caring.” In this case, however, not sharing is caring.

So, whether you need a routine cleaning, emergency dental care, or another one of our many dental services, our team can help. Come and experience judgment-free, compassionate dental care for yourself at Nebraska Family Dentistry today.

We offer many amenities, including TVs with headphones, online scheduling, blankets and pillows, and dental payment plans. See you soon!

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