The problem with it is that recurrent part. Once infected the virus hides, most likely in a nerve trunk, and surfaces as a lesion on the lips or vicinity thereof, triggered by a plethora of conditions, including: sunlight, stress, generalized weakened resistance, and sometimes just dumb bad luck, perhaps the day before a photo shoot or an important job interview.
Why this comes to mind at this time in my life is that number two son, recently definitely middle-aged as he is in mid-forties, just had a serious recurrence and, on the recommendation of one of his fellow teachers, asked me to write a prescription for Zovirax.
I was familiar with the product from Dental Meetings over the last several years, and had brought home a few samples, all of which seemed to be in a forgotten place when I had the need to use them. So I wrote the prescription, and it seems to have been the promised miracle drug, clearing up the lesion from the “aura” stage without recurrence some two months later.
Where was that product fifty years ago?
The first treatment I remember came not from my dental education or even post-graduate education. It was anecdotal and, as I remember it, called for placement of a red dye on the affected area and exposure to ultra violet light (pretty easy to find in Haight-Ashbury times). Since the dye and the light are both carcinogenic I feel fortunate not to have traded an innocuous malady for a fatal one.
The next treatment, also anecdotal is one I still use: daily doses of Bioflavonoids, which must have some effect since I can count on the fingers of one hand any episodes over the last multi-years since I began the regime. I decided to see if the science supports the results. What I found is that there are more disclaimers for the generic acyclovir’s effectiveness than are seen on afternoon advertisements for medication during afternoon reruns of Bones or Soaps. The tablets, which are priced in the mid-teen range as to cost almost list themselves as placeboes. Antivirals affect viruses but don't cure their effects. The ointment, which is what I wrote the prescription for promises little better, and has a price tag approaching $200, a figure short of the $747 that was on Tim’s EOB. His copayment was $30.
I found a natural product (maybe my Bioflavonoids) competitively priced with the tablets as a five-day regime.
I thought I would see what the ADA had to say about advances in viral control: almost nothing since 2005, where they were still advising there is no cure for cold sores, and questionable improvement by treatment over letting nature take its course.
Being in the midst of recuperation from a total hip replacement I was impressed that the ADA supports the American Heart Association and the American Orthopedic Associations recommendation to make prophylactic antibiotic treatment for joint replacements elective. Since I recently had to have my Hygienist confirm that fact before she would clean my teeth, I was pleased to see the ADA on top of that issue.
Later today I will be attending a Webinar on the Dental Quality Alliance Committee and metrics to follow to determine Best Practices for desired Outcomes. It would seem to me that viruses should be high on the list of what we track, particularly as to how we treat their effects. I recently wrote about the HPV and how directly it has been connected to Oral Cancer. Michael Douglas has very recently put himself in the spotlight as being infected by the HPV during oral sex, and we have a vaccine for that virus!
Although my infection was much less specific, I believe there are things to learn from this prevalent condition.
I am intrigued by recent applications of a governmental right called “imminent domain”. In my next post I’ll tell you why. Please stop on by.