From the Guidelines
To treat a canker sore, start with over-the-counter options like topical benzocaine or hydrogen peroxide rinses to reduce pain and promote healing, as recommended by recent guidelines 1. When managing canker sores, it's essential to consider the complexity and diversity of oral ulcerations, which can pose considerable diagnostic and therapeutic challenges 1. The exact cause of canker sores is unknown, but stress, minor injuries, certain foods, and nutritional deficiencies can trigger them.
Treatment Options
- Apply topical benzocaine or hydrogen peroxide directly to the sore up to four times daily to reduce pain and promote healing.
- Use salt water rinses (1/2 teaspoon salt in 8 ounces warm water) to reduce inflammation and kill bacteria.
- For pain relief, take ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours or acetaminophen (Tylenol) 500-1000mg every 6 hours as needed.
- Avoid spicy, acidic, or rough foods that can irritate the sore further.
Persistent or Severe Sores
For persistent or severe sores, prescription options include triamcinolone dental paste (Kenalog in Orabase), prescription-strength mouthwashes containing lidocaine or steroids, or oral steroids in extreme cases 2. It's crucial to consult a healthcare provider if sores are larger than 1cm, last longer than two weeks, or occur frequently.
Quality of Life
Treatment should be tailored according to how it affects the patient's quality of life, and oral hygiene is essential in managing canker sores 2. By following these guidelines and considering the patient's individual needs, healthcare providers can improve outcomes and reduce unnecessary financial burden 1.
From the FDA Drug Label
Temporarily relieves pain associated with the following mouth and gum irritations: toothache sore gums canker sores braces minor dental procedures The treatment for canker sore is benzocaine (TOP), which temporarily relieves pain associated with canker sores 3.
- Key points: + Relieves pain associated with canker sores + Temporary relief If symptoms do not improve in 7 days, or if irritation, pain or redness persists or worsens, swelling, rash or fever develops, stop use and ask a doctor or dentist 4.
From the Research
Treatment Options for Canker Sores
- Chlorhexidine has been studied as a potential treatment for canker sores, with a study from 1993 comparing its efficacy to triamcinolone acetonide in treating recurrent aphthous stomatitis 5.
- The study found that there was no significant difference in pain intensity and perception between the two treatments, suggesting that chlorhexidine may be a viable option for treating canker sores.
- Another study from 2019 investigated the use of intralesional triamcinolone acetonide therapy for inflammatory oral ulcers, including canker sores, and found that it was an effective treatment in achieving complete resolution of symptoms in 81.7% of patients 6.
Mechanism of Action
- Chlorhexidine is a widely used antiseptic that has been shown to have persistent antimicrobial effects due to its strong binding to proteins in the skin and mucosa 7.
- This property makes it an effective ingredient in mouthwashes and other oral care products, and may contribute to its potential efficacy in treating canker sores.
Efficacy and Safety
- The 1993 study found that chlorhexidine was not significantly different from triamcinolone acetonide in terms of pain control, suggesting that it may be a safe and effective alternative treatment for canker sores 5.
- The 2019 study found that intralesional triamcinolone acetonide therapy was effective in reducing pain and ulcer size, with a significant reduction in pain score and ulcer size after the first injection 6.