What are the treatment options for recurrent aphthous stomatitis (mouth ulcers)?

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Last updated: May 18, 2025View editorial policy

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From the Guidelines

To treat mouth ulcers, start with topical measures such as local corticosteroids, lidocaine gel, and chlorhexidine, as these have been shown to be effective in managing oral ulcers 1. When it comes to treating mouth ulcers, the goal is to reduce pain, inflammation, and prevent infection.

  • Topical corticosteroids can help reduce inflammation and promote healing.
  • Lidocaine gel can provide pain relief, making it easier to eat and drink.
  • Chlorhexidine can help prevent infection and promote oral hygiene. It's also important to maintain good oral hygiene, avoid spicy or acidic foods, and avoid smoking or using tobacco products. In some cases, systemic measures such as azathioprine, IFN-α, or TNF-α antagonists may be necessary for resistant cases 1. However, these should be used under the guidance of a healthcare professional, as they can have significant side effects. Recent studies have also highlighted the importance of preventive measures, such as eliminating sources of trauma, avoiding painful stimuli, and maintaining effective oral hygiene 1. Additionally, expert consensus guidelines have been developed for the diagnosis and treatment of difficult and complicated oral ulcers, emphasizing the need for a comprehensive assessment and standardized procedure 1. Overall, the treatment of mouth ulcers should be tailored to the individual patient's needs, taking into account the severity of the ulcers, the patient's medical history, and their quality of life.
  • Regular follow-up with a healthcare professional is crucial to monitor the healing progress and adjust the treatment plan as needed.
  • Patients should also be educated on how to manage their symptoms, prevent recurrence, and maintain good oral hygiene. By prioritizing the patient's quality of life and using evidence-based treatments, healthcare professionals can provide effective care for patients with mouth ulcers.

From the Research

Treatment Options for Mouth Ulcers

  • Topical corticosteroids, antiseptic/anti-inflammatory agents, and local anesthetics are commonly used to treat oral aphthous ulcers 2
  • Avoiding hard, acidic, and salty foods, as well as toothpastes containing sodium lauryl sulfate, can help prevent mouth ulcers 2
  • In severe cases, systemic drugs such as colchicine, pentoxifylline, or prednisolone may be used in combination with local measures 2
  • Functional hydrogels have shown promise in promoting wound healing and may be a potential treatment option for oral ulcers 3

Diagnosis and Management

  • Differentiating recurrent aphthous stomatitis (RAS) from recurrent oral ulceration (ROU) secondary to systemic disease is crucial for proper diagnosis and treatment 4
  • A definitive diagnosis is essential for effective treatment and management of oral ulcers, which can be caused by various underlying conditions 5
  • Intralesional steroid therapy (IST) has been shown to be effective in treating inflammatory oral ulcers, with complete resolution achieved in 81.7% of patients 6

Considerations for Treatment

  • Treatment should be tailored to the severity of the problem, taking into account the frequency of ulcers, intensity of pain, and responsiveness to treatment 2
  • Topical antiseptic agents and local anesthetics should be tried first, with topical corticosteroids used if these are ineffective 2
  • Concomitant topical steroid therapy may be used in combination with IST for optimal results 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The treatment of chronic recurrent oral aphthous ulcers.

Deutsches Arzteblatt international, 2014

Research

Multifunctional hydrogels for the healing of oral ulcers.

Journal of biomedical materials research. Part A, 2025

Research

Differential diagnosis and management of oral ulcers.

Seminars in cutaneous medicine and surgery, 2015

Research

Intralesional triamcinolone acetonide therapy for inflammatory oral ulcers.

Oral surgery, oral medicine, oral pathology and oral radiology, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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