From the Guidelines
For mouth sores, I recommend using a topical anaesthetic preparation, such as viscous lidocaine 2%, 15 mL per application, as an alternative to other treatments. This is based on the UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016, which suggests the use of topical anaesthetic preparations for oral discomfort 1.
Some key points to consider when treating mouth sores include:
- Using an antiseptic oral rinse twice daily to reduce bacterial colonization of the mucosa, such as 1.5% hydrogen peroxide mouthwash or 0.2% chlorhexidine digluconate mouthwash 1
- Taking oral and lip swabs regularly if bacterial or candidal secondary infection is suspected, and treating candidal infection with nystatin oral suspension or miconazole oral gel 1
- Considering the use of a topical corticosteroid four times daily, such as betamethasone sodium phosphate or clobetasol propionate, to reduce inflammation and promote healing 1
It's also important to note that slow healing of the oral mucosa may reflect secondary infection by, or reactivation of, HSV, and that prescription medications like antimicrobial mouthwashes, corticosteroid ointments, or systemic medications may be needed for severe or persistent mouth sores lasting more than two weeks.
From the FDA Drug Label
Stop use and ask doctor or dentist if sore mouth symptoms do not improve in 7 days irritation, pain or redness persists or worsens swelling, rash or fever develops The answer to what to give for mouth sore is not directly stated in the provided drug labels.
- Benzocaine (TOP) is mentioned, but the labels only provide instructions on when to stop use and consult a doctor or dentist, rather than recommending it as a treatment for mouth sores.
- The labels do not provide a clear answer to the question of what to give for mouth sore, only warning against the persistence or worsening of symptoms 2, 2.
From the Research
Treatment Options for Mouth Sores
To manage mouth sores, the following options can be considered:
- Avoiding hard, acidic, and salty foods and toothpastes containing sodium lauryl sulfate, as well as alcohol and carbonated drinks 3
- Using topical antiseptic/anti-inflammatory agents such as triclosan and diclofenac, and local anesthetics such as lidocaine 3
- Applying topical corticosteroids for more severe cases 3
- Considering systemic drugs such as colchicine, pentoxifylline, or prednisolone in severe cases 3
Topical Therapies
Topical therapies can be effective in managing mouth sores, including:
- Topical 1% lidocaine, which has been shown to reduce pain intensity in patients with oral mucosal lesions due to trauma or minor oral aphthous ulcer 4
- Topical antiseptic and anti-inflammatory agents, which can help reduce pain and inflammation 3
Systemic Therapies
Systemic therapies may be considered for more severe cases of mouth sores, including:
- Systemic corticosteroids, which can help reduce inflammation and pain 3
- Immunosuppressive agents, which may be used in cases of refractory or severe oral aphthous ulcers due to Adamantiades-Behçet disease 3
Diagnosis and Management
It is essential to establish a definitive diagnosis of the underlying cause of mouth sores, as some may indicate an underlying systemic condition 5, 6. A treatment strategy should be based on the immunopathologic nature of the lesion and may involve a combination of topical and systemic therapies 5.