From the Research
Aphthous stomatitis typically resolves on its own without treatment, usually within 7-14 days for minor aphthous ulcers, and while individual ulcers heal spontaneously, the condition itself can be recurrent, with new ulcers forming periodically throughout a person's life. Most patients experience episodes separated by ulcer-free periods rather than having a truly chronic persistent condition. The exact cause of aphthous stomatitis remains unclear, but it is believed to involve immune dysregulation, with triggers including stress, trauma, certain foods, and hormonal changes 1.
Treatment and Management
Treatment focuses on symptom management rather than cure, with topical agents like benzocaine (Orajel), lidocaine rinses, or triamcinolone dental paste (Kenalog in Orabase 0.1%) applied 2-4 times daily to reduce pain. For severe or frequent recurrences, providers might prescribe corticosteroid rinses like dexamethasone elixir or systemic medications such as colchicine, pentoxifylline, or occasionally low-dose prednisone 2.
Key Considerations
Some key considerations in the management of aphthous stomatitis include:
- Identifying and controlling possible predisposing factors
- Excluding possible underlying systemic causes
- Using a detailed clinical history along with complementary procedures such as laboratory tests, where required
- Prescribing drug treatment only in cases of continuous outbreaks and symptoms, with initial application of local treatments in all cases 3, 4.
Systemic Therapy
Systemic therapy is indicated in situations where pain is intense and topical treatment is unable to afford symptom relief, such as in patients with constant and aggressive outbreaks (major aphthae), and may include corticosteroids (prednisone) or thalidomide, among other drugs 1, 5.
Quality of Life and Morbidity
The primary goal of treatment is to reduce pain and improve healing time, thereby improving the patient's quality of life and reducing morbidity associated with aphthous stomatitis. While no therapy is definitive, topical and systemic medications can help manage symptoms and improve outcomes for patients with this condition 1, 2.