From the Guidelines
Treatment for an aphthous ulcer on the cheek involves both over-the-counter and prescription options, with the most recent and highest quality study 1 suggesting a focus on reducing inflammation and promoting healing.
Key Considerations
- Start with topical pain relievers like benzocaine (Orajel, Anbesol) or lidocaine 2% gel applied directly to the ulcer 3-4 times daily before meals.
- Rinse with saltwater (1/2 teaspoon salt in 8 ounces warm water) or alcohol-free antimicrobial mouthwash several times daily.
- Over-the-counter products containing ingredients like benzocaine, hydrogen peroxide, or fluocinonide can provide relief.
- For persistent or severe ulcers, prescription options include triamcinolone acetonide dental paste (0.1%) applied 2-3 times daily, or dexamethasone elixir (0.5mg/5mL) used as a rinse for 2 minutes then spit out, 3-4 times daily.
- Avoid spicy, acidic, or rough foods that can irritate the ulcer.
Additional Guidance
- Most aphthous ulcers heal within 7-14 days without scarring.
- These treatments work by reducing inflammation, providing pain relief, and creating a protective barrier over the exposed nerve endings in the ulcer, which helps reduce pain and promote healing of the damaged oral mucosa, as supported by studies such as 1 and 1.
- It's essential to follow the guidance of the most recent study, which emphasizes the importance of a standardized procedure for oral ulceration diagnosis and treatment, as outlined in 1.
From the Research
Treatment for Aphthous Ulcer on the Cheek
- The primary goals of therapy for aphthous ulcers are relief of pain, reduction of ulcer duration, and restoration of normal oral function 2.
- Topical medications, such as antimicrobial mouthwashes and topical corticosteroids, can achieve the primary goals but have not been shown to alter recurrence or remission rates 2.
- Systemic medications can be tried if topical therapy is ineffective, with options including levamisole, oral corticosteroids, and thalidomide 2, 3.
Topical Treatments
- Topical anesthetics, such as 1% lidocaine, have been shown to be effective in reducing pain associated with oral mucosal trauma or minor oral aphthous ulcer 4.
- Topical corticosteroids are considered the first line of treatment for oral aphthous ulcers 5.
- Sucralfate and topical antiseptic/anti-inflammatory agents, such as triclosan and diclofenac, may also be used as topical treatments 3, 6.
Systemic Treatments
- Colchicine, pentoxifylline, and prednisolone may be used as systemic treatments for severe cases of aphthous ulcers 6.
- Thalidomide is effective but has limitations due to its toxicity and cost, and should be used only as an alternative to oral corticosteroids 2, 3.
- Immunosuppressive agents may be given systemically for refractory or particularly severe oral aphthous ulcers due to Adamantiades-Behçet disease 6.