From the Guidelines
Aphthous ulcers should be managed with a focus on pain relief, promoting healing, and addressing potential underlying causes, with treatment options including topical corticosteroids, antimicrobial mouth rinses, and systemic treatments for severe cases. The management of aphthous ulcers is complex and diverse, with various causes including traumatic, infectious, allergic factors, and associations with skin disease, autoimmune disease, tumor, inflammatory bowel disease, and more 1.
Key Considerations
- Recurrent aphthous ulcers (RAU) may be caused by disturbed immune response, genetic predisposition, nutrient deficiency, oral trauma, anxiety or stress, but the exact cause is often unknown 1.
- Topical treatments like benzocaine or lidocaine gels can provide temporary pain relief, while antimicrobial mouth rinses containing chlorhexidine 0.12% can reduce secondary infection and inflammation.
- Topical corticosteroids such as triamcinolone acetonide 0.1% dental paste can reduce inflammation and speed healing.
Treatment Options
- For mild cases, over-the-counter topical treatments and antimicrobial mouth rinses may be sufficient.
- For more severe or recurrent cases, prescription options including dexamethasone elixir or clobetasol 0.05% gel may be necessary.
- Systemic treatments like prednisone or colchicine may be required for severe cases.
Additional Recommendations
- Patients should avoid spicy, acidic, or rough-textured foods during healing and maintain good oral hygiene using a soft-bristled toothbrush.
- Recurrent episodes may indicate underlying nutritional deficiencies or systemic conditions that should be investigated if ulcers are frequent or severe 1.
From the Research
Management of Aphthous Ulcers
The management of aphthous ulcers involves a combination of topical and systemic treatments, as well as lifestyle modifications.
- Avoiding hard, acidic, and salty foods, and toothpastes containing sodium lauryl sulfate, can help prevent the formation of aphthous ulcers 2.
- Topical treatments, such as antimicrobial mouthwashes and topical corticosteroids, can help reduce pain and improve healing time 3, 4.
- Systemic medications, such as colchicine, pentoxifylline, or prednisolone, may be used in severe cases or when topical treatments are ineffective 2, 3.
Treatment Approaches
Different treatment approaches may be used depending on the severity and frequency of the ulcers.
- For mild cases, topical treatments and lifestyle modifications may be sufficient 2, 4.
- For more severe cases, a multidisciplinary treatment approach may be necessary, involving a combination of topical and systemic treatments, as well as lifestyle modifications 5.
- In some cases, systemic immunosuppressive agents may be used to treat refractory or severe oral aphthous ulcers due to Adamantiades-Behçet disease 2.
Goals of Treatment
The goals of treatment for aphthous ulcers are to: