From the Guidelines
Non-prescription treatments for recurrent aphthous (canker sore) ulcers include topical protective agents, antimicrobial mouth rinses, and over-the-counter pain relievers. When considering treatment options, it's essential to prioritize those that promote healing, prevent secondary infection, and provide pain relief. Some effective options include:
- Topical benzocaine products like Orajel or Anbesol (20% concentration) for immediate pain management, applied directly to the ulcer up to 4 times daily for temporary numbing 1.
- Antimicrobial mouth rinses containing chlorhexidine 0.12% (such as over-the-counter Peridex) used twice daily to help prevent secondary infection and promote healing.
- Topical protective agents like Orabase paste to create a barrier over the ulcer.
- Salt water rinses (1/2 teaspoon salt in 8 ounces warm water) used 3-4 times daily to reduce inflammation and cleanse the area.
- Over-the-counter pain relievers like ibuprofen (400mg every 6-8 hours) or acetaminophen (500mg every 6 hours) for systemic relief. It's crucial to note that while these treatments can provide relief, if ulcers are severe, persistent (lasting over 2 weeks), unusually large, or accompanied by fever, seeking professional medical care is recommended. In the context of real-life clinical medicine, it's essential to prioritize treatments that are evidence-based and have the potential to improve patient outcomes, such as reducing morbidity, mortality, and enhancing quality of life. Given the available evidence, topical protective agents and antimicrobial mouth rinses are recommended as first-line treatments for recurrent aphthous ulcers. These treatments can help promote healing, prevent secondary infection, and provide pain relief, ultimately improving patient outcomes. It's also important to consider the potential benefits and limitations of each treatment option, as well as the individual patient's needs and medical history, when making treatment decisions. By prioritizing evidence-based treatments and considering the unique needs of each patient, healthcare providers can help improve outcomes and enhance quality of life for individuals with recurrent aphthous ulcers.
From the Research
Non-Prescription Treatments for Recurrent Aphthous Ulcers
- Topical anesthetics, topical steroids, and sucralfate are commonly used as first-line therapy for recurrent aphthous stomatitis (RAS) 2
- Over-the-counter (OTC) treatments, such as local anesthetic agents, oxygenating agents, mouth rinses, and barriers, are available for aphthous ulcerations 3
- CankerMelts GX patches, which contain glycyrrhiza (licorice) extract, have been shown to be effective in reducing lesion duration, size, and pain 3
- Aloe vera gel has been found to be effective in accelerating ulcer healing and reducing pain, with superior results compared to amlexanox 4
- Honey has been shown to be effective in reducing minor aphthous ulcer pain, size, and erythema, with no reported side effects 5
Dietary Considerations
- Avoiding hard, acidic, and salty foods, as well as toothpastes containing sodium lauryl sulfate, may help prevent recurrent aphthous ulcers 6
- Avoiding alcohol and carbonated drinks may also be beneficial 6