How are canker sores treated?

Treatment of Canker Sores

Topical benzocaine-containing products are the first-line treatment for canker sores, providing temporary pain relief while the sore heals naturally. 1

First-Line Treatment Options

• Topical anesthetics: Benzocaine-containing products like Red Cross Canker Sore Medication, Maximum Strength Anbesol, and Orajel Mouth Aid provide effective pain relief 1, 2

  • Red Cross Canker Sore Medication has been shown to have the longest duration and greatest intensity of anesthetic effect 2
  • Apply as directed on the product label, typically several times daily

• Pain management considerations:

  • Regular assessment of pain is crucial, at least once daily 3
  • Use minimal amounts of topical anesthetics in infants to avoid systemic absorption 3

Additional Treatment Approaches

• Adhesive tablets: Mucoadhesive tablets containing natural active agents (citrus oil and magnesium) can reduce pain and decrease healing time 4

  • These tablets adhere to the mucosal tissue and gradually erode over 8 hours, providing sustained release of active ingredients

• Topical steroids: Can be used for more severe cases but should be limited to less than 2 weeks of use 3

• Caustic agents: Silver nitrate and phenol can stop the growth and pain of lesions by breaking extracellular matrix viscosity 5

When to Seek Further Medical Attention

Stop use of over-the-counter treatments and consult a doctor or dentist if 1:

• Sore mouth symptoms do not improve within 7 days
• Irritation, pain, or redness persists or worsens
• Swelling, rash, or fever develops

Underlying Factors to Consider

Canker sores may be associated with several factors that should be addressed:

• Haematinic deficiency: Found in up to 20% of patients with recurrent aphthous stomatitis 6
• Genetic predisposition: Strong associations with genotypes of IL-1beta and IL-6, with a positive family history in about one-third of patients 6
• Trauma to oral mucosa: Can trigger or worsen canker sores 3, 7
• Smoking cessation: May precipitate or exacerbate canker sores in some cases 6
• Food hypersensitivity: Various foods have been implicated as trigger agents in individual cases 5, 7

Prevention and Maintenance

• Oral hygiene: Maintain good oral hygiene with a soft toothbrush and mild fluoride toothpaste 3
• Regular dental examinations: Important for ongoing oral health 3
• Avoid irritants: Identify and avoid foods or substances that may trigger canker sores 3
• Monitor for systemic disease: For patients with recurrent lesions, investigate potential underlying factors 3

Special Considerations

• For recurrent aphthous stomatitis (RAS), systemic corticosteroids can completely suppress the lesions in severe cases 5
• Treatment remains somewhat unsatisfactory as most therapies only reduce severity but do not prevent recurrence 6
• Consider associated systemic disorders in patients with frequent recurrences, including Behçet's disease, complex aphthosis variants, and HIV disease 7