From the Research
For tongue ulcers, antibiotics are typically not the first-line treatment as most oral ulcers are not bacterial in origin. Instead, topical treatments like chlorhexidine mouthwash (0.12-0.2%) used twice daily or benzydamine hydrochloride spray for pain relief are recommended 1. If the ulcer appears infected, a dentist might prescribe topical antibiotics such as tetracycline suspension (250mg capsule dissolved in water as a rinse for 2 minutes, 4 times daily) or minocycline (100mg capsule dissolved similarly). For severe cases with systemic infection, oral amoxicillin (500mg three times daily for 5-7 days) or clindamycin (300mg four times daily for 5-7 days) may be prescribed, as suggested by older studies 2. However, it's essential to note that most tongue ulcers are caused by trauma, stress, or immune responses rather than bacteria, which is why antibiotics aren't routinely needed.
Some key points to consider when treating tongue ulcers include:
- Avoiding hard, acidic, and salty foods and toothpastes containing sodium lauryl sulfate, as well as alcohol and carbonated drinks 1
- Using antiseptic agents and local anesthetics as first-line treatment, with topical corticosteroids as an alternative if these are ineffective 1
- Considering systemic treatment with colchicine, pentoxifylline, or prednisolone in severe cases, although the efficacy of systemic treatment is debated 1
- Recognizing that the treatment of chronic recurrent oral aphthous ulcers is symptomatic, mainly with topically applied agents, and tailored to the severity of the problem in the individual case 1
It's crucial to see a healthcare provider for proper diagnosis, as persistent ulcers lasting more than two weeks could indicate more serious conditions requiring different treatment approaches. The provided evidence, particularly the study from 2014 1, highlights the importance of a tailored treatment approach and the limited role of antibiotics in managing tongue ulcers.