What are the discharge instructions for a patient with a painful and enlarging canker sore?

Discharge Instructions for Painful and Enlarging Canker Sore

For a painful and enlarging canker sore, apply chlorhexidine gluconate 0.2% (Corsodyl) to prevent secondary infection, use non-alcoholic analgesic rinses like benzydamine hydrochloride 0.15% (Difflam) for pain relief, and apply protective gels such as Gengigel or Gelclair to form a barrier over the ulcer. 1

Immediate Management

• Pain control options:

  • Apply topical anesthetics containing benzocaine (like Red Cross Canker Sore Medication, which has shown the longest duration and greatest intensity of anesthetic effect) 2
  • Use non-alcoholic analgesic rinses before eating or brushing teeth 1
  • Consider oral analgesics (NSAIDs) for systemic pain control if needed 1

• Promote healing:

  • Apply protective gels (Gengigel or Gelclair) to form a barrier over the ulcer 1
  • Use chlorhexidine gluconate 0.2% rinse to prevent secondary infection 1
  • For large ulcers present for one week, topical corticosteroids may be necessary 1

Home Care Instructions

• Oral hygiene:

  • Maintain good oral hygiene using a soft toothbrush 1
  • Use mild fluoride-containing toothpaste 1
  • Rinse gently after meals with warm salt water

• Diet modifications:

  • Avoid hard, sharp, spicy, or acidic foods that may irritate the ulcer 1
  • Stay hydrated to keep oral tissues moist 1
  • Choose soft, bland foods until healing occurs

• Denture care (if applicable):

  • Remove dentures at night to allow tissues to recover 1
  • Clean dentures thoroughly daily 1
  • Consider denture adhesives to improve fit 1

When to Seek Medical Attention

• If the canker sore:
  • Persists beyond 2 weeks despite treatment 1
  • Becomes increasingly painful or enlarges significantly
  • Is accompanied by fever or significant swelling
  • Interferes with eating or drinking to the point of dehydration
  • Shows signs of secondary infection (increased redness, pus, spreading inflammation)

Expected Course and Follow-up

• Most minor aphthous ulcers (canker sores) heal within 7-14 days without scarring 1, 3
• No routine follow-up is typically needed for simple canker sores
• If canker sores recur frequently or are particularly severe, evaluation for underlying conditions may be warranted 1

Prevention of Future Episodes

• Apply medicated lip balm containing natural moisturizers regularly 1
• Avoid known triggers (certain foods, stress) 1
• Inspect oral mucosa daily for early signs of new ulcers 1
• Increase water intake to improve overall hydration 1

Remember that while most canker sores are benign and self-limiting, persistent or recurrent ulcers may indicate an underlying condition requiring further evaluation.