From the Guidelines
Topical measures, such as local corticosteroids, should be the first line of treatment for aphthous ulcers (canker sores). When considering treatment options for aphthous ulcers, it's essential to prioritize approaches that minimize morbidity, mortality, and improve quality of life. Some key considerations for treatment include:
- Topical corticosteroids as a first-line treatment 1
- Oral hygiene is crucial in managing oral ulcers 1
- Topical treatments like lidocaine gel and chlorhexidine can be effective 1
- Sucralfate suspension has been shown to be effective for oral and genital ulcers in an RCT 1 For more resistant cases, systemic measures such as azathioprine, IFNa, and TNFa antagonists may be considered 1. However, these should be used with caution due to potential side effects. In general, treatment should be tailored to the individual patient's needs and quality of life 1.
From the FDA Drug Label
Temporarily relieves pain associated with the following mouth and gum irritations: toothache sore gums canker sores braces minor dental procedures The treatment for aphthous ulcers (canker sores) is to use a topical medication such as benzocaine to temporarily relieve pain associated with the condition 2.
- The goal of treatment is to provide symptomatic relief.
- If symptoms do not improve in 7 days, or if irritation, pain, or redness persists or worsens, users should stop use and consult a doctor or dentist 2.
From the Research
Treatment Options for Aphthous Ulcers
- Topical anesthetics, such as benzocaine, can provide relief of pain associated with aphthous ulcers 3
- Topical corticosteroids, such as triamcinolone acetonide in Orabase, are commonly used to treat oral aphthous ulceration 4
- A novel dental paste containing dexamethasone, known as dexamucobase, has been shown to be effective in treating oral aphthous ulceration with some advantages over traditional treatments 4
- Systemic medications, such as levamisole, oral corticosteroids, and thalidomide, can be used to treat severe cases of aphthous ulcers or cases that do not respond to topical agents 5
Efficacy of Different Treatments
- Topical anesthetics were found to be more effective than corticosteroids in managing recurrent aphthous ulcers in one study 6
- Dexamethasone ointment has been shown to be effective and safe in the treatment of recurrent aphthous ulceration, with significant differences in ulcer size and pain level compared to a control group 7
- The healing ratio of dexamethasone ointment was found to be 83.33% in one study, compared to 54.70% in a control group 7
Management Strategies
- The primary goals of therapy for aphthous ulcers are relief of pain, reduction of ulcer duration, and restoration of normal oral function 5
- Secondary goals include reduction in the frequency and severity of recurrences and maintenance of remission 5
- A variety of topical and systemic medications can be used to manage aphthous ulcers, including corticosteroids, local anesthetics, and nutritional supplements 6