What are the names of topical treatments for oral mouth issues?

Topical Treatments for Oral Mouth Conditions

The most effective topical treatments for oral mouth conditions include topical corticosteroids (such as 0.1% triamcinolone acetonide in orabase), topical anesthetics (such as lidocaine 2% solution and benzydamine hydrochloride), and antiseptic mouthwashes (such as chlorhexidine gluconate 0.2%). 1

First-Line Topical Treatments

Topical Corticosteroids

• Triamcinolone acetonide 0.1% in adhesive paste - First-line treatment for most oral ulcers, applied 2-4 times daily until healing 1
• Other effective options include:
  • Clobetasol 0.05% ointment
  • Betamethasone sodium phosphate (dissolve 0.5mg tablet in 10mL water as mouthwash)
  • Fluticasone propionate
  • Beclomethasone dipropionate 50-200μg or budesonide 50-200μg (using asthma inhaler) 2, 1

Topical Anesthetics/Analgesics

• Benzydamine hydrochloride 0.15% (Difflam Oral Rinse) - Anti-inflammatory oral rinse used every 3 hours, particularly before eating 2
• Lidocaine viscous 2% solution - For severe oral discomfort 2, 1
• Cocaine mouthwashes 2-5% - For severe oral discomfort, three times daily 2

Antiseptic Mouthwashes

• Chlorhexidine gluconate 0.2% (Corsodyl) - Reduces bacterial colonization 2, 1
• Hexetidine 0.1% (Oraldene) 2
• Hydrogen peroxide solutions (1.5% or 1:4 dilution) - Used twice daily 2

Barrier Preparations and Mucoprotectants

• White soft paraffin ointment - Apply to lips every 2 hours for protection 2
• Mucoprotectant mouthwash (e.g., Gelclair) - Used three times daily to protect ulcerated surfaces 2, 1
• Sucralfate suspension - Effective for oral ulcers 1

Advanced Topical Options for Resistant Cases

• Tacrolimus 0.1% ointment - For resistant oral ulcers 1
• Intralesional triamcinolone acetonide injections - For persistent lesions 1
• Topical ciclosporin (100 mg/mL) - May benefit oral pemphigus but is expensive 2

Application Methods and Considerations

Application Techniques

• For multiple oral erosions: Use mouthwashes (hold in mouth for 5 minutes)
• For isolated lesions: Apply ointments or pastes directly to affected area
• For lips: Apply white soft paraffin ointment every 2 hours 2

Duration of Application

• Topical anesthetics: Effectiveness depends on application time (minimum 2-5 minutes) 3
• Corticosteroids: Apply 2-4 times daily until healing (typically 7-14 days) 1

Important Precautions

Side Effects and Monitoring

• Monitor for systemic absorption of topical corticosteroids, which can cause HPA axis suppression 4
• Watch for signs of oral candidiasis, which may develop with prolonged corticosteroid use 2
• Lidocaine absorption through damaged oral mucosa is minimal but should be monitored in patients with extensive ulceration 5

Red Flags

• Any oral lesion persisting beyond 2 weeks despite treatment requires biopsy to rule out malignancy 1
• Induration, fixation, unexplained bleeding, or cervical lymphadenopathy are warning signs for potential malignancy 1

Supportive Measures

• Maintain good oral hygiene using soft toothbrush and mild non-foaming toothpaste
• Rinse with saline solution 4-6 times daily
• Avoid spicy, acidic, rough foods, and alcohol
• Use soft diets and soft toothbrushes to minimize trauma 2, 1

Topical treatments should be selected based on the specific oral condition, severity of symptoms, and patient tolerance. Regular monitoring is essential, especially for persistent cases, to ensure proper diagnosis and treatment.