From the Guidelines
For recurrent aphthous stomatitis, I recommend starting with topical corticosteroids, such as clobetasol propionate 0.05%, mixed in equal amounts with Orabase, applied directly to the sulci, labial or buccal mucosae daily during the acute phase, as this has been found to be effective in reducing inflammation and promoting healing 1. When considering treatment options, it's essential to prioritize reducing inflammation and preventing secondary infections.
- Topical anaesthetic preparations, such as viscous lidocaine 2%, can be used as an alternative to relieve pain 1.
- Antiseptic oral rinses, like 0.2% chlorhexidine digluconate mouthwash, can be used twice daily to reduce bacterial colonization of the mucosa 1.
- In cases of suspected secondary infection, oral and lip swabs should be taken regularly, and treatment with nystatin oral suspension or miconazole oral gel may be necessary 1. It's crucial to note that the treatment of recurrent aphthous stomatitis should focus on reducing morbidity, mortality, and improving quality of life, and the chosen treatment should be based on the most recent and highest quality evidence available 1.
- The use of topical corticosteroids, such as clobetasol propionate 0.05%, has been found to be effective in reducing inflammation and promoting healing, making it a recommended treatment option for recurrent aphthous stomatitis 1.
From the Research
Medications for Recurrent Aphthous Stomatitis
The following medications are prescribed for recurrent aphthous stomatitis (canker sores):
- Topical anesthetics, such as benzocaine 2 and lidocaine 3
- Topical corticosteroids, such as triamcinolone acetonide 4 and prednisolone 3
- Antimicrobial mouthwashes 5
- Antiseptic/anti-inflammatory agents, such as triclosan and diclofenac 3
- Systemic medications, such as levamisole 5, colchicine, pentoxifylline, and prednisone 3, 4
- Thalidomide, for severe cases 5, 4
- Dessicating agents, such as a concentrated mixture of sulfates 6
- Anti-inflammatory drugs, such as amlexanox 4
- Antibiotics, such as tetracyclines 4
Treatment Approaches
Treatment approaches for recurrent aphthous stomatitis include:
- Identifying and controlling predisposing factors 4
- Excluding underlying systemic causes 4
- Using a detailed clinical history and complementary procedures, such as laboratory tests 4
- Applying local treatments, such as topical medications 5, 3, 4
- Using systemic therapy, such as corticosteroids or thalidomide, for severe cases 5, 4