From the Guidelines
The treatment of aphthous stomatitis primarily focuses on symptom management and promoting healing, with the most effective approach being a combination of topical corticosteroids, analgesics, and good oral hygiene, as suggested by expert opinion 1. The goal of treatment is to reduce inflammation, relieve pain, and promote healing. For mild cases, over-the-counter topical medications containing benzocaine can provide temporary pain relief when applied directly to ulcers 3-4 times daily. Rinsing with salt water or a 1:1 mixture of hydrogen peroxide and water several times daily can help reduce inflammation and prevent secondary infection. Some key considerations for treatment include:
- Topical corticosteroids like triamcinolone acetonide dental paste (0.1%) applied 2-3 times daily directly to lesions, or dexamethasone elixir (0.5mg/5mL) used as a rinse for 2 minutes then spit out, 3-4 times daily, as recommended by expert opinion 1.
- Topical tetracycline suspension (250mg capsule dissolved in 5mL water) can also be used as a rinse for 2-3 minutes four times daily to reduce inflammation and promote healing.
- For severe or recurrent cases, systemic medications may be necessary, including oral prednisone (40-60mg daily for 5-7 days with taper), colchicine (0.6mg twice daily), or pentoxifylline (400mg three times daily), as suggested by expert opinion 1. It is essential to note that patients should avoid spicy, acidic, or rough foods during healing and maintain good oral hygiene. If ulcers persist beyond two weeks, are unusually large (>1cm), or recur frequently, further evaluation is recommended to rule out underlying systemic conditions. Preventive measures, such as eliminating sources of trauma and avoiding painful stimuli, are also crucial in reducing the severity of stomatitis, as highlighted in the guidelines for diagnosis, treatment, and follow-up 1.
From the FDA Drug Label
Stop use and ask doctor or dentist if sore mouth symptoms do not improve in 7 days irritation, pain or redness persists or worsens swelling, rash or fever develops The treatment for Aphthous (canker sore) stomatitis is not directly stated in the provided drug labels.
- No specific treatment is mentioned for Aphthous stomatitis in the given labels.
- The labels provide information on the use of benzocaine and triamcinolone acetonide for other conditions, but not specifically for Aphthous stomatitis 2, 3.
From the Research
Treatment Options for Aphthous Stomatitis
The treatment for aphthous stomatitis, also known as canker sores, involves a variety of options, including:
- No treatment
- Treatment of associated systemic diseases or conditions (e.g., celiac sprue, vitamin deficiencies) 4
- Systemic medications
- Topical medications
- Conversion of the aphthous ulcer to a wound
- Palliative treatments 4
Topical Treatments
Topical treatments are preferred due to fewer associated side effects 4. Available topical medications include:
- Antiseptics (chlorhexidine) 5
- Anti-inflammatory drugs (amlexanox) 5
- Antibiotics (tetracyclines) 5
- Corticosteroids (triamcinolone acetonide) 5, 6, 7
- Local anesthetics (lidocaine) 8
- Topical antiseptic/anti-inflammatory agents (triclosan and diclofenac) 8
Systemic Treatments
Systemic treatments are indicated in severe cases, such as constant and aggressive outbreaks (major aphthae) 5. Available systemic medications include:
Alternative Therapies
Alternative therapies, such as low-level laser therapy, have also been studied and shown to be effective in reducing pain and ulcer size 7.
Management Approach
The management of aphthous stomatitis should be based on identification and control of possible predisposing factors, exclusion of underlying systemic causes, and use of a detailed clinical history along with complementary procedures such as laboratory tests 5. Treatment should be tailored to the severity of the problem in the individual case, including the frequency of ulcers, intensity of pain, and responsiveness of the lesions to treatment 8.