What are the application guidelines for triamcinolone (corticosteroid) dental paste?

Application Guidelines for Triamcinolone Dental Paste

For isolated oral erosions, apply triamcinolone acetonide 0.1% in adhesive paste directly to the dried lesion, using a small amount to cover the affected area. 1

Preparation Before Application

• Dry the oral mucosa thoroughly before applying the paste to ensure proper adhesion to the lesion 1
• Avoid eating or drinking for at least 30 minutes before application to maintain a dry surface 1
• Gently clean the area with water if needed, then pat dry with gauze 1

Application Technique

• Apply a thin layer directly to the isolated erosion or ulcer, avoiding application to large areas of normal mucosa 1
• Use the paste sparingly—a small dab is typically sufficient to cover a single lesion 1
• Press the paste gently onto the dried mucosa to promote adhesion of the paste to the lesion site 1
• The adhesive base (Orabase) helps the medication remain in contact with the lesion for extended periods 1

Frequency and Duration

• Apply up to 2-4 times daily as needed for symptom control 1
• Continue application until the lesion heals or as directed by your healthcare provider 1
• For maintenance after initial improvement, consider reducing frequency rather than stopping abruptly 1

Important Timing Considerations

• Apply after meals and at bedtime for optimal contact time with the lesion 1
• Avoid eating or drinking for at least 30 minutes after application to allow the paste to adhere and work effectively 1
• If using other oral treatments, apply the triamcinolone paste last to ensure it stays in place 1

Adjunctive Oral Care Measures

• Use soft toothbrushes to minimize trauma to oral lesions 1
• Maintain soft diets to reduce mechanical irritation of erosions 1
• Consider topical analgesics (benzydamine hydrochloride 0.15%) before eating or toothbrushing if pain is significant 1
• Use antiseptic mouthwashes (chlorhexidine gluconate 0.2%) to maintain oral hygiene and prevent secondary infection 1
• Monitor for and treat oral candidiasis, as patients using topical corticosteroids are susceptible to fungal overgrowth 1

When Paste is Not Appropriate

• For multiple oral erosions, mouthwashes are more practical than paste application 1
• Consider betamethasone sodium phosphate 0.5 mg dissolved in 10 mL water as a rinse-and-spit solution for widespread disease 1
• Alternatively, clobetasol 0.05% ointment mixed in 50% Orabase can be used for localized lesions on dried mucosa 1

Common Pitfalls to Avoid

• Do not apply to wet mucosa—the paste will not adhere properly and will be ineffective 1
• Avoid overuse—excessive application does not improve efficacy and may increase risk of local adverse effects 1
• Do not use as monotherapy for severe or widespread disease—systemic therapy is typically required in these cases 1
• Be aware that dilution of the preparation may be necessary if irritation occurs, though this is less common with paste formulations than mouthwashes 1

Monitoring and Follow-up

• Monitor for local adverse effects including mucosal atrophy, though this is rare with appropriate use 1
• Watch for signs of secondary infection, particularly candidiasis, which should be treated promptly 1
• If no improvement occurs within 2 weeks, reassess the diagnosis and consider alternative or additional therapies 1