What is the treatment for recurrent aphthous stomatitis (canker sores) on the tongue and lips?

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From the Guidelines

For treating canker sores on the tongue and lips, the most effective approach is to use a combination of topical anesthetics, antiseptic oral rinses, and good oral hygiene practices, as recommended by the most recent and highest quality study 1. To manage canker sores, start by applying a topical anesthetic preparation, such as viscous lidocaine 2%, 15 mL per application, to reduce pain and discomfort 1. Additionally, use an antiseptic oral rinse, like 1.5% hydrogen peroxide mouthwash or 0.2% chlorhexidine digluconate mouthwash, twice daily to reduce bacterial colonization of the mucosa 1. Some key considerations for managing canker sores include:

  • Avoiding spicy, acidic, or rough foods that can irritate sores
  • Using a soft-bristled toothbrush to prevent further irritation
  • Practicing good dental and mouth hygiene, including regular brushing and flossing
  • Evaluating the use of dental appliances, such as braces or dentures, to ensure they are not causing irritation 1
  • Considering the use of a topical corticosteroid, such as betamethasone sodium phosphate or clobetasol propionate, to reduce inflammation and promote healing 1 It is essential to note that canker sores can be caused by immune system reactions, minor injuries, or nutritional deficiencies, particularly B vitamins, iron, and zinc. Maintaining good oral hygiene and addressing potential triggers can help prevent future outbreaks. If sores are large, extremely painful, last longer than two weeks, or occur frequently, it is recommended to consult a healthcare provider for further evaluation and treatment.

From the Research

Treatment Options for Mouth Canker Sores

  • Canker sore medications, such as those containing benzocaine, can provide relief from pain associated with aphthous ulcers or other minor irritations of the mouth 2.
  • Amlexanox 5% paste has been shown to be effective in reducing ulcer size, pain duration, and healing time, making it a viable treatment option for recurrent canker sores 3.
  • Topical oral medications, such as ORABASE Soothe.N.Seal, can provide effective pain relief and aid in the healing process of oral ulcerations, including canker sores 4.

Characteristics of Effective Treatments

  • Anesthetic effect: Medications containing local anesthetics, such as benzocaine, can provide anesthetic effects, with Red Cross Canker Sore Medication showing the longest duration and greatest intensity 2.
  • Pain relief: Topical medications, such as Amlexanox 5% paste and ORABASE Soothe.N.Seal, can provide significant pain relief and reduce healing time 3, 4.
  • Healing time: Amlexanox 5% paste has been shown to reduce healing time, making it a effective treatment option for recurrent canker sores 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinical treatment evaluations of a new topical oral medication.

Compendium of continuing education in dentistry. (Jamesburg, N.J. : 1995). Supplement, 2001

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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