From the Guidelines
To treat canker sores, it is recommended to start with over-the-counter options like Orajel, Anbesol, or Kank-A which contain benzocaine to provide pain relief, as well as rinsing with salt water or a solution of equal parts hydrogen peroxide and water to clean the area and reduce inflammation 1. When considering treatment options, it's essential to prioritize the patient's quality of life and minimize potential complications.
- Over-the-counter antimicrobial mouthwashes containing chlorhexidine or products with coating agents like Zilactin-B can protect the sore while it heals.
- For pain management, taking ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours or acetaminophen (Tylenol) 500-1000mg every 6 hours as needed can help alleviate discomfort.
- Most canker sores heal within 7-14 days without treatment, but if sores are large (over 1cm), extremely painful, last longer than two weeks, or occur frequently, it's crucial to consult a healthcare provider who may prescribe stronger treatments like topical steroids or cauterizing agents.
- Avoiding spicy, acidic, or rough foods during healing can prevent irritation, while maintaining good oral hygiene helps prevent infection and promotes healing. It's also important to note that some cases of oral ulcers may be caused by underlying systemic conditions, and a comprehensive diagnostic work-up may be necessary to determine the underlying cause 1.
- In cases where the cause is unknown, such as recurrent aphthous ulcers (RAU), treatment should focus on managing symptoms and promoting healing.
- Topical measures, such as steroid preparations, lidocaine gel, and chlorhexidine, can be effective in managing oral ulcers, and systemic measures may be necessary for more resistant cases.
From the FDA Drug Label
Temporarily relieves pain associated with the following mouth and gum irritations: toothache sore gums canker sores braces minor dental procedures Benzocaine (TOP) can be used for canker sore treatment to temporarily relieve pain.
- The drug is used for temporary pain relief associated with canker sores. 2
From the Research
Canker Sore Treatment Options
- Topical corticosteroids, such as dexamethasone ointment, have been shown to be effective in reducing ulcer size, alleviating pain, and hastening healing in patients with recurrent aphthous ulceration 3, 4.
- Local anesthetics, such as 1% lidocaine cream, can provide significant pain relief for patients with oral mucosal lesions due to trauma or minor oral aphthous ulcer 5.
- Antiseptic agents and local anesthetics should be tried first, and if these are ineffective, topical corticosteroids can be used 6.
- In severe cases, local measures can be combined with systemic drugs, such as colchicine, pentoxifylline, or prednisolone 6.
- Avoiding hard, acidic, and salty foods, as well as toothpastes containing sodium lauryl sulfate, can help prevent canker sores 6.
Treatment Efficacy
- Dexamethasone ointment has been shown to have a healing ratio of 83.33% in patients with recurrent aphthous ulceration, compared to 54.70% in the control group 3, 4.
- Topical 1% lidocaine cream has been shown to reduce pain intensity by 29.4 mm ± 17.0, which was significantly greater than the decrease obtained with the placebo cream 5.
- The efficacy of systemic treatment is debated, and other immunosuppressive agents should be given systemically only for refractory or particularly severe oral aphthous ulcers due to Adamantiades-Behçet disease 6.