What are the prescription treatment options for aphthous ulcers (canker sores)?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

Prescription treatment for canker sores should include topical corticosteroids, such as dexamethasone mouth rinse (0.1 mg/ml) or clobetasol gel/ointment (0.05%), as first-line therapy to reduce inflammation and promote healing 1. When it comes to managing canker sores, the goal is to alleviate symptoms, promote healing, and prevent recurrence.

  • Topical corticosteroids, like dexamethasone mouth rinse (0.1 mg/ml) or clobetasol gel/ointment (0.05%), are recommended as first-line therapy for their anti-inflammatory properties 1.
  • For severe cases, systemic corticosteroids, such as oral prednisone (30-60 mg or 1 mg/kg) for 1 week, followed by dose tapering, may be considered to quickly bring symptoms under control 1.
  • Other treatment options, like coating agents, topical analgesic or anti-inflammatory agents, and alternative mouthwashes, may also be considered to manage symptoms and promote healing 1.
  • It's essential to note that treatment should be individualized, and patients should be advised to use these approaches under the guidance of a healthcare professional.
  • The use of sodium bicarbonate containing mouthwash, chewing gum, candy, salivary substitutes, or sialogogues may also be beneficial in preventing and treating stomatitis, including canker sores 1.
  • Analgesics, such as viscous lidocaine (2%) or topical NSAIDs (e.g., amlexanox 5% oral paste), may be used to manage pain associated with canker sores 1.

From the Research

Canker Sore Prescription Treatment Options

  • Amlexanox is considered an effective treatment for canker sores, with a 5% paste formulation showing significant benefits 2
  • The use of Amlexanox 5% paste has been shown to:
    • Reduce ulcer size
    • Decrease pain duration
    • Shorten healing time 2

Key Findings

  • Studies suggest that Amlexanox may be the most effective overall treatment for recurrent canker sores 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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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