Last week I talked about some of the causes of aphthous ulcers (canker sores) and things you can avoid helping lessen the probability of an outbreak.  Now I would like to talk about some of the specific treatments that can be utilized when an outbreak does occur.

Treatments can vary from herbal and home remedies to over-the-counter preparations to prescription creams and gels.  Left untreated, canker sores usually heal in a week or two, but may recur monthly or several times in a year.  Rinsing with antimicrobial mouthrinses may help reduce the irritation and over-the-counter topical anesthetics can also provide relief.  Numbing agents available include Orabase B, Oraljel and UlcerEase, all of which numb the area.  They are limited in their duration, but can help if utilized prior to eating.

Barrier products coat and protect the ulcer from further irritation.  Rincinol P.R.N is one of the first non-prescription rinses for oral pain relief that forms a bio-adherent protective coating over the tissue surface to quickly provide long-lasting relief without numbing, stinging or burning.  Other barrier products include Orabase Soothe-N-Seal, Zialctin and ORA5.

The cleansing agents Peroxyl Oral rinse and Gly-oxide have also been used to ease the discomfort and help heal the oral ulcerations.  The home remedy mixture of one teaspoon milk of magnesia and one teaspoon Benadryl liquid is swished and expectorated four to six times a day to help minimize the pain.

Ancient Egyptians used myrrh as a mouthwash to treat their oral ailments while American Indians and early settlers used cankerroot as a tea to treat both sore throat and canker sores.  Cherokee Indians also used wild geranium as an astringent to stop the bleeding of open wounds and as a rinse to treat canker sores.

In situations where the mouth ulcers are numerous, large or just too painful to stand, your dentist can prescribe a variety of topical medications to help them heal much quicker.  I have always been in favor of getting rid of them as quickly as possible!  Prescription medications act to reduce inflammation and speed healing.  Medications such as Apthasol, Kenalog in Orabase, Diprolene, Temovate and my favorite Lidex are often utilized.  Gel treatments will work best in the mouth.  Creams wash away quickly and ointments can stick to fingers or applicators more than they stick to the ulcer.  Every dentist will have his/her favorite prescription that they like to use. 

As I mentioned last week, prevention is a good thing not only for your teeth, but for oral ulcers as well.  Patients may want to try an elimination and challenge diet to sleuth out any food triggers of their oral ulcerations.  Also avoid hard, crunchy, abrasive, hot, spicy and acidic foods or drinks while they have an outbreak.  Next week we will take a closer look at another oral ulceration – the dreaded cold sore (fever blister)!