Aphthous ulcers in the mouth are common. They are also commonly recurrent.
The causes are unclear although they are associated with some systemic conditions, many treatments have been suggested and there is evidence for effectiveness of some of them.
- NSAID gargle
- Saline rinses
- Directly applied local anaesthetic (symptomatic only)
- Benzydamine spray/rinse (Difflam®)
- Carbenoxolone gel (Bioral®)
- Sucralfate suspension
- Steroid as:
- Tetracycline/Minocycline or DOxycycline, opened and used as a mouthwash.
- Thalidomide in intractable, slow-healing ulcers in HIV patients.
With RCT evidence available
- Chlorhexidine gluconate mouth rinses reduce the severity of each episode of ulceration, but do not reduce recurrences.
- RCTs found that chlorhexidine reduced the mean severity of pain compared with an inert preparation.
- Topical corticosteroids
- Small RCTs found that topical corticosteroids reduced the number of ulcer days compared with control preparations. They also don't prevent more ulcers. They may reduce the duration and pain of ulcers and hasten pain relief without causing notable local or systemic adverse effects.
- Hexitidine On limited RCTs it probably doesn't work.
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- ↑ Scully C, Felix DH. Oral medicine--update for the dental practitioner. Aphthous and other common ulcers. British dental journal 2005;199:259-64. (Direct link – subscription may be required.)
- ↑ Scully C, Felix DH. Oral medicine--update for the dental practitioner. Mouth ulcers of more serious connotation. British dental journal 2005;199:339-43. (Direct link – subscription may be required.)
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/2587982
- ↑ Ball SC, Sepkowitz KA, Jacobs JL. Thalidomide for treatment of oral aphthous ulcers in patients with human immunodeficiency virus: case report and review. The American journal of gastroenterology 1997;92:169-70.
- ↑ Jacobson JM, Greenspan JS, Spritzler J, Ketter N, Fahey JL, Jackson JB, et al. Thalidomide for the treatment of oral aphthous ulcers in patients with human immunodeficiency virus infection. National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group. The New England journal of medicine 1997;336:1487-93.
- ↑ Clin Evid 2004;12:1–2. BMJ Publishing Group Ltd 2004