Mouth ulcers are more common than many think. The incidence of apthous ulcers (the most common form of oral ulcers) is 20%, which is one out of every 5 people. In fact, I had one underneath my tongue this past week. Fortunately for everyone with the unpleasant experience of dealing with canker sores, there are numerous methods of treating them.
I have broken up the different treatments into a few groups to make it easy for you all. Always remember to consult your doctor about the best treatment for you and for potential allergies or cross reactions with other medications before beginning any treatment.
Aphthasol Oral Paste (Amlexanox) -This is one of the most effective treatments I have seen with my patients. It is a prescription only oral paste that is placed on the ulcer using your finger to accelerate healing and pain relief by cauterizing the tissue and inducing a reparative response. Usually it reduces the ulcer by a whole day.
Kenalog/Oralone (triamcinolone topical) – A topical corticosteroid that will reduce redness and the inflammatory response that is occurring and creating the ulcer.
Decadron (dexamethasone) – Another topical corticosteroid designed to decrease the inflammation causing the canker sore.
Temovate (clobetasol propionate)- A corticosteroid paste placed over the ulcer to reduce inflammation.
Debacterol (Sulfuric Acid) – Debacterol is an effective cauterizing agent and will seal off the ulcer and help promote healing.
Silver Nitrate Sticks – You can also get these by prescription, though they are very caustic so you much be very careful about how you use them and where you keep them. Silver nitrate is a cauterizing agent and will seal over the ulcer and induce a reparative response.
Compounded Rinses and Pastes – Your doctor can also have some special rinses (i.e. Magic Mouthwash) or pastes compounded by your pharmacist. The pastes work best when they are particularly sticky and work like a therapeutic band-aid.
Systemic Corticosteroids – These are prescribed for systemic problems like Behcet Syndrome where multiple areas of the body are effected. It you have sore in your mouth and other areas at once, see your doctor.
Acid Etch – Your orthodontist or dentist has lots of this sitting around that they use when sticking braces or white fillings to your teeth. We can place it directly on your canker sore to help seal it off and get it to heal faster, and it actually works pretty well.
Laser Therapy – If your orthodontist or dentist has a diode laser in their office like we do, this is another great option for treating canker sores. The laser decreases the activity of nerves responsible for sensing pain and usually there is a very quick resolution of pain. Additionally, the diode laser increases the healing process and small ulcers many times heal a day after treatment. Ulcers are definitely a problem when you have braces, so it is really nice to be able to heal these up quickly.
Orabase – This contains benzocaine to numb the ulcer and it will also stick to the ulcer and form a skin to help shield it from further irritation.
Tea Bag – Holding a freshly wet bag of black tea up against the ulcer and allowing for the tannic acids from the tea to soak into the ulcer seems to help.
Salt Poultice – By taking some salt and adding just a drop or two of warm water to make a slightly moist mass of salt you can then place the salt directly onto the ulcer. This will sting quite a bit at first, but it will desensitize the area. I’m not sure really why it helps at all by I have tried it and it helps make the ulcer less painful, so you can give it a shot. You can also try a warm salt water rinse. I have also heard of people saying that biting their ulcers helps, so using salt is definitely not the strangest treatment out there.