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WHAT ARE THE Options for TREATMENTS FOR A CANKER SORE (APTHOUS ULCER)?
* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024.
The best treatment option MIGHT have changed since that time.
1. Topical Anesthetics:
A. Benzocaine (Orajel, may help relieve pain).
B. Lidocaine Suspension (Rinse and Spit)
2. Antibiotics (prevent secondary infections)
A. chlorhexidine oropharygngel mouthwash. 10-15 ml 2 x/d
3. Oral Corticosteroids Paste:
A. Triamcinolone paste “Kenolog In Orabase” 0.025% 0.1% 0.5% tid as needed (PRN)
B. Dexamethasone 0.5 mg/5 mL 3 times a day (PRN)
C. Clobetasol ointment 0.05% (PRN)
D. Fluocinonide ointment 0.05% in Carboxymethylcellulose mucosal protective paste (1:1) applied 3 times a day (PRN)
4. For Severe Cases:
A. Oral Prednisone 40 mg q day x ~ 5 Days
5. Vitamins
A. Iron
B. B12
CAUTION
1. Do NOT swallow lidocaine liquid mouth rinse because it can anesthetize the esophagus and make you more likely to get food into lung, which will lead to pneumonia.
2. All medication, including all anesthetic medications, and antiviral medication have a risk of side effects.
3. Possible Mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.
4. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
5. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.
Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.
WHAT ARE THE SYMPTOMS OF A CANKER SORE (Apthous Ulcer)?
The symptoms of a Canker Sore (Apthous Ulcer) are one or a few painful sores on the lips or inside the mouth. They appear as white or gray small erosions about 3-6 mm. Pain is usually increased when eating or drinking certain foods, especially those containing salt.
Canker Sores do NOT cause a tingling discomfort or itching in the area. They also do change very much is appearance from beginning to end. Lesions that cause a tingling sensation are more likely caused by Herpes Simplex Virus I or 2 (Cold Sore) and respond best to antiviral medications.
WHAT CAUSES AN APTHOUS ULCERS OR CANKER SORE?
Apthous Ulcers are NOT caused by a virus. This is different than Cold Sores which are caused by Herpes Simplex Virus 1 or 2. Instead of a virus there is disruption in the person’s immune system, most notably Cytokines, such as IL-2, IL-10, and TN-alpha. This disruption in the immune system can be brought on by stress, trauma, and a variety of food. The foods include chocolate, coffee, peanuts, eggs, cereals, almonds, strawberries, cheese, and tomatoes.
HOW ARE CANKER SORES (APTHOUS ULCERS) DIAGNOSED?
Canker Sores can be diagnosis based on a careful history and a brief visual exam.