Dear Doctor
I have been having recurrent sores in my mouth for the past couple of years. What is the best treatment for them?
Dear Patient
There is no cure for aphthous ulcers.
But, most aphthous ulcers do not require treatment since they usually resolve spontaneously within 10-14 days.
However, there are medications that are used to treat aphthous ulcers and these include:
1. Prescription Medications
1. Analgesics or pain relievers
Topical analgesics are those pain relievers which are applied inside the mouth and they include:
a. Benzocaine (Oragel)
Systemic analgesics or those which are swallowed can also be used to relieve pain. Examples include ibuprofen (brufen, advil) and acetaminophen (paracetamol, tylenol).
2. Anti-inflammaty agents to reduce the inflammation
Topical anti-inflammatories or those which are applied to the ulcers include:
a. Triamcinolone 0.1% in orabase (Kenalog in Orabase)
3. Antibiotics to treat bacterial super-infections
These are usually prescribed when the sore is red, crusted and discharging pus.
Home Remedies For Aphthous Ulcers
Home remedies used to treat Aphthous ulcers include:
1. Saline gargle
Dissolve 1 teaspoon of salt in 1 cup of lukewarm water to make a gargle. Swish the solution in your mouth for 30 seconds and spit it out. The salt gargle is best used right after meals and right before going to bed. The antiseptic properties of the salt help prevent the ulcers from getting infected.
2. Baking soda gargle
Dissolve 1 teaspoon of salt and ½ teaspoon of baking soda (Sodium bicarbonate) in 1 cup of lukewarm water to make a gargle. Swish the solution in your mouth for 30 seconds and spit it out. The gargle is best used right after meals and right before going to bed. The antiseptic properties of the salt and baking soda combined with the discomfort relieving properties of the baking soda are beneficial for managing Aphthous ulcers.
3. Zinc gluconate lozenges
Sucking on 4-6 zinc gluconate lozenges each day is reported to hasten the healing of Aphthous ulcers and reduce their discomfort.
General Measures
General measures recommended to manage Aphthous ulcers include:
a. Eating a soft diet and using a straw to drink since this prevents contact between the ulcers and the fluids.
b. Avoiding acidic foods like citrus fruits (orange, grapefruit) and salty foods (like crisps) and spicy foods.
c. Avoiding the triggering factors. For example you can change from oral nicotine replacement therapy and use patches.
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