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Treatments and drugs
By Mayo Clinic staffTreatment usually isn't necessary for minor canker sores, which tend to clear on their own in a week or two. But large, persistent or unusually painful sores often need medical care. A number of treatment options exist, ranging from mouth rinses and topical ointments to systemic corticosteroids for the most-severe cases.
- Mouth rinses. If you have several canker sores, your doctor may prescribe a mouth rinse containing the steroid dexamethasone (dek-suh-METH-uh-sown) to reduce pain and inflammation. Oral suspensions of the antibiotic tetracycline also can reduce pain and cut healing time, but tetracycline has drawbacks. It can make you more susceptible to oral thrush, a fungal infection that causes painful mouth sores, and it can permanently discolor children's teeth.
- Topical pastes. Over-the-counter and prescription pastes with active ingredients such as benzocaine (Anbesol), amlexanox (Aphthasol) and fluocinonide (Lidex, Vanos) can help relieve pain and speed healing if applied to individual sores as soon as they appear. Your doctor may recommend applying the paste to the sore two to four times a day until it heals.
- Oral medications. Medications not intended specifically for canker sore treatment, such as the heartburn drug cimetidine (Tagamet) and colchicine, which is normally used to treat gout, may be helpful for canker sores. Your doctor may prescribe oral steroid medications when severe canker sores don't respond to other treatments, but because of serious side effects, they're usually considered a last resort.
- Cautery of sores. During cautery, an instrument or chemical substance is used to burn, sear or destroy tissue. Debacterol is a topical solution designed to treat canker sores and gum problems. By chemically cauterizing canker sores, this medication may reduce healing time to about a week. Silver nitrate — another option for chemical cautery of canker sores — hasn't been shown to speed healing, but it may help relieve canker sore pain.
- Nutritional supplements. Your doctor may prescribe a nutritional supplement if you consume low amounts of important nutrients, such as folate (folic acid), vitamin B-6, vitamin B-12 or zinc.
If your canker sores relate to a more serious health problem, your doctor will treat the underlying condition.
References
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Feb. 2, 2012.
- Long SS, et al., eds. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/174218004-3/925169573/1679/31.html#4-u1.0-B978-0-443-06687-0..50030-8--cesec16_721. Accessed Feb. 2, 2012.
- Flint PW, et al. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05283-2..X0001-8--TOP&isbn=978-0-323-05283-2&uniqId=230100505-57. Accessed Feb. 2, 2012.
- Canker sores, cold sores & common mouth sores. American Dental Association. http://www.ada.org/2982.aspx?currentTab=1. Accessed Feb. 2, 2012.
- Stomatitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/dental_disorders/symptoms_of_dental_and_oral_disorders/stomatitis.html. Accessed Feb. 2, 2012.
- Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed Feb. 6, 2012.
- Goldstein BG, et al. Oral lesions. http://www.uptodate.com/home/index.html. Accessed Feb. 6, 2012.
- AskMayoExpert. Recurrent aphthous ulcers. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
- Morelli V, et al. Alternative therapies for common dermatologic disorders, part 2. Primary Care Clinics in Office Practice. 2010;37:285.
- Bailey J, et al. What is the most effective way to treat recurrent canker sores? The Journal of Family Practice. 2011;60:621.
- Messadi DV, et al. Aphthous ulcers. Dermatologic Therapy. 2010;23:281.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 21, 2012.
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