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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 lesions 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 a number of canker sores, your doctor may prescribe a mouth rinse containing the steroid dexamethasone 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 lesions, and it can permanently discolor children's teeth.
- Topical pastes. Over-the-counter and prescription pastes with active ingredients such as benzocaine (Orabase), amlexanox (Aphthasol) and fluocinonide (Lidex, Vanos), can help relieve pain and speed healing if applied to individual lesions as soon as they appear. Benzocaine has been linked to a rare but serious, sometimes deadly, condition that decreases the amount of oxygen that the blood can carry. Don't use benzocaine in children younger than age 2 without supervision from a health care professional, as this age group has been the most affected. If you're an adult, never use more than the recommended dose of benzocaine and consider talking with your doctor.
- 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. Oral steroid medications are sometimes prescribed when severe canker sores don't respond to other treatments. But because the side effects of steroids are serious, these are usually considered a treatment of last resort.
- Debacterol. This topical solution was specifically designed to treat canker sores and gum problems. By chemically cauterizing lesions, it reduces healing time to about a week.
- Nutritional supplements. Your doctor is likely to prescribe a nutritional supplement if you consume low amounts of important nutrients, such as folate (folic acid), vitamin B-6, vitamin B-12 and zinc.
- Other conditions. If your canker sores seem to be related to a more serious health problem, your doctor will treat the underlying condition.
References
- Morelli JG. Disorders of the mucous membranes. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/174218004-3/925169573/1608/1550.html#4-u1.0-B978-1-4160-2450-7..50665-4--cesec7_12116. Accessed Dec. 4, 2009.
- Leggiadro RJ. Infections of the oral cavity. In: 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 Dec. 4, 2009.
- Travers JB, et al. Physiology of the oral cavity. In: Cummings CW, et al. Otolaryngology: Head & Neck Surgery. 4th ed. http://www.mdconsult.com/das/book/body/174218004-4/0/1263/586.html?tocnode=49543605&fromURL=586.html#4-u1.0-B0-323-01985-4..50067-8--cesec61_2453. Accessed Dec. 4, 2009.
- Common mouth sores. American Dental Association. http://www.ada.org/public/topics/mouth_sores.asp. Accessed Dec. 4, 2009.
- Mouth sores. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec08/ch112/ch112a.html. Accessed Dec. 4, 2009.
- Amsterdam JT. Oral medicine. In: Marx JA, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.: Mosby; 2006. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-323-05472-0..00068-2--s0160&uniq=174218004&isbn=978-0-323-05472-0&sid=925188259.Accessed Dec. 4, 2009.
- Rakel D, et al. Recurrent aphthous ulceration. In: Rakel RE. Integrative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/174218004-8/925191198/1494/118.html#4-u1.0-B978-1-4160-2954-0..50075-2_3684. Accessed Dec. 4, 2009.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 9, 2009.
- Benzocaine topical products: Sprays, gels and liquids — risk of methemoglobinemia. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm250264.htm. Accessed Apr. 8, 2011.
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