David C. Adams, DDS, MS

How do you treat canker sores...?

After I finished dental school,  my regimen was to have the patient rinse with 1 teaspoon of salt with 1 teaspoon of baking soda dissolved in 8 ounces of warm water. My sister-in-law, who suffers from Recurrent Aphthous Stomatitis (RAS), asked if there was something more that could be done.

RAS affect sup to 25 percent of the population, often first ocurring in adolescence. While the cause of RAS is unknown, a glitch in the body's autoimmune system may contribute to the outbreaks. Prevention includes avoiding trauma, which is difficult for patients wearing orthodontic appliances, and avoiding toothpastes that contain sodium lauryl sulfate.

Treatment of RAS aims to suppress the immune response in order to reduce pain and shorten the duration of the ulcers.

Over-the-counter treatment options include:

1. 1-2 T Maalox mixed with 1/2 T Benadryl. Swish 1 tsp. 4 times per day
2. Liquids contianing benzocaine, such as Abnesol, Oragel, Orabase, Zilactin-B. This strictly relives discomfort and does not shorten duration.

Prescription treatment options include:

1. Amlexanox (Aphthasol), which reduced the size of the lesion and duration
2. 5% lactic acid mouthwash - 1 tsp. 3 times per day befor emeals significantly reduces signs and symptoms
3. Debacterol - This is a topical sulfuric acid agent that reduces pain and duration. Its drawback is that it is expensive. 
4. A topical steroid is now my first choie. I prefer to prescribe a Triamcinoclone rinse with viscous lidocaine. Another prescription steroid is floucinonide (lidex).

These options should help prevent sore losers.

by Dr. Alison Fallgatter

(This article was featured in the December 2008 issue of the AAO eNewsletter New and Younger Members Online.)