Aphthous Stomatitis
Treatment

There is no cure for an aphthous ulcer. Most recurrent minor aphthous ulcers heal within 1–2 weeks without any treatment. The main goal of treatment is to lessen pain and discomfort and promote healing.

The vast majority of people with aphthous stomatitis have minor symptoms and do not require any specific therapy. The pain is often tolerable with simple dietary modification during an episode of ulceration such as avoiding spicy and acidic foods and beverages. Many different topical and systemic medications have been proposed, sometimes showing little or no evidence of usefulness when formally investigated.

Patient Advice

Do's

Orabase provides pain relief by creating a physical barrier over the ulcer.

• use a soft-bristled toothbrush
• drink cool drinks through a straw
• eat softer foods
• get regular dental check-ups
• eat a healthy, balanced diet
• reduce stress

Don'ts

• do not eat very spicy, salty or acidic food
• do not eat rough, crunchy food, such as toast or crisps
• do not drink very hot or acidic drinks, such as fruit juice
• do not use chewing gum
• do not use toothpaste containing sodium lauryl sulphate

Treatments

The first line therapy for aphthous stomatitis is topical agents rather than systemic medication, with topical corticosteroids being the mainstay treatment. Systemic treatment is usually reserved for severe disease due to the risk of adverse side effects associated with many of these agents.

A systematic review found that no single systemic intervention was found to be effective. Good oral hygiene is important to prevent secondary infection of the ulcers.

Physical barrier: Orabase (often combined with triamcinolone).

Pain relief: Benzydamine hydrochloride mouthwash or spray, Amlexanox paste, viscous lidocaine, diclofenac in hyaluronan.

Inflammation reduction:

• Hydrocortisone sodium succinate (topical mild corticosteroid)
• Stronger topical steroids include: Beclomethasone dipropionate aerosol, fluocinonide, clobetasol, betamethasone sodium phosphate, dexamethasone.