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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Canker sores facts
• What are canker sores?
• What are symptoms of canker sores?
• What are the causes of canker sores?
• Are canker sores the same as fever blisters?
• What steps can be taken to help canker sores?
• What is the treatment for canker sores?
• What kind of topical medications (gels or ointments) are available for canker sores?
• Can mouthwash solutions be used with canker sores?
• What oral medications are available to help canker sores?
• What should I do if I get canker sores frequently?
• What research is being done in the area of canker sores?
• Patient Comments: Canker Sores - Oral Medications
• Patient Comments: Canker Sores - Experience
• Patient Comments: Canker Sores - Topical Medications
• Patient Comments: Canker Sores - Effective Treatments
• Patient Comments: Canker Sores - Symptoms
• Find a local Ear, Nose, & Throat Doctor in your town
• Canker Sores Index

Yes, there are several mouthwash solutions you can use. One type of mouthwash used for canker sores is diphenhydramine suspension (Benadryl Allergy liquid and others). This liquid medication can be used as a mouth rinse in adults to provide temporary relief from the pain caused by canker sores. Patients should not swallow the diphenhydramine, but simply use it as a mouth rinse. This is generally available over the counter.

Furthermore, steroid anti-inflammatory mouth rinses can be prescribed for patients with severe sores. Steroid mouth rinses have been shown to reduce the inflammation and number of recurrences and are reserved for more severe cases due to potential side effects. These potent drugs can cause many undesirable side effects, and should be used only under the close supervision of a dentist or physician.

There are also mouth rinses containing the antibiotic tetracycline that may reduce the unpleasant symptoms of canker sores and speed healing by preventing bacterial infections in the sores. Clinical studies at the National Institute of Dental Research have shown that rinsing the mouth with tetracycline several times a day usually relieves pain in 24 hours and allows complete healing in five to seven days. The U.S. Food and Drug Administration warns, however, that tetracycline given to pregnant women and young children can permanently stain the children's teeth.

Both steroid and tetracycline treatments require a prescription and care of a dentist or physician.

Oral pain medications such as, ibuprofen (Advil) or acetaminophen (Tylenol) may be taken for pain relief if the sores are intolerable. Some patients may get relief from sucking on zinc lozenges, or taking vitamin B and C complex.

There is no evidence that antibiotics taken orally are helpful. If the canker sores are caused by a yeast infection, a topical anti-fungal medication can be used, [for example, nystatin (Mycostatin, Nystatin)]. Some people with AIDS (HIV infection) who have repeated bouts of canker sores respond well to thalidomide (Thalomid oral). This medication can also be used for severe canker sores not related to AIDS. Thalidomide is associated with very severe birth defect and, therefore, its use is very limited.

Patients with severe recurrent and non-healing canker sores may also need to take steroid or other immuno-suppressant drugs orally. But they are associated with major side effects if taken long term and their use should be closely monitored by the prescribing doctor.

In other situations, if the presumed cause is another illness, such as lupus, treating the underlying illness often results in healing the ulcers. Vitamins and other nutritional supplements often prevent recurrences or reduce the severity of canker sores in patients with a nutritional deficiency. L-lysine over-the-counter is used as a preventative treatment. Patients with food allergies can reduce the frequency of canker sores by avoiding those foods.