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.
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.
Can mouthwash solutions be used to treat canker sores?
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.
What oral medications are available to
help canker sores?
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.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
There are a variety of diseases and conditions that can cause tongue problems, discoloration, and soreness. Though most tongue problems are not serious. Conditions such as leukoplakia, oral thrush, and oral lichen planus may cause a white tongue while Kawasaki syndrome, scarlet fever, and geographic tongue may cause the tongue to appear red. A black hairy tongue may be caused by overgrown papillae on the tongue. Canker sores, smoking, and trauma may cause soreness of the tongue.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Signs and symptoms of celiac disease include malabsorbption (diarrhea, foul smelling gas, bloating, and increased amounts of fat in the stool) and malnutrition (weight loss, edema, anemia, bruising easily, neuropathy, and infertility). Treatment for celiac disease is a gluten free diet, and at times if necessary, medications
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Behcet's syndrome is a disease characterized by three symptoms: genital ulcers, recurring mouth ulcers, and inflammation around the pupil of the eye. Symptoms of Behcet's syndrome may also include inflammation of other areas of the body, such as the brain, joints, skin, retina, and bowels. Oral steroids, antiinflammatory drugs, and steroid gels, pastes, and creams may be used to treat Behcet's syndrome.
Gum problems may be caused by improper brushing and flossing, gum disease, canker sores, treatments and hormonal changes. Symptoms of gum problems include red, swollen, sore and bleeding gums. These symptoms can be prevented by brushing twice a day, flossing daily, eating a well-balanced diet, drinking enough water, not smoking, and relaxing.
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