Canker Sores (cont.)
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.
Next: What should I do if I get canker sores frequently? »
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