Management

Treatment is generally not required.

Measures that may help in the management of the acute episode include:

• a short course of a low-potency topical corticosteroid e.g. hydrocortisone lozenges (one lozenge four times per day)
• a topical analgesic (e.g. benzydamine hydrochloride) if ulcers are very painful

Doxycycline rinsed in the mouth may be of value in the treatment of recurrent apthous ulceration. Note though that doxycycline stains teeth and should be avoided in children under 12 years of age.

There is evidence that regular use of chlorhexidine gluconate mouth rinses increases the number of ulcer free days and reduced the severity of each episode of ulceration compared with control preparations but did not affect the incidence of recurrent ulceration (1,2).

Dexamethasone ointment has been revealed to be an efficient treatment of recurrent aphthous ulceration and with no safety concerns (3)

Reference:

1. Chadwick B, Addy M, Walker DM. Hexetidine mouthrinse in the management of minor aphthous ulceration and as an adjunct to oral hygiene. Br Dent J 1991;171:83?87.
2. Meiller TF, Kutcher MJ, Overholser CD, et al. Effect of an antimicrobial mouthrinse on recurrent aphthous ulcerations. Oral Surg Oral Med Oral Pathol 1991;72:425?429
3. Liu C et al. Efficacy and safety of dexamethasone ointment on recurrent aphthous ulceration. Am J Med. 2012 Mar;125(3):292-301.