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Aphthous ulcer - Management
How should I manage aphthous ulcers?
- Where possible manage precipitating factors:
- Oral trauma: use a softer toothbrush, and avoid hard foods such as toast.
- Anxiety or stress: try relaxation techniques (e.g. yoga, meditation, exercise).
- Certain foods: if there is an obvious relationship to particular foods these are best avoided.
- Stopping smoking: explain that smoking cessation may precipitate ulceration, but that this will settle and the overall health benefits are greater than the short-term discomfort; nicotine replacement therapy may provide some relief.
- Offer symptomatic treatment for pain, discomfort, and swelling. Options include:
- A low-potency topical corticosteroid (e.g. hydrocortisone lozenges). Encourage people with prodromal symptoms, such as tingling or swelling, to apply corticosteroids at this stage. Otherwise, they should be applied as soon as the ulcers appear.
- An antimicrobial mouthwash (e.g. chlorhexidine gluconate).
- A topical analgesic (e.g. benzydamine hydrochloride) if ulcers are very painful.
- If ulcers are infrequent, mild, and not interfering with daily activities (e.g. eating), treatment may not be needed.
- Advise the person to return if there is worsening of, or no improvement in, symptoms with treatment or if the ulcer persists after 3 weeks.
In depth
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