There is an oral paste that has been shown to ease pain and speed healing of canker sores in healthy people and has been approved by the US Food and Drug Administration.
The drug is called Aphthasol®; its generic name--amelxanox. Researchers do not know how it works yet, although they believe it inhibits inflammation and offers protection as a wound covering. It should be applied four times daily and may sting or burn. Dentists or physicians can prescribe Aphthasol to patients who have recurring mouth problems with canker sores.
Canker sores are small--usually one to two mm--often white, painful, non-contagious, inflammatory lesions. They appear on the soft tissues and folds of the inner cheeks and lips, or the floor of the mouth.
Many factors are believed to cause canker sores to make them worse, including stress, food allergies, heredity, injury to the mouth, or use of a hard-bristled toothbrush. Dietary deficiencies of iron, folic acid, or vitamin B-12 also are possible causes for canker sores.
Canker sores normally clear up on their own within 10 to 14 days. Over-the-counter products containing lidocaine or benzocaine can relieve mouth pain temporarily but do not promote healing.
Triclosan, an antimicrobial agent added to some toothpastes and mouth rinses, has been shown to have anti-inflammatory and analgesic effects that help ease the symptoms of canker sores. Researchers believe that when triclosan dissolves in the oral cavity, it stabilizes and protects cells from irritating agents and bacteria that may cause canker sores.
A study conducted in Norway suggests that sodium laurel sulfate, a detergent and foaming agent found in many toothpastes, can aggravate canker sores. Ingredients, including triclosan and sodium laurel sulfate, are listed on the toothpaste package.
"We do not yet know how to prevent canker sores," explains Vicki Grandinetti, D.D.S., a general dentist. "Good oral hygiene and a balanced, nutritional diet may help significantly. Patients who are prone to canker sores probably should avoid heavily spiced foods, as well as citrus and other highly acidic foods, and be careful when brushing teeth."
Dr. Grandinetti says that as many as 20% of Americans suffer from canker sores. "Canker sores can be painful but generally are not a cause for concern," she concludes. "However, if you have one or more persistent lesions that last longer than two weeks, and especially if they are not painful, schedule an appointment with a dentist for a dental examination."
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