Aphthous ulcers or Recurrent Aphthous Disease(RAD) are inflammatory lesions of the mucous lining of the mouth which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth. It is usually painful and associated with redness, swelling, and occasional bleeding from the affected area.
The cause of RAD is unknown, although several factors are suspected including genetics,stress, nutritional deficiencies, diet, hormonal changes, and immunological disorders etc.
Treatment for RAD is symptomatic; the goals being to decrease pain, healing time, number and size of the ulcer, and to increase disease-free periods. Current treatment options include topical agents, systemic and topical steroids, long term oral riboflavin, Lactobacillus, proton pump inhibitors, cauterization, antibiotics, mouth washes containing active enzymes, laser treatments etc. Always advise the patient avoid stress, constipation, IBS, and use soft bristle dental brushes.
I have tried 5% Amlexanox oral paste (Lexanox Â®) as it decreases healing time and pain. It also prevents recurrences if applied in the prodromal stage. It seems very safe and effective for the treatment of recurrent minor aphthous ulcers.
Rebamipide (RebagenÂ®) is also used as a long-term treatment for recurrent oral aphthous, given 100 mg three times a day for 7 days.
For isolated Apthous ulcers I try cauterizing with Caustic-Silver nitrate after giving local anesthesia.