Getting a canker sore can be a real nuisance. You are likely in for about a week of mouth pain, especially when you try to eat anything spicy or acidic such as an orange or tomato. For most of us it's a temporary situation and our mouth ulcer will soon heal without treatment. But for some unlucky people, no matter how many home remedies for canker sores they try, nothing seems to work. So if your pain gets worse, you have a lot of problems eating or drinking, if you have a really large sore, or they keep coming back, it's time to see a doctor or dentist.
In addition to an examination to rule out other things that could mimic canker sores, such as oral cancer, your doctor might want to run some tests, including food sensitivities (a frequent cause of mouth ulcers) or a vitamin deficiency, which is another possible cause of repeated outbreaks. He can also prescribe something to help make you feel better. There are several types of drugs, both topical and oral treatments, your health care provider may suggest.
Cauterize
One class of treatment cauterizes canker sores. In other words, it chemically burns the ulcer, killing the nerve endings and creating a protective cover over the lesion. There are several possibilities; silver nitrate is one option. This comes in stick form and is not a prescription-only item. You may be able to find it yourself, but it is best to have a professional apply it to your canker sore so you don't overdo it and hurt yourself. Most people find they experience a sizable reduction in pain shortly after the stick is applied. It doesn't really help healing, although it's possible you could shave a few days off. There is also a prescription-only drug called Debaterol which performs similarly to the silver nitrate, and can also offer fairly quick relief.
Anti-Inflammatories
Another type of medical treatment is an anti-inflammatory ointment. One commonly used is called Triamcinolone Acetonide,also known as Kenalog in Orabase. It is helpful for easing the pain and discomfort but it doesn't promote healing. This ointment can be applied several times a day; the trick is keeping it in place without it washing off. Dexamethasone is a mouth rinse that also helps reduce inflammation and it can provide some pain relief as well. This is something you would swirl in your mouth; it is not meant to be swallowed.
Numbing Agents
A prescription numbing gel such as Viscous Lidocaine is also sometimes used. I am not a big fan of this topical treatment, as you have to be careful not to swallow any of the gel, and trying to refrain from that when it's coating your mouth is not an easy feat.
Corticosteroids
Oral corticosteroids are occasionally used when other, more common treatments fail. They are used In the toughest cases only because steroids can have unpleasant side effects. They can cause weight gain, brittle bones and other potential serious issues and should not be taken lightly.
Other Medications
In some situations medications used for other purposes such as rheumatoid arthritis (RA) have been used successfully. Again, there can be considerable side effects and they are expensive, so they are not the first-line choice. Typical options include Enbrel and Remicade and they are usually given via infusion.
I want to reiterate that most of the time, medical treatment for your canker sores is not necessary. Most people find relief using home remedies. But there are times when medical intervention may be required. As a reminder, if your canker sores last an unusually long time, more than 2-3 weeks, you should seek medical care to rule out other conditions. If you get frequent outbreaks, it may be because of an underlying condition. With your doctor's help, you can figure out what that is and hopefully reduce or eliminate your outbreaks.
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