What is the most effective way to treat recurrent canker sores?
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Amlexanox appears to be most effective overall. Amlexanox 5% paste reduces ulcer size, pain duration, and healing time (strength of recommendation [SOR]: A, multiple randomized controlled trials [RCTs]). Topical steroids may alleviate pain and decrease ulcer burden, defined as total number of ulcers over a measured time, usually 4 to 6 weeks (SOR: B, multiple small heterogenous RCTs). Chemical cautery agents also lessen pain (SOR: A, single RCTs on differing agents), and chlorhexidine mouthwashes may reduce overall ulcer burden (SOR: B, heterogeneous RCTs). The herbal preparation Eupatorium laevigatum alleviates pain and improves healing (SOR: B, single RCT). Oral vitamin B12 supplements and avoiding toothpastes containing sodium lauryl sulfate may prevent recurrent ulcers (SOR: B, small RCTs).
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