How are aphthous ulcers prevented?

Updated: Feb 25, 2019
  • Author: Michael C Plewa, MD; Chief Editor: Russell W Steele, MD  more...
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  • Dietary supplementation with vitamins, zinc, [92] or iron may prevent recurrence of aphthous ulcers (canker sores) in some individuals. Studies of lysine supplementation are preliminary and equivocal. [83]

  • Vitamin B12 supplementation may prevent ulcer recurrence even when B12 values are normal. [79, 80, 81]

  • A gluten-free diet is unlikely to improve recurrent aphthous ulcers (RAUs), or canker sores, [93] unless the patient has celiac disease (gluten-sensitive enteropathy), which may be present in as many as 5% of patients in whom recurrent aphthous ulcers (canker sores) are initially diagnosed.

  • Susceptible patients may benefit from avoiding toothpaste or mouthwash products containing sodium lauryl sulfate (SLS). [26, 27]

  • Use of a low-intensity ultrasound toothbrush may decrease recurrent aphthous ulcers (canker sores) activity. [94]

  • Regular use of a mouthguard while sleeping may also decrease recurrent aphthous ulcers (canker sores). [85]

  • Use of mouthwash or toothpaste with triclosan [95] or amyloglucosidase and glucose oxidase (Zendium) may decrease recurrent aphthous ulcers (canker sores). [96]

  • Stress reduction may be useful, although evidence for this intervention is lacking.

  • Although numerous reasons abound for convincing a pediatric patient to quit smoking or chewing tobacco, cessation does not have a beneficial effect on recurrent aphthous ulcers (canker sores), which nicotine appears to prevent.

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