Medicines for mouth ulcers

Key points about mouth ulcer medication

  • Most mouth ulcers clear up on their own within 1–2 weeks.
  • If your ulcer is painful or not healing as quickly as you think it should, there are treatments you can use.
  • Mouth ulcer medicines help protect the ulcerated area, relieve pain, reduce swelling or prevent further infection. 
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Mouth ulcer medicines help protect the ulcerated area, relieve pain, reduce swelling or prevent further infection. The choice of medicine will depend on the severity of the discomfort you are experiencing and the cause of the ulcer. You can buy some treatments from your pharmacy. Talk to your pharmacist about the right one for you. 

If you have had a mouth ulcer for more than 3 weeks, see your doctor. They can check that it's not serious. They may prescribe a stronger medication to treat severe, recurrent or infected mouth ulcers. Read more about mouth ulcers.

Take paracetamol for pain relief. Read more about paracetamol.

Salt-water (saline) mouthwashes can help relieve pain and can be prepared by mixing half a teaspoon of salt in a glass of warm water. Rinse your mouth as needed and spit out. Repeat as often as you like.

Antiseptic mouthwashes such as chlorhexidine mouthwash are used to prevent secondary infection, by reducing the build-up of bacteria. Rinse your mouth with the mouthwash, and spit out (do not swallow) twice a day. It should not be used within 30 minutes of using toothpaste.

You can buy Orabase® paste from your Pharmacy. Orabase® paste acts as a protective covering when applied to the mouth ulcer. This helps to prevent irritation from foods and drinks, and eases discomfort.

A small amount of paste is dabbed on the affected area as often as needed, particularly after eating. Do not rub it in. 

Steroid-containing pastes can be bought from your pharmacy without a prescription, after consultation with your pharmacist. They may be used for some forms of mouth ulcers but are not suitable if you have got a viral, bacterial or fungal infection in your mouth or throat (eg, oral thrush) as steroids can make these infections worse. Check with your pharmacist if steroid-containing pastes are suitable for you. 

Steroid-containing pastes help to relieve pain, inflammation (redness), discomfort and accelerate healing. A small amount of paste is pressed or dabbed on the affected area. Do not rub it in. These pastes are best applied at bedtime (allowing the paste to work throughout the night) but depending on how severe your symptoms are, it may be necessary to apply it 2–3 times a day, preferably after meals. 

Pain relievers applied to the affected area may be in the form of mouthwash, spray, gel or lozenges. They offer pain relief to the area in and around the ulcer. They have a limited role in the management of mouth ulcers because they work for only a short duration. Examples of local analgesics include:

  • Lidocaine gel (Xylocaine®Mucosoothe) can be applied thinly to the ulcer using a cotton bud.
  • Benzydamine mouthwash or spray (Difflam®) may reduce pain from mouth ulcers or mucositis (inflammation of mucus membranes) after radiation therapy. Some people find the full-strength mouthwash stings, but it can be diluted with an equal volume of water if needed.
  • Choline salicylate dental gel (eg, Bonjela® and Ora-sed®) may relieve discomfort. Before applying the gel, wipe the surface free of mucus, then apply a small amount of gel (cover the tip of the index finger) and rub into affected area not more often than every 3 hours. Avoid getting it on your dentures – wait at least 30 minutes after use before putting dentures back in. 

Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Sharon Leitch, GP and Senior Lecturer, University of Otago

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