The vast majority of people with<unk>  have minor symptoms and do not require any specific therapy. The pain is often tolerable with simple dietary modification during an episode of ulceration such as avoiding spicy and acidic foods and beverages. Many different topical and systemic medications have been proposed (see table), sometimes showing little or no evidence of usefulness when formally investigated. Some of the results of interventions for RAS may in truth represent a placebo effect. No therapy is curative, with treatment aiming to relieve pain, promote healing and reduce the frequency of episodes of ulceration. Medication The first line of therapy for<unk>  is topical agents rather than systemic medication, with topical corticosteroids being the mainstay treatment. Systemic treatment is usually reserved for severe disease due to the risk of adverse side effects associated with many of these agents. A systematic review found that no single systemic intervention was found to be effective. Good oral hygiene is important to prevent secondary infection of the ulcers. Occasionally, in females where ulceration is correlated to the menstrual cycle or to birth control pills, progestogen or a change in birth control may be beneficial. Use of nicotine replacement therapy for people who have developed oral ulceration after stopping smoking has also been reported. Starting smoking again does not usually lessen the condition. Trauma can be reduced by avoiding rough or sharp foodstuffs and by brushing teeth with care. If sodium lauryl sulfate is suspected to be the cause, avoidance of products containing this chemical may be useful and prevent recurrence in some individuals. Similarly patch testing may indicate that food allergy is responsible, and the diet modified accordingly. If investigations reveal deficiency states, correction of the deficiency may result in resolution of the ulceration. For example, there is some evidence that vitamin B12 supplementation may prevent recurrence in some individuals. Medications Drug type Intended action Example(s) Topical covering agents / barriers Reduce pain Orabase (often combined with triamcinolone). Topical analgesics / anesthetics / anti-inflammatory agents Reduce pain Benzydamine hydrochloride mouthwash or spray, Amlexanox paste, viscous lidocaine, diclofenac in hyaluronan. Topical antiseptics Speed healing (prevent secondary infection) Doxycycline, tetracycline, minocycline, chlorhexidine gluconate, triclosan. Topical mild potency corticosteroids Reduce inflammation Hydrocortisone sodium succinate. Topical moderate potency corticosteroids Reduce inflammation Beclomethasone dipropionate aerosol, fluocinonide, clobetasol, betamethasone sodium phosphate, dexamethasone. Systemic medications Various, mostly modulating immune response Prednisolone, colchicine, pentoxifylline, azathioprine, thalidomide, dapsone, mycophenolate mofetil, adalimumab, vitamin B12, Clofazimine, Levamisole, Montelukast, Sulodexide, Other Surgical excision of<unk>  ulcers has been described, but it is an ineffective and inappropriate treatment. Silver nitrate has also been used as a chemical cauterant. Apart from the mainstream approaches detailed above, there are numerous treatments of unproven effectiveness, ranging from herbal remedies to otherwise alternative treatments, including Aloe vera, Myrtus communis, Rosa damascena, potassium alum, zinc sulfate, nicotine, polio virus vaccine and prostaglandin E2. Finally, a steroid rinse known as dexamethasone elixir has shown to be quite effective against pre-sores (which usually present themselves as small, reddish bumps), as well as sores that are already in existence.
Aphthous stomatitis
Herpes labialis
Contact stomatitis
Denture-related stomatitis
Bovine papular stomatitis
Oral candidiasis
Adenoviral keratoconjunctivitis
Dermatophagia