OTC treatments for canker sores.

Off-the-shelf canker sore preparations.

While there’s no real cure for canker sores (more formally referred to as recurrent minor aphthous ulcers), there are a number of different treatment approaches that can be useful in providing palliative care (e.g. promote healing, relieve pain, prevent secondary infection).

This page explains the use of over-the-counter (OTC) treatments. These are the kinds of products you buy directly off the shelf of your local store. And their use would be most appropriate for people who just experience occasional outbreaks, involving relatively routine-sized lesions. Characteristics Page

FYI: As alternative treatment approaches, we have additional pages that describe the use of home remedy solutions Jump ahead. and prescription medications. Jump ahead.

How over-the-counter products work.

• A) SLS-free products.
• B) Protective films.
• C) Numbing agents.
• D) Antibacterial compounds.
• E) Ulcer cleansing agents.

Locations where canker sores form.

OTC canker sore treatments –

A) Sodium lauryl sulfate (SLS) free products.

Background.

A person can reduce their level of exposure to SLS simply by choosing products that have been formulated without it. And as a result, hopefully, they’ll find that they either have fewer canker sore outbreaks, or experience less intense symptoms with those lesions that do form.

Don’t overlook the fact that the use of SLS-free products can be used seamlessly with other treatment methods too.

Does this approach work?

SLS studies Study findings. haven’t been entirely conclusive about what level of benefit can be expected. However, for any one person, it should be simple enough to determine if this approach is beneficial for them.

To do so, all you need to do is some simple record keeping. Compare what you’ve experienced during alternating periods of using and not using SLS-free products. Admittedly, however, if your usual frequency of outbreaks is just occasional, coming to a definitive conclusion may take some time.

SLS-free products.

Several manufacturers formulate versions of their products without SLS. Some of the brands we’ve noticed are:

• Toothpaste – Sensodyne, Verve, Hello, Tom’s of Maine, Squigle, Rembrandt, Biotine, Burt’s Bees, Therabreath, Cleure
• Mouth rinse – Therabreath, Hello, Cleure

(If you’re aware of other brands, please mention them in a page comment below.)

You’ll probably find it easy enough to find products to use. Because it’s a selling point for them, they’re usually marked prominently with the term “SLS-free.”

Cost.

SLS-free products usually are a bit more expensive than their regular counterparts. For example, a 5 oz. tube of toothpaste might cost around 2 to 4 dollars more. So, testing to see how this approach works for you has some cost associated with it, although not a lot.

Which brands make the best choice?

In regard to canker sore prevention, it’s not having SLS in the formulation that provides the benefit. So from that standpoint, all should be equivalently effective.

• In choosing a toothpaste, we will say we seriously question the use of any one that doesn’t contain an appropriate level of fluoride (as explained on our best anti-cavity toothpaste page).

  Watch out for products labeled as being “natural” because they frequently do not contain fluoride. (By the way, most well water does naturally contain some level of fluoride, so exactly what that term means, we don’t know.)

• If you’re curious about what compounds a good mouth rinse should contain, this page addresses the subject of effective mouthwash ingredients.

B) Barrier films / Oral bandages.

Bioadhesive paste products can create a semi-lasting film over wet oral tissues, possibly for as long as 6 hours. Two such brands are Orabase® and Zilactin®.

What the film does.

When used over canker sores, this type of covering can provide two benefits:

1) It acts as a barrier. – The film helps to protect the sore from exposure to irritating substances like foods and beverages. It also helps to create a protected environment that promotes healing.

2) It can be used as a way to apply medications. – Some manufacturers add compounds to their pastes that provide some type of treatment benefit. For example, a common addition is an anesthetic Approach benefits..

Variations.

More modern formulations of these kinds of products are based on the compound cyanoacrylate. (This is the main component of “super” glue.) It helps to form a longer-lasting film. Orabase Soothe-N-Seal® was the first product of this type to receive FDA approval.

Does it work?

When you have a sore that hurts, none of these products probably creates a covering that’s as durable as you’d like.

But yes, and especially in the case of products that contain numbing agents (discussed more below), using one can provide some relief.

Tip.

▲ Section references – Dunlap, Narang

C) Numbing agents.

Comparatively larger, or especially awkwardly located, canker sores can be so sensitive to touch that a person must limit their mouth movements (eating, chewing gum, sometimes even just smiling).

In these cases, applying a medication that contains a numbing agent to the sore may make it possible for the person to return to somewhat normal activities.

What’s available?

You should be able to find products that contain compounds such as benzocaine, benzoin tincture, lidocaine, camphor, and phenol. (Benzocaine is the anesthetic compound that a dentist might rub on your gums before giving you a shot. Lidocaine is the anesthetic that’s usually given as a dental shot to numb teeth.)

• The products you find might be a liquid, gel, ointment, rinse, lozenge or spray. Or as mentioned above, some anesthetic compounds are mixed in with barrier-film pastes.
• Some of the brand names you’re likely to find are: Orabase®, Orajel®, Kank-A®, SensoGard®, Tanac®, UlcerEase®, Zilactin® and Anbesol®.

Does it work?

Numbing agents don’t speed up the healing process but yes, if you’re having a lot of pain they can provide some much-needed relief.

Tip.

▲ Section references – Altenburg

D) Antibacterial compounds.

Iodine.

Some OTC products contain antibacterial compounds such as iodine. They may either be a liquid or paste that you apply directly to the sore. The idea is that their use helps to prevent the formation of secondary bacterial infection, which would delay the healing of the lesion.

(Ora5® contains iodine and copper sulfate. The latter is an astringent that helps to reduce ulcer pain. One study reported that the use of Ora-5® did decrease ulcer size and pain (initially). But duration still exceeded 7 days and pain actually increased between days 5 and 8.) (Dale)

Triclosan.

Toothpaste or mouthwash that contains the antibacterial triclosan is another treatment approach that’s had success with canker sores. As added benefits, this compound also has analgesic (pain-relieving) and anti-inflammatory (stifles the inflammation process, thus lesion size) properties. (Altenburg)

▲ Section references – Dale, Altenburg

Rinses

Some research suggests that rinsing with prescription antibacterial solutions Proposed mechanism. can both speed up healing and lessen pain.

Listerine® (or a generic equivalent) can be used as an OTC substitute (two to three times a day). It does contain alcohol, however, which some people may find irritates their sores.

E) Cleansing agents.

Debris that accumulates on the ulcerated surface of a canker sore may interfere with its normal healing. Using an OTC cleansing agent can be a gentle way of removing it.

These types of products usually contain an active ingredient (carbamide peroxide, hydrogen peroxide or sodium perborate monohydrate) and glycerin (which makes their consistency syrupy).

When they’re applied, they release oxygen. This, in turn, creates a foaming action that helps to cleanse the lesion and carry away debris. The release of oxygen also creates an environment that’s inhospitable to some types of bacteria. The glycerin component forms a coating that helps to protect the sore. Some of the brand names associated with these kinds of products are Gly-oxide®, Amosan® and Cankaid®.

When applying these products …

Some OTC products create a stinging sensation when they are initially applied and then, usually within some moments, start to provide relief. You may be able to minimize their initial sting by numbing your sore with an ice cube first.

Also, in passing, we’ll mention that canker sores are not contagious. That means, when treating them (touching them, disposing of applicators used to apply medication, etc..), there are no special concerns about the potential to spread them. For more details: Canker sores are not contagious.