title: The treatment of chronic recurrent oral aphthous ulcers.
abstract: BACKGROUND
  Chronic recurrent oral aphthous ulcers are the most common type of inflammatory efflorescence of the oral mucosa, with a prevalence of 2% to 10% in Caucasian populations. To treat them properly, physicians should know their clinical appearance and course, conditioning factors, underlying causes, and differential diagnosis.
  
  
  METHODS
  This review is based on pertinent articles that were retrieved by a selective search in PubMed and in the Cochrane Central Register of Controlled Trials.
  
  
  RESULTS
  Hard, acidic, and salty foods and toothpastes containing sodium lauryl sulfate should be avoided, along with alcohol and carbonated drinks. In Germany, the only drugs that have been approved to treat oral aphthous ulcers are corticosteroids, topical antiseptic/anti-inflammatory agents such as triclosan and diclofenac, and local anesthetics such as lidocaine. Antiseptic agents and local anesthetics should be tried first; if these are ineffective, topical cortico steroids should be used. In severe cases, local measures can be combined with systemic drugs, e.g., colchicine, pentoxifylline, or prednisolone. The efficacy of systemic treatment is debated. Other immunosuppressive agents should be given systemically only for refractory or particularly severe oral aphthous ulcers due to Adamantiades-Behçet disease.
  
  
  CONCLUSIONS
  The treatment of chronic recurrent oral aphthous ulcers is symptomatic, mainly with topically applied agents. It is tailored to the severity of the problem in the individual case, i.e., the frequency of ulcers, the intensity of pain, and the responsiveness of the lesions to treatment. Effective treatment relieves pain, lessens functional impairment, and lowers the frequency and severity of recurrences.
authors.affiliation: Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Pharmacy, Dessau Medical Center, Department of Dermatology and Andrology, Faculty of Medicine, Ain Shams University, Cairo (Egypt).
authors.forename: Andreas
authors.initials: A
authors.lastname: Altenburg
authors.forename: Nadine
authors.initials: N
authors.lastname: El-Haj
authors.forename: Christiana
authors.initials: C
authors.lastname: Micheli
authors.forename: Marion
authors.initials: M
authors.lastname: Puttkammer
authors.forename: Mohammed Badawy
authors.initials: MB
authors.lastname: Abdel-Naser
authors.forename: Christos C
authors.initials: CC
authors.lastname: Zouboulis
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000379:methods*; D004035:Diet Therapy / Q000379:methods; D005157:Facial Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D012008:Recurrence; D013281:Stomatitis, Aphthous / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local; D000891:Anti-Infective Agents, Local; D000893:Anti-Inflammatory Agents; D008012:Lidocaine