Health Tips

We can all agree that mouth ulcer is such a nuisance. It is the nemesis to all the spicy food lover --- bid goodbye to your favourite Nasi Lemak. But it does not have to be that way. There are various products available in your nearby pharmacy store that can relieve the pain and make your mouth ulcer heals faster. 

But before that, what is mouth ulcer? How does it come about?

Background of Mouth Ulcer

Mouth ulcer is medically known as an aphthous ulcer. It is a common condition characterised by superficial, painful oral lesions. Majority of the people will have a minor aphthous ulcer (MAU), the mildest form of mouth ulcer. More serious mouth ulcers include major aphthous ulcer, herpetiform ulcers;  or those caused by herpes simplex infections, medications, oral cancer or Steven-Johnson Syndrome. Mild mouth ulcer usually takes 7 to 14 days to heal, while the pain may subside after 3 to 4 days. Depending on the cause, some mouth ulcers tend to reoccur after a few weeks to months.

Products that can be used for mouth ulcers

Typically, a pharmacist would recommend you one or more of the following medications for mouth ulcers: local anaesthetics, choline salicylate, chlorhexidine mouthwash, corticosteroids, NSAIDs and/or protectants. Many products in the market today have a combination of at least two of those ingredients.

Local anaesthetics

This group of products is useful to provide quick relief to the pain caused by mouth ulcers. However, due to their short duration of action, you might have to apply it frequently (e.g. apply every 20 minutes), which is inconvenient for some of the busier individuals. These products contain the anaesthetics called lidocaine, which is generally safe but may elicit allergic reactions in some people. 

Example of product: Medijel®

Choline salicylate

Products contain choline salicylate are effective for pain relief in mouth ulcer as well. You may find these products in the over-the-counter section in any community pharmacies. They are regarded as safe for adults and children over 16 years old. However, the manufacturer of these products does not recommend children younger than 16 years old to use this group of products due to the concern of developing Reye Syndrome. Nevertheless, the use of choline salicylate among young children is still up for debate in the medical community. You are encouraged to speak to a doctor or pharmacist if you wish to offer these products to young children or babies.

Examples of product: Bonjela® gel, Oral Aid® gel

Chlorhexidine mouthwash

Chlorhexidine mouthwash is not being used to treat the ulcer itself, but rather for the treatment and prevention of gingivitis and maintenance of oral hygiene, which also contributes to the management of mouth ulcer. You may rinse around your mouth with 10 ml of the mouthwash for about 1 minute twice a day. Some of the side effects of chlorhexidine mouthwash include tongue and tooth discolouration, burning of the tongue and change in taste. 

Examples of product: Oradex® Antibacterial mouthwash, Bactidol®  

Corticosteroids 

These are the ‘strongest’ products you can get for mouth ulcer. As corticosteroid is a controlled medicine, these products are stored in the pharmacy shelf, which can only be dispensed by the pharmacist. Corticosteroid is effective in reducing inflammation caused by the mouth ulcer. It should not be used long-term and is regarded as safe for adults and children above 12 years old.

E.g. Oral Aid® Lotion, Kanolone® oral base

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are also effective for pain relief and reducing inflammation in mouth ulcer. In most of the pharmacies in Malaysia, the only NSAID used for mouth ulcer is benzydamine. Other NSAIDs such as diclofenac (Voltaren®, Voren®), meloxicam (Mobic®)  and mefenamic acid (Ponstan®) are only reserved for other types of more severe pain. You should not take those medications for mild mouth ulcer without talking to your doctor or pharmacist.

Example of product: Difflam® mouth gel

Protectants

As the name suggests, protectants can cover the mouth ulcers, thus hasten up the healing process. This group of products can be found in the over-the-counter section in a pharmacy and is safe to be used by any age groups and pregnant women. Protectants are available in gel or spray form. Do remember to avoid eating or drinking for at least an hour after applying it. 

Example of product: Aloclair® gel and spray

Tell your doctor or pharmacist if you:

• Experience painless ulcers, as it may suggest a more serious condition such as cancer.

• Have other lesions outside the mouth.

• Have many large (>1cm) ulcers 

• Suspect that it is caused by a new medication, herbs or supplements that you just started on.

• Pregnant or breastfeeding

• Have blisters on hands and feet, and have cold-like symptoms and fever. This suggests hand, foot and mouth disease (HFMD). 

Written by

Ms.Toh Ker Ro