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In some cases, biopsy of the ulcer may be necessary.

Conventional treatments include topical steroids, mouthwash, or an oral paste for symptomatic relief. In severe cases, systemic glucocorticoids may be prescribed.

Therapeutic Considerations

1) Avoid toothpastes containing sodium lauryl sulfate

Sodium lauryl sulfate (SLS) is an irritant detergent commonly found in toothpaste. People with recurrent canker sores may benefit by switching to a brand of toothpaste that does not contain SLS, which is believed to abrade the protective mucus layer in the mouth and increase the likelihood of developing canker sores.

Research studies have found a decreased incidence of recurrent canker sores after two months of avoiding SLS, however, one double-blind study did not support this finding.

2) Deglycyrrhizinated licorice (DGL)

DGL is the herb licorice that has had the glycyrrhizic acid removed, the portion that can increase blood pressure. In one research study, DGL was found to promote the healing of canker sores, with a 50-75% improvement in one day. This study used a mouthwash made of powdered DGL mixed with water.