These agents have been found to be particular effective in the management of recurrent minor aphthous ulcers. [1] a preparation of Triamcinolone 0.1% can be applied to ulcers two to four times a day. This treatment also provides a protective local coating for the ulcer. [1] The use of Immune Modulators in the management and treatment of aphthous ulcers is more aligned to research in those patients who have HIV / AIDS. In these patients the healing times of the ulcers may be protracted due to the depressed immune response. A treatment for ulcers that has been found to be effective is Thalidomide (Thalomid). [1]

However, as McBride (2001) points out,"... Thalidomide is contraindicated in non-HIV infected patients because of its potential for significant side effects and teratogenicity..." [1].

There are a number of other strategies and agents that can provide relief to the sufferer of this condition. One of these is the use of 2% viscous lidocaine applied with a cotton swab several times daily. [1] benzocaine preparations that can be obtained from pharmacies can also be used to alleviate the symptoms of the ulcers and over-the-counter agents such as Orabase or Zilactin-B coat aphthous ulcers and provide local protection. [1] Prescription topical corticosteroids such as Kenalog can help to deal with painful ulcers that are difficult to heal. [2]

There is an extensive range of alternative remedies that claim to help with the alleviation of symptoms and the promotion of the healing process. For example, the use of Vitamin C, vitamin B complex and lysine "...may speed healing when taken orally at the onset of lesions..." [1]. Other remedies include herbal combinations, such as sage and chamomile mouthwash. Echinacea is also reported to speed healing through its positive effect on the modulation of the immune...

Other natural remedies that has often been cited as helpful in the control of the symptoms of this condition include carrots, celery and cantaloupe juices. However the literature also notes that these agents and remedies have not been tested on scientific and controlled tests.
Another aspect that is germane to the management of oral aphthae is the control of diet and the avoidance of food and commercial products that can either trigger or worsen the ulcers. [2] lack of certain essential vitamins and minerals in a diet may also be a factor in the control of minor aphthous ulceration.

4. Conclusion

The literature on this subject makes it evidently clear that aphthous ulcers are not well understood in a clinical sense. As discussed, in the absence of a definitive etiology, the management of this condition has tended to focus on 'potentiating factors' and preventative strategies. To this end there is a wide array of agents and medications that can help to alleviate the symptoms and possibly accelerate the healing process of the condition. These include anti-inflammatories, immune modulators and alternative products.

The literature also notes that the ulcers are slow to heal where there are other with there are other associated conditions present, such as uveitis, arthritis, fever, or adenopathy. [1].