Exodontia.Info
Treatment of Oral Diseases
Oral Ulcers

Relief of Pain

  • Non-Steroidal Anti-Inflammatory Drugs (NSAID's)
  • Paracetamol
  • Codeine
  • Benzocaine lozenges (Merocaine / Dequacaine)
  • Xylocaine 2% gel
  • Difflam M/W

Healing of Ulcers

  • Tetracycline 250 mg capsules QDS M/W. Dissolve in
    10 mls water and hold in mouth > 2 mins. Also used
    for herpetiform oral ulceration
  • Mysteclin analogue: 1 Tetracycline capsule in 10 mls
    water + 1 ml Nystatin suspension
  • Chlorhexidine M/W

Prevention of New Ulcers

  • Corlan (Hydrocortisone) 2.5 mg lozenges. Sucked
    QDS. Initially for 2 - 3 months
  • Adcortyl in Orabase (Triamcinolone). Applied to
    individual ulcers & nocté. Best anteriorly
  • Betnesol (Betamethasone) 0.5 mg tablets dissolved in
    water & hold in mouth > 3 mins. QDS
  • Bextasol (Betamethasone valerate) spray & Becotide
    (Beclomethasone) inhaler. 1 puff TDS / QDS to
    affected area.
  • Prednesol (Prednisolone) 5 mg tablets dissolved in
    water & hold in mouth > 3 mins. QDS.
  • Prednisolone 5 mg tablets. Start at 40 mg for 4/7 and
    reduce over 2/52 to a maintenance dose of 10 mg.
    Steroid screen at 1/7, 1/12 & 3/12.
  • Azathioprine 50 mg tablets. In combination with
    Prednisolone. 100 mg OD. Hæmatological screen 1/7,
    2/12 & every 3/12.

Miscellaneous

  • Carbenoxolone 20 mg. OD / BD.
  • Cimetidine 200 - 400 mg. BD.
  • Colchicine 500 μg. OD. 2/52, reduce to 250 μg. FBC
    after 1/12; then every 3/12.
  • Dapsone 1 - 2 mg / kg body weight. OD.
  • Disodium chromoglygate 100 mg capsules as rinse for
    >3 mins & then swallowed.
  • Sulphasalazine (Salazopyrin) 250 - 500 mg (up to
    1000 mg) daily.
  • Fluocinolone (Synalar) gel. 0.25%. Apply to ulcers.
    Nocté.
  • Gengigel
  • Aspirin tablets (iii) powdered and dissolved in small
    amount of water.  Used as M/W.  Do not swallow.
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Lichen Planus

  • Betnesol (Betamethasone) 0.5 mg tablets dissolved in
    water & hold in mouth > 3 mins. QDS.water & water &
    hold in mouth
  • Bextasol (Betamethasone valerate) spray & Becotide
    (Beclomethasone) inhaler. 1 puff TDS / QDS to
    affected area.
  • Prednesol (Prednisolone) 5 mg tablets dissolved in
    water & hold in mouth
    > 3 mins. QDS.
  • Corlan (Hydrocortisone) 2.5 mg lozenges. Sucked
    QDS.
    Initially for 2 - 3 months.
  • Adcortyl in Orabase (Triamcinolone). Applied to
    individual ulcers & nocté. Best anteriorly.
  • Prednisolone 5 mg tablets. Start at 40 mg for 4/7 and
    reduce over 2/52 to a maintenance dose of 10 mg.
    Steroid screen at 1/7, 1/12 & 3/12.
  • Azathioprine 50 mg tablets. In combination with
    Prednisolone. 100 mg OD. Hæmatological screen 1/7,
    2/12 & every 3/12.

Behçet's Syndrome

  • Colchicine 500 μg. OD. 2/52, reduce to 250 μg. FBC
    after 1/12; then every 3/12.
  • Prednisolone 5 mg tablets. Start at 40 mg for 4/7 and
    reduce over 2/52 to a maintenance dose of 10 - 20
    mg. Steroid screen at 1/7, 1/12 & 3/12.
  • Azathioprine 50 mg tablets. In combination with
    Prednisolone
    (Prednisolone 10 mg alternate days, Azathioprine, 50
    mg OD). 50 - 100 mg OD. Hæmatological screen 1/7,
    2/12 & every 3/12.

Pemphigus, Pemphigoid & Erythema Multiforme

  • Prednisolone 5 mg tablets. Start at 40 mg for 4/7 and
    reduce over 2/52 to a maintenance dose of 10 - 20
    mg. Steroid screen at 1/7, 1/12 & 3/12.
  • Azathioprine 50 mg tablets. In combination with
    Prednisolone
    (Prednisolone 10mg alternate days, Azathioprine,
    50mg OD). 50 - 100 mg OD. Hæmatological screen
    1/7, 2/12 & every 3/12.

Oral Crohn's

  • Sulphasalazine (Salazopyrin) 250 - 500 mg (up to
    1000 mg) daily.
British National Formulary Medications for Oral Conditions

Emedicine Medications for Oral Ulceration
Anti-Fungals

  • Amphotericin lozenges 10mg. QDS. 10 - 14/7.
  • Miconazole gel. 25 mg / ml. QDS. 10 - 14/7.  Apply to
    lip / denture / tongue. Useful if combined with
    Amphoteracin.
  • Nystatin pastilles. 100k units. QDS. 10 - 14/7.
  • Nystatin suspension.  100k units / ml. 1ml QDS. 10 -
    14/7.
  • Fluconazole. 50 - 100 mg. OD. 10 - 14/7.

Saliva Substitutes

  • Saliva Orthana. 50 ml spray. Spray onto tongue &
    buccal mucosa PRN.
  • Polyethylene Oxide (Polyox) tablets. 150 mg
    lozenges. Suck one PRN.
  • Hypromellose M/W. 500ml. 5 mls PRN.

Atypical Facial Pain & Burning Mouth Syndrome

  • Prothiaden (Dothiepin). 75 - 150 mg. Nocté.
  • Nortriptyline 30mg & Fluphenazine 1.5 mg. 2 tablets.
    Nocté.
  • Nortriptyline 10mg & Fluphenazine 0.5 mg. 2 - 3
    tablets. Nocté. Minimum of 6 - 8/52.
  • α-Lipoic Acid

Trigeminal Neuralgia

  • Carbamazepine (Tegretol). 800 - 1200 mg daily (200
    mg QDS). Monitor plasma levels 4 - 12 mg / l. Start at
    100 mg BD & increase slowly until best result achieved.

Iron & Vitamins

  • Ferrous Sulphate. 200 mg. BD. 4 - 6/52.
  • Ferrous Fumarate. 200 mg. BD. 4 - 6/52.
  • Folic Acid. 5 mg. OD. 4 - 6/52.
  • B12 (hydroxycobalamin). 1 mg. TDS 2/52; then 1 mg
    every 2 - 3/12.
Last Updated 18th August 2010