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VOLUME 9 , ISSUE 3 ( March, 2008 ) > List of Articles


Review of Over-the-counter Treatments for Aphthous Ulceration and Results from Use of a Dissolving Oral Patch Containing Glycyrrhiza Complex Herbal Extract

Jeff Burgess, Peter Van der Ven, Michael Martin, Jeffrey Sherman, Jeff Haley

Citation Information : Burgess J, Van der Ven P, Martin M, Sherman J, Haley J. Review of Over-the-counter Treatments for Aphthous Ulceration and Results from Use of a Dissolving Oral Patch Containing Glycyrrhiza Complex Herbal Extract. J Contemp Dent Pract 2008; 9 (3):88-98.

DOI: 10.5005/jcdp-9-3-88

License: CC BY-NC 3.0

Published Online: 01-09-2009

Copyright Statement:  Copyright © 2008; The Author(s).



The aim of this article is to present a review of over-the-counter (OTC) treatment strategies used for aphthous ulcerations and to provide results from the use of an herbal extract containing glycyrrhiza.


Aphthous ulceration, a disease of the intra-oral mucosa, is a common condition of unknown etiology that is often self-managed by OTC (no prescription required) medication.


Preparations currently on the market can be divided into several categories: local anesthetic agents, oxygenating agents, mouth rinses, and barriers - further subdivided into paste coverings such as gels or dissolvable or non-dissolvable adhesive patches containing plant extract or synthetic drugs. Other strategies include herbs, hematinic replacement, or off-label OTC drug applications. While many OTC treatments are available and accepted for use with aphthous ulceration, a review of the literature via a number of published research search engines suggests that to date there are no randomized controlled studies to demonstrate OTC preparations do more than manage symptoms. Exceptions include OTC cyanoacrylate products and CankerMelts® GX patches which include glycyrrhiza (licorice) extract. The use of CankerMelts has been shown to alter the course of the condition by reducing lesion duration, size, and pain.


The results of the studies reviewed here suggest CankerMelts GX discs may be as effective as amlexanox (which must be prescribed) in reducing pain and speeding healing. In addition it can be applied by the patient without the adverse events associated with cyanoacrylate formulations.


Burgess J, van der Ven P, Martin M, Sherman J, Haley J. Review of Over-the-counter Treatments for Aphthous Ulceration and Results from Use of a Dissolving Oral Patch Containing Glycyrrhiza Complex Herbal Extract. J Contemp Dent Pract 2008 March; (9)3:088-098.

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  1. Color Atlas of Common Oral Diseases, Second Edition. 1998. Lippincott. Williams and Wilkins, Philadelphia.
  2. Pharmacological management of recurrent oral mucosal ulceration. Drugs. 1990; 39(1):54-65.
  3. Semin Cutan Med Surt. 1997; 16(4):278-283.
  4. Recurrent aphthous stomatitis. Quintessence Int. 2000; 31:95-112.
  5. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med. 1998; 9:306-321.
  6. Over-the Counter Products for Oral Ulcerations; J Calif Dent Assoc. 1998;March:1-5.
  7. . Date accessed October 1, 2007.
  8. . and Date accessed November 13, 2007.
  9. Effect of hydrogen peroxide on developing plaque and gingivitis in man. J Clin Periodontol. 1979; 6(2):115-130.
  10. J Clin Periodontol. 2000; 27(1):9-15.
  11. Clincal evaluation of benzydamine, chlorhexidine, and placebo mouthwashes in the management of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol. 1987; 63:189-191
  12. Mucosal diseases series, Number VI Recurrent aphthous stomatitis. Oral Diseases. 2006; 12:1-21.
  13. Benzydamine hydrochloride in the treatment of ulceration associated with recently placed fixed orthodontic appliances. Eur J Orthod. 1986; 8(1):61-64.
  14. Photocontact dermatitis after gargling with a solution containing benzydamine. Contact Dermatitis. 2002; 47(1):53.
  15. Date accessed November 13, 2007.
  16. In vitro cytotoxicity of chlorhexidine gluconate, benzydamine-HCL and povidone iodine mouthrinses on human gingival fibroblasts. SADJ 2001; 56(10):455-460.
  17. Fatal large-volume mouthwash ingestion in an adult: a review and the possible role of phenolic compound toxicity. J Intensive Care Med. 2003; 18(3):160-162.
  18. Sodium retention from mouthwashes. Clin Prev Dent. 1989; 11(4):3-6.
  19. Use of proprietary agents to relieve recurrent aphthous stomatitis. Br Dent J. 1997; 182(4):144-146.
  20. Chlorhexidine gluconate mouthwash in the management of minor aphthous ulceration. A double blind, placebo-controlled cross-over trial. Br Dent J. 1987; 162:106-110.
  21. Habitane in the treatment of aphthous ulceratiohn. J Clin Periodontol. 1977; 4(5):108-116.
  22. Mouthrinses. Adv Dent Res. 1994; 8(2): 291-301.
  23. Date accessed September 13, 2007.
  24. Date accessed September 13, 2007.
  25. Date accessed September 13, 2007.
  26. Mucosal Diseases Series Number VI, Recurrent Aphthous Stomatitis. Oral Dis. 2006; 12:1-21.
  27. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying haematinic deficiencies. Ann Dent 1992; 51:14-16.
  28. Date accessed, September 13, 2007.
  29. Norwegian LongoVital and recurrent aphthous ulceration: a randomized, double-blind, placebo-controlled study. Oral Dis. 2005; 11(6):374-378.
  30. The effect of LongoVital on recurrent aphthous stomatitis in a controlled clinical trial. Oral Health Prev Dent. 2005; 3(1):3-8.
  31.;;;;;;;;; Date accessed September 13, 2007.
  32. Sucralfate suspension as a treatment of recurrent aphthous stomatitis. J Intern Med. 1994, 236d(3):341-343.
  33. Open preliminary clinical trial of clobetasol propionate ointment in adhesive paste for treatment of chronic oral vesiculoerosive diseases. Oral Surg Oral Med Oral Pathol. 1991; 71:283-287.
  34. Selecting topical and systemic agents for recurrent aphthous stomatitis. Cutis. 2001; 68:201-206.
  35. Use of Honey in Treatment of Aphthous Ulcers. Abstract 1262, IADR 83rd General Session, March 9-12, 2005.
  36. Intraoral digital imaging documenting recurrent aphthous ulcer healing in 2-octyl cyanoacrylate versus sham-treated lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 89:425-431.
  37. A clinical trial on isobutyl cyanoacrylate as a protective adhesive in recurrent aphthous ulceration (RAU). Egyptian Dent J. 1984; 30:361-372.
  38. Evaluation of a bioadhesive device for the management of aphthous ulcers. J Am Dent Assoc. 2001; 132: 368-376.
  39. Efficacy of bioadhesive patches in the treatment of recurrent aphthous stomatitis. J Oral Pathol Med. 1996; 25(8):416-419.
  40. The effectiveness and acceptance of a medical device for the treatment of aphthous stomatitis. Clinical observation in pediatric age. Minerva Padiatr. 2000; 52(1-2):15-20.
  41. Risk and safety assessment on the consumption of Licorice root (Glycyrrhiza sp.), its extract and powder as a food ingredient, with emphasis on the pharmacology and toxicology of glycyrrhizin. Regul Toxicol Pharmacol. 2006; 46(3):167-192.
  42. Skin Pharmacol. 1990; 3(4):268-271.
  43. Deglycyrrhizinated liquorice in aphthous ulcers. J Assoc Physicians India. 1989; 37:647.
  44. 5% Amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers. Oral Surg Oral Med Oral Rathol Oral Radiol Endod. 1997;83:222-230.
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