Over the counter product: CankerMelts
Discussion: Aphthous stomatitis, or
canker sores, are noncontagious mouth ulcers/sores afflicting 25% of the Ameri- can population, primarily females younger than 20 years. Recurrent outbreaks may occur three to four times a year.1 Specific causes are unknown; however, stress, trauma, infections, and hormonal changes during menses have been associated with outbreaks.2–4 Initial symptoms are various sized white/yellowish/gray lesions in the form of liquid-filled craters surrounded by an erythematous halo. These heal spon- taneously within 1 to 2 weeks.1 The ulcers are very painful, worsening with eating/ drinking. No cure exists for canker sores, although symptomatic relief is available. Treatment goals are controlling pain, promoting healing, and preventing recur- rence using peroxide solutions, topical anesthetics, topical protectants, topical steroids, and/or systemic analgesics.5,6 Complementary alternative medicine has also been used including, licorice (GX) and slippery elm.
Licorice root contains GX, specifically flavanoids, which have antioxidant, anti- inflammatory, and antiviral properties.7 In a small 1989 study, a licorice root extract rinse was administered with significant reduction in pain and lesion duration, although palatability was an issue.
Orahealth, along with the National Institutes of Health and the University of Washington, developed a highly concen- trated, palatable, oral GX-containing disk that self-adheres on or adjacent to the ulcer.9 Haley et al.10 reported that 26 of 27 patients using the disk reported heal- ing of their lesions within 3 days and pain relief within 5 minutes of application. The results of a follow-up study indicated sig- nificant benefits in pain reduction and visual ulcer resolution.11–13 Although small studies have demonstrated potential ben- efit and genotoxic studies have indicated that GX is neither mutagenic nor terato- genic, use of GX requires further study.14 Each disk contains natural GX 30 mg with added collagen, which, according to the manufacturer, aids in reducing pain and pain duration. To experience systemic adverse effects, the patient would have to use at least 90 discs within a 72-hour period. As an alternative medicine, the safety and effectiveness of GX have not been demonstrated to FDA, and phar- macists making such recommendations risk the legal consequences of making unsupported verbal claims for unproven products.
Category: Canker sore treatment
Manufacturer: Orahealth
Ingredient: Licorice (glycyrrhiza
root extract [GX]) with added collagen
Use: Treatment of symptomatic aphthous
ulcers
Availability: Package of 12 timereleased
adhesive disks
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