Quote:
>Re: pain relief of aphthous ulcers with AgNO3 cautery.
>I take issue with your statement that pain goes away almost immediately.
>The very act of cauterizing the base of the ulcer with the sticks is probably
>one of the worst pains (beaten perhaps only by dental drilling sans anesthetic)
>that anyone could experience. I can remember profuse lacrimation and myoclonic
>jerks the last time I did one.
>Nevertheless, for the agony that is thus prevented I also recommend cautery.
>The sharp lancinating severe pains associated with the ulcer are replaced by
>dull ache associated with having your mouth burned. Definately worth it in my
>book :-)
As one of the multitudes afflicted with recurrent aphthous ulcers from time to
time, I did a little case control study (n=1) in the mid-70's with silver
nitrate sticks. I determined the average "life" of individual ulcers to be
8 days, by keeping track of their appearance and disappearance individually
(unhappiness is having two or three at different stages of maturation at the
same time :-(). Then I tried silver nitrate cautery on perhaps 6 or 8 of
them over a period of several months, applying the cautery at various stages--
at the time of first discomfort (< 1 mm break in mucous membrane), out to
the mature and most painful stage (3-4 mm crater). Result? Regardless of
the time of silver nitrate cautery application, the ulcers lasted (you guessed
it) 8 days. The cautery also turned a number of small ones into raging
sources of pain.
Other things that don't work? Kenalog (steroid)/Orabase cream, tetracycline,
mouthwashes, aspirin (swallowed or applied as a paste to the ulcer), megadose
vitamin C.
Things that do work appear to be all preventive: avoid foods that cause
them, avoid concurrent infections (e.g., colds), good dental hygiene including
professional plaque removal, good general health (e.g., regular exercise).
Bottom line: if you know of something which really cures your canker sores,
consider yourself one of the fortunate ones. Medical science won't help
you very much.
Dan Masys, MD