Timely therapy for oral ulcers

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What are the most time efficient interventions to shorten the duration of oral ulcers?
—Hillel B. Naiman, MD, Spring Valley, N.Y.

First, it is important to ascertain the diagnosis. The differential diagnosis could include aphthous ulcers, trauma, and, rarely, intraoral herpes simplex, as well as many other rare entities. Assuming that the diagnosis is aphthous ulcers, one very effective intervention is local intralesional injection of triamcinolone acetonide suspension. I use 0.1-0.3 cc of triamcinolone in a 10-mg/cc concentration. This can help reduce pain and time to healing.
—Jeffrey M. Weinberg, MD (121-3)

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