Herbs that may be helpful
Licorice that has had the glycyrrhizic acid
removed is called deglycyrrhizinated licorice (DGL). Glycyrrhizic acid is the portion of
licorice root that can increase blood pressure
and cause water retention in some people. The
wound-healing and soothing components of the
root remain in DGL.
A mixture of DGL and warm water applied to the inside of the mouth may shorten the healing
time for canker sores, according to a double-blind trial.32 This DGL mixture is
made by combining 200 mg of powdered DGL and 200 ml of warm water. It can then be swished in
the mouth for two to three minutes, then spit out. This procedure may be repeated each morning
and evening for one week. Chewable DGL tablets may be an acceptable substitute.
A gel containing the aloe polysaccharide
acemannon was found in one double-blind trial to speed the healing of canker sores better than
the conventional treatment Orabase Plain®.33 The gel was applied four times
daily. Because acemannon levels can vary widely in commercial aloe gel products, it is
difficult to translate these results to the use of aloe gel for canker sores.
The antiviral, immune-enhancing, and
wound-healing properties of echinacea may make
this herb a reasonable choice for canker sores. Liquid echinacea in the amount of 4 ml can be
swished in the mouth for two to three minutes, then swallowed. This procedure may be repeated
three times per day. However, no research has investigated the possible effects of this
Because of its soothing effect on mucous membranes (including the lining of the mouth) and
its healing properties, chamomile may be tried
for canker sores and other mouth irritations.34 A strong tea made from chamomile
tincture can be swished in the mouth before swallowing, three to four times per day. Goldenseal has also been used historically as a
mouthwash to help heal canker sores.
Myrrh, another traditional remedy with
wound-healing properties, has a long history of use for mouth and gum irritations. Some
herbalists suggest mixing 200 to 300 mg of herbal extract or 4 ml of myrrh tincture with warm
water and swishing it in the mouth before swallowing; this can be done two to three times per
Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain
tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth
rinse and then are spit out. None of these herbs has been studied in modern times. Examples of
astringent herbs include agrimony, cranesbill,
tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German
Commission E for local inflammations of the mouth, presumably a condition that includes canker
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
1. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis
2. Ferguson R, Basu MK, Asquith P, Cooke WT. Jejunal mucosal
abnormalities in patients with recurrent aphthous ulceration. Br Med J
3. Ferguson MM, Wray D, Carmichael HA, et al. Coeliac disease associated
with recurrent aphthae. Gut 1980;21:223–6.
4. Hunter IP, Ferguson MM, Scully C, et al. Effects of dietary gluten
elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten
enteropathy. Oral Surg Oral Med Oral Pathol 1993;75:595–8.
5. O’Farrelly C, O’Mahony C, Graeme-Cook F, et al. Gliadin
antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J
Oral Pathol Med 1991;20:476–8.
6. Hay KD, Reade PC. The use of an elimination diet in the treatment of
recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol
7. Wright A, Ryan FP, Willingham SE, et al. Food allergy or intolerance
in severe recurrent aphthous ulceration of the mouth. BMJ 1986;292:1237.
8. Nolan A, Lamey PJ, Milligan KA, Forsyth A. Recurrent aphthous
ulceration and food sensitivity. J Oral Pathol Med
9. Wray D, Vlagopoulos TP, Siraganian RP. Food allergens and basophil
histamine release in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol
10. Chanine L, Sempson N, Wagoner C. The effect of sodium lauryl sulfate
on recurrent aphthous ulcers: a clinical study. Compend Contin Educ Dent
11. Herlosfson BB, Barkvoll P. Sodium lauryl sulfate and recurrent
aphthous ulcers. A preliminary trial. Acta Odontol Scand 1994;52:257–9.
12. Herlosfson BB, Barkvoll P. The effect of two toothpaste detergents on
the frequency of recurrent aphthous ulcers. Acta Odontol Scand
13. McCartan BE, Lamey PJ, Wallace AM. Salivary cortisol and anxiety in
recurrent aphthous stomatitis. J Oral Pathol Med 1996;25:357–9.
14. Pedersen A. Psychologic stress and recurrent aphthous ulceration.
J Oral Pathol Med 1989;18:119–22.
15. Porter SR, Scully C, Flint S. Hematologic status in recurrent
aphthous stomatitis compared to other oral disease. Oral Surg Oral Med Oral Pathol
16. Palopoli J, Waxman J. Recurrent aphthous stomatitis and vitamin B12
deficiency. South Med J 1990;83:475–7.
17. Wray D, Ferguson MM, Hutcheon WA, Dagg JH. Nutritional deficiencies
in recurrent aphthae. J Oral Pathol 1978;7:418–23.
18. Barnadas MA, Remacha A, Condomines J, de Moragas JM. [Hematologic
deficiencies in patients with recurrent oral aphthae]. Med Clin (Barc)
1997;109:85–7 [in Spanish].
19. Olson JA, Feinberg I, Silverman S, et al. Serum vitamin B12, folate,
and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol
20. Weusten BL, van de Wiel A. Aphthous ulcers and vitamin B12
deficiency. Neth J Med 1998;53:172–5.
21. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis:
the efficacy of replacement therapy in patients with underlying hematinic deficiencies.
Ann Dent 1992;51:14–6.
22. Wray D, Ferguson MM, Mason DK, et al. Recurrent aphthae: treatment
with vitamin B12, folic acid, and iron. Br Med J 1975;2(5969):490–3.
23. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous
ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral
Pathol Med 1991;20:389–91.
24. Haisraeli-Shalish M, Livneh A, Katz J, et al. Recurrent aphthous
stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod
25. Pang JF. Relation between treatment with traditional Chinese medicine
for recurrent aphthous ulcer and human zinc and copper. Zhongguo Zhong Xi Yi Jie He Za
Zhi 1992;12:280–2, 260–1 [in Chinese].
26. Endre L. Recurrent aphthous ulceration with zinc deficiency and
cellular immune deficiency. Oral Surg Oral Med Oral Pathol 1991;72:559–61.
27. Merchant HW, Gangarosa LP, Glassman AB, Sobel RE. Zinc sulfate
supplementation for treatment of recurring oral ulcers. South Med J
28. Wray D. A double-blind trial of systemic zinc sulfate in recurrent
aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469–72.
29. James APR. Common dermatologic disorders. CIBA Clin Symposia
30. Werbach MR. Nutritional Influences on Illness, 2d ed.
Tarzana, CA: Third Line Press, 1993, 56 [review].
31. Gerenrich RL, Hart RW. Treatment of oral ulcerations with Bacid
(Lactobacillus acidophilus). Oral Surg 1970;30:196–200.
32. Das SK, Gulati AK, Singh VP. Deglycyrrhizinated licorice in aphthous
ulcers. J Assoc Physicians India 1989; 37:647.
33. Plemons JM, Reps TD, Binnie WH, et al. Evaluation of acemannan in the
treatment of recurrent aphthous stomatitis. Wounds 1994;6:40–5.
34. Nasemann T. Kamillosan therapy in dermatology. Z
Allgemeinmed 1975; 25:1105–6.