The March 2001 JADA has two items that I believe are related.
Dr. Mark J. Kutcher and colleagues’ article ("Evaluation of a Bioadhesive Device for the Management of Aphthous Ulcers") regarding a bioadhesive device for management of aphthous ulcers offers promising therapy for these painful lesions.
In the News section, scientists at the National Institute of Dental and Craniofacial Research report that wound healing was markedly impaired in animal models without the gene for the protein secretory leukocyte inhibitor, or SLPI.
They found increased inflammation and activity of the enzyme elastase, which destroys tissues. When researchers topically applied SLPI to the wounds, they found that it reversed tissue destruction and hastened healing. These fluids bathe mucosal surfaces, and the researchers go on to say that SLPI has anti-inflammatory, antiviral, antifungal and antibacterial properties. They further note that nature’s way of healing may be the reason that animals instinctively lick their wounds.
When vitamin E and vitamin E oil were touted as cures for so many ailments in the late 1980s, I began having my patients rub the oil on painful aphthous ulcers. They seemed to show improvement, but over time we began to feel that it was not the oil but the removal of the white covering that promoted healing.
Since then, I have had many patients, as well as family and friends, experience a shortened duration of pain if they catch the lesion early, use a topical such as Anbesol or just tolerate the discomfort and rotate a cotton tip applicator to the lesion until, ideally, they get a bleeding surface. If this is done early, and particularly if it is repeated several times, the pain and duration is generally much reduced.1
The good results we saw in patients may well be related to the ability of SLPI to reach the depths of the crater once the protective plug has been removed. I would first consider "nature’s cure" rather than a bioprotective device on selected patients and observe the results. Where self-treatment is ineffective, proceed to newer or traditional remedies.
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