Abstract

ABSTRACT:
BACKGROUND:
Recurrent aphthous ulcer (RAU) is a common oral disease. It is treated by a variety of agents. Lactic acid has been used in the treatment of many skin diseases.
OBJECTIVE:
To assess the therapeutic, prophylactic effectiveness and safety of 5% lactic acid mouthwash in management of patients with RAU.
PATIENTS AND METHODS:
This single blind placebo controlled therapeutic study where 40 patients with early onset RAU were recruited in Department of Dermatology -Baghdad Teaching Hospital from April 2005-April 2006. Patients ages ranged 20-60 (29.6 ±9.6) years and were divided randomly into 2 groups (20 patients for each one):Group A used 5% lactic acid mouthwash,5 ml twice daily. Group B was instructed to use distilled water as placebo in a similar way to Group A. Short term assessment of each patient of both groups was done to evaluate the therapeutic effect of drug by using oral clinical manifestation index (OCMI), mean size of largest diameter of ulcers. A long term assessment was done for each patient to evaluate the prophylactic effect of drug by using OCMI before, after 1, 2& 3 months of therapy.
RESULTS:
The mean of OCMI in group A started to decline directly after 4 days of therapy and to its lower level after 8 days, and it was statistically significant (P value <0.05).The change in mean of OCMI of group B after 4 and 8 days of therapy was also statistically significant (P value <0.05).The response rate after 4 days of therapy in Group A was 33.3% and in Group B was 6.44%, while the response rate after 8 days of therapy in Group A was 69.16% and in Group B was 44.98%. The difference in response rates after 4 and 8 days between groups A and B was statistically significant (P value <0.05).The mean size of ulcers in Group A started to decline directly after 4 days of therapy and to its lower level after 8 days of therapy. It was statistically significant (P value <0.05). The change in mean size of ulcers of group B after 4 and 8 days of therapy was also statistically significant (P value <0.05). The response rate after 4 days of therapy in group A was 44.92% and in Group B was 15.08%, while the response rate after 8 days of therapy in group A was 85.68% and in group B was 55.36%. The difference in response rates after 4 & 8 days between Groups A and B was statistically significant (P value <0.05). The therapeutic action of lactic acid mouth wash was statistically significant more effective than placebo. Lactic acid mouth wash showed statistically significant prophylactic effect in comparison to placebo after 1,2&3 months from starting therapy using oral clinical manifestation index, (P value <0.05).
CONCLUSION:
Lactic acid 5% mouthwash is a new, safe effective therapeutic and prophylactic remedy in management of RAU.