Episode 51: More useful clinical trials - with a gentler touch - Part II
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In episode 51, we again bring in the charming Dr. Tina Korownyk to help us work through 4 more recent studies that hopefully will have relevance to your practice.
Comments
A point perhaps overlooked in
A point perhaps overlooked in your evaluation of aphthous ulcers was noted in the responses to the original article. Many people will respond to a simple change in toothpaste. The most commonly used surfactant in toothpaste (sodium lauryl sulfate) is harsh on mucosa and skin and there are alternatives to this. Many people respond just to this. Also, the tartar control agents in toothpaste cause mouth ulcers in many. Somehow, it seems more reasonable to first try changing toothpaste than to TAKE something. Beyond that, B-12 would be quite reasonable to try... it is simple, cheap, and generally harmless in the amounts mentioned.
From Mike A - Thanks
From Mike A - Thanks Coolshade for raising this issue. The presentation of the paper on B12 for oral aphthous ulcers was certainly not meant to be a comprehensive review of the topic. It is of course wise to look for potential causes of the recurrent ulcers and alleviate those causes (such as toothpaste, medications or recurrent trauma). In many cases, the cause is unknown and if simple measures don’t work, B12 MAY be an option. However, as it is just one small trial, more evidence is required before we can strongly recommend it beyond an option when other options have been tried. A good evidence based-review of the topic is available at Clin Evid 2005;13:1687-94.
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