ABSTRACT
BACKGROUND: Recurrent aphthous ulcerations (RAU) are the most common oral mucosal disease among the general population including in Iraq. There is no uniformly effective therapy for this disease. OBJECTIVE: To evaluate the therapeutic efficacy and safety of 5-percent lactic acid mouthwash in the treatment of patients with recurrent aphthous ulcerations. METHODS: This is a single-blind controlled therapeutic study. We recruited 80 subjects with early-onset oral aphthosis from patients who attended Baghdad Teaching Hospital Department of Dermatology and Venereology in the period between April 2004 and April 2005. Of those subjects, 10 defaulted; the remaining 70 patients were divided into two groups, A and B. Subjects in group A (36 patients) were instructed to use 5-percent lactic acid mouthwash, one teaspoonful three times daily before meals. Subjects in group B (34 patients) were instructed to use placebo (distilled water mouthwash) in a similar way. Assessment of each patient of both groups was done by using oral clinical manifestation index (OCMI) before, after 3 days and after 7 days of therapy. RESULTS: The mean of OCMI in group A started to decline after 3 days of therapy and attained statistically significant lower level after 7 days of therapy (p <0.05). The change in the mean OCMI of group B after 3 and 7 days of therapy was also statistically significant (p <0.05). However, the response rate (percentage of change in the mean) after 3 days of therapy in group A was 63.6 percent and in group B was 8.8 percent, and the response rate after 7 days of therapy in group A was 90.8 percent and in group B was 35.7 percent. The difference in the response rates after 3 and 7 days between groups A and B was statistically significant (p <0.05). No significant side effects were noticed apart from mild irritation in two patients using lactic acid. CONCLUSIONS: Lactic acid 5 percent mouthwash is a new effective mode of therapy for patients with RAU and had significantly reduced the signs and symptoms of the disease, especially when compared with placebo. The mechanism of action may be related to increasing spontaneous secretion of endothelial growth factor from keratinocytes.
