What do systematic reviews say?

Bee propolis (one 500 mg capsule per day) vs placebo

Bee propolis (one 500 mg capsule per day) showed no clear difference in mean number of lesions over treatment period compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 months (minimum)
  MD -2.6 [-7.30, 2.10]
  1 study · 19 participants
  GRADE not reported

Beta-glucan (1.3/1.6 beta-glucan 10 mg twice daily for 20 days) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  20 days
  There was no reporting of adverse effects.
  1 study · 31 participants
  GRADE not reported

Levamisole 50 mg three times per day for days 1 and 2 vs Levamisole 50 mg three times per day for day 1 and placebo for day 2 (lower dose)

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  16 weeks
  Two patients in each group reported unwanted effects.
  1 study
  GRADE not reported

LongoVital (herbal plus vitamin component) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 months
  Forty patients were randomised to receive LongoVital (herbal plus vitamin) or placebo (Kolseth 2005). Data presented as medians with 95% confidence intervals, unsuitable for further analysis. The authors report no…
  1 study · 40 participants
  GRADE not reported

Bee propolis (one 500 mg capsule per day) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 months (minimum)
  The authors report a statistically significant difference in the reduction of outbreaks based on the difference between expected and observed number of ulcers (Fisher's exact test, one sided, P=0.04).
  1 study · 19 participants
  GRADE not reported

Betamethasone (systemic corticosteroid) vs Placebo or no treatment

The review found no eligible studies for this question.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  Table 1 (Systemic agents used in the management of aphthous stomatitis): 'Studies of these corticosteroids were not found or included in the review but are included here for completeness. They are not given orally for…
  0 studies
  No studies found

Individualised homeopathic medicine (two doses over 24 hours) vs placebo

Individualised homeopathic medicine (two doses over 24 hours) led to higher complete ulcer healing by end of study (day 6) compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 days
  RR 2.00 [1.39, 2.89]
  1 study · 100 participants
  GRADE not reported

LongoVital (herbal plus vitamin component) vs LongoVital (herbal component alone)

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 months
  A single trial at high risk of bias (Kolseth 2005) randomised participants to the herbal component of LongoVital alone or LongoVital with herbal plus vitamin component. Data presented as medians with 95% CIs,…
  1 study · 40 participants
  GRADE not reported

LongoVital (herbal plus vitamin component) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 months
  Reported adverse events were minor and evenly distributed between the groups.
  1 study · 40 participants
  GRADE not reported

Multivitamin vs placebo

Daily multivitamin showed no clear difference in mean number of new lesions compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  MD -0.41 [-1.85, 1.03]
  1 study
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Colchicine (0.5 mg per day for 3 months) showed no clear difference in pain at completion of treatment compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  3 months
  MD -0.16 [-1.18, 0.86]
  1 study · 34 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

Prednisone (oral, commencing 25 mg with phased dose reduction over 2… led to lower total number of new lesions over 2-month treatment period compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  MD -4.20 [-4.84, -3.56]
  1 study · 40 participants
  GRADE not reported

Camel thorn (plant distillate) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  up to 14 days
  The authors report lower pain and smaller lesions in the camel thorn group up to 10 days after referral; a statistically significant difference in pain intensity was also reported.
  1 study · 93 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  Femiano 2003 (high risk of bias) reports days to resolution of pain and days to epithelialization of aphthae at 1 month, and number of aphthae per month after the first and second months; data presented as…
  1 study · 20 participants
  GRADE not reported

Beta-glucan (1.3/1.6 beta-glucan 10 mg twice daily for 20 days) vs placebo

Beta-glucan (1.3/1.6 beta-glucan 10 mg twice daily for 20 days) led to lower ulcer severity score (USS) compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  20 days
  MD -4.38 [-6.17, -2.59]
  1 study · 31 participants
  GRADE not reported

Camel thorn (plant distillate) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  up to 14 days
  A single trial (Pourahmad 2010, unclear risk of bias) randomised 93 participants to camel thorn distillate (n=49) or placebo (n=44). Mean time to complete resolution was 4.02 days (range 3 to 7) for camel thorn…
  1 study · 93 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  Femiano 2003: one significant adverse event (gastritis) for the prednisone group versus none for placebo. Femiano 2010: more drug-related adverse effects for those treated with prednisone than placebo.
  2 studies
  GRADE not reported

Vitamin B12 (sublingual, 1000 mcg daily for 6 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  6 months
  No adverse events were associated with receiving vitamin B12 or placebo in this study.
  1 study · 58 participants
  GRADE not reported

LongoVital (herbal component alone) vs placebo

LongoVital (herbal component alone) showed no clear difference in general degree of discomfort compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 to 6 months
  MD -0.30 [-0.37, 0.97]
  1 study · 50 participants
  GRADE not reported

Sulodexide (heparin plus dermatan sulphate chains) vs prednisone

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  Sulodexide was without significant adverse events; one significant adverse event (gastritis) was reported for the prednisone group.
  1 study · 20 participants
  GRADE not reported