These present as recurrent, multiple, small, round, or ovoid ulcers, with circumscribed margins, having yellow or gray floors and are surrounded by erythematous haloes, present first in childhood or adolescence.2 The term “recurrent aphthous stomatitis” should be reserved for recurrent ulcers confined to the mouth and seen in the absence of systemic disease.1 Various factors have been suggested GDC-0973 manufacturer to precipitate outbreaks of recurrent aphthous stomatitis in predisposed

persons, including oral trauma, the cessation of smoking for reasons that are unclear,3 anxiety or stress,4 sensitivities to food (e.g., to preservatives and agents such as benzoic acid cinnamaldehyde, and hormonal changes related to the menstrual cycle).5 However, evidence to support the causative role of these factors is scarce. Amlexanox (C16H14N2O4) is a topical anti-inflammatory, anti-allergic drug. It SNS-032 has been developed as a 5% topical oral paste for the treatment of patients with RAS.9 It is currently the only clinically proven product approved by the US FDA for the treatment of aphthous ulcers.7 Most of the systemic absorption of Amlexanox

is via the gastrointestinal tract and the amount absorbed directly through the active ulcer is not a significant portion of the applied dose. After a single oral application of 100 mg of paste (5 mg Amlexanox), maximal serum levels are observed at 2.4 h [Table 1].8 Aphthous ulcers are most common recurrent multiple ulcers in oral mucosa. The goal of treatment is to decrease pain, healing time, ulcer size, erythema and prevent recurrence. Current treatments mainly used are topical agents from such as antimicrobials, Amlexanox, anesthetics, and corticosteroids. Systemic steroids, Azathioprin, Colchicine, Cyclosporine, Thalidomide, Levamisole,

Cyclophosphamide, Dapsone, Pentoxiphylline should be reserved only in refractory cases as these medications are associated with many side effects when compared to topical medications.16 Long term safety study was also done evaluating the various biochemical parameters in blood and urine, proved beyond doubt that Amlexanox did not cause any serious side effects to liver, kidney or any other organ.17 Clinical trials to prove the efficacy of Amlexanox in treatment of Aphthous ulcer though started from 1993, only the clinical trial done in 201115 had compared the recurrence rate between the Amlexanox and control group and proved that Amlexanox prevents recurrence when compared to the control group. Clinical trials done in the year 1997 was conducted in large number of samples when compared to other clinical trials. 8 out of 10 clinical trials had proved statistically that reduction of pain, healing time and ulcer size is better in Amlexanox when compared to control group.