Canker Sore Treatment

Magic Mouthwash for Canker Sores

Often known as Duke’s Magic Mouthwash because the original recipe was first developed at Duke University, this special concoction may help relieve the pain and inflammation of severe mouth sores. The formula  is often used for people undergoing chemo or radiation because a frequent side effect of these cancer treatments  is oral ulcers. Some people, particular those who suffer from recurring aphthous ulcers (RAS) also use it for treating their mouth sores.

Duke's Magic Mouthwash is sometimes prescribed to relieve severe canker sores.Ingredients

What makes up magic mouthwash can vary. There is no one recipe and it must be prescribed by a physician. The mouthwash is usually made in a compounding pharmacy with ingredients specified by a doctor. While there are numerous variations that make up the formula, most contain at least three ingredients. Common elements  include Maalox, Benadryl , antibiotics and viscous lidocaine. The reasoning for the formulation is that it combines a variety of ingredients to treat a range of conditions that  may be going on within the mouth. Common recipe components include:

  • Diphenhydramine, a common ingredient in  Benadryl. It is an antihistamine and analgesic, which helps reduce inflammation and pain.
  • Lidocaine – a topical anesthetic for pain relief; it will temporarily numb the area.
  • Maalox or Kaopectate – an antacid which helps coat the ingredients on the sore
  • Tetracycline – antibiotic to reduce bacteria around the lesion
  • Glucocorticoids – anti-inflammatory steroid
  • Nystatin – an antifungal agent that may be added for candidiasis (more typically for cancer patients)

There may be other ingredients added such as Sulcralfate, a coating agent, or Erythromycin, an antibiotic.


If you have multiple canker sores in the mouth, the typical dose is 5ml swished around the mouth and then spat out. For mouth ulcers far back in the throat or on the roof of the mouth, the solution can be gargled. If you only have one sore,  you might just dab the compound  on your ulcer using an eyedropper  or  a  cotton swab.

The mixture can be used every four to six hours, or as your doctor has prescribed.  You should wait at least 30 minutes after using magic mouthwash before eating or drinking anything, or you may reduce the effectiveness of the treatment.

How Well Does It Work

While there have been very few studies to evaluate the effectiveness of magic mouthwash for pain and inflammation relief, it is fairly widely prescribed and used. One controlled study found there was no difference in effectiveness versus salt water or baking soda and water rinses. However, patients who have tried the compounded mouthwash may beg to differ. When oral ulcers cause so much pain and inflammation that eating and drinking are excruciating, using magic mouthwash may soothe the pain. Further, the addition of antibiotics can help prevent severe mouth sores from getting infected.

Side Effects

There is some concern about safety because there is no standard formula. To reduce the possibility of drug interactions or allergic reactions, the pharmacist must be very clear on what the prescribing physician has specified and compound the formula exactly as prescribed. For instance, some people are allergic to Lidocaine or to certain antibiotics such as Erythromycin.

Home Made Alternative

As mentioned, the real “magic mouthwash” contains prescription medications and must be prescribed by a doctor and made in a pharmacy. If you want to try a modified recipe for home use, you can combine equal part of maalox, kaopectate  or Milk of Magnesia and Benadryl Childrens Allergy Liquid Medicine.  Why the child’s formula? The adult version contains alcohol, which may cause burning or stinging or dry out oral tissues.

You can rinse your mouth with your home made mixture several times a day. While you shouldn’t swallow it, it isn’t necessary and you should spit it out. There are also over-the-counter numbing liquids such as Chloraseptic throat spray that are used for relieving sore throats. You might want to add this to your  mix to help temporarily relieve the pain. The best part is that you can easily find all the over-the-counter ingredients for your own mouthwash at your local CVS, Walgreens, Walmart or other drugstore.

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