Are you taking folic acid?
My rhuemy said that taking mtx, folic acid is a must to prevent mouth sores. Call your rheumy for a prescription of Folic acid....over the counter dose is not enough, you need prescription strength.

Took a look at your profile and it doesn't mention if you are on Methotraxate. If you are on it and forgot to mention it, then you need to be on Folic Acid too. So, get in touch with your doctor to see if he/she can provide you with a prescription for Folic Acid. Hope you feel better soon!

My doctor prescribed 1 mg of folic acid when I started mtx. When I have mouth sores I increase the dose to 3 mg and they go away fairly quickly. It doesn't happen very often.

Hope you feel better soon.

I take 1mg of folic acid a day and when i get mouth sores my doc tells me to take two for a couple days (2mgs) until they are gone. Hope this helps

Hi Angel,

I have been on MTX 25mg injections weekly for 2 years. My Rheumy prescribed Folic Acid 5mg every day, maybe this is the protocol for Australia as no one else seems to be on this amount every day. I haven't had problems with my mouth.

Hope u r feeling better soon.

Take care, Anna

I was on mthx for 10 years, with mouth sores the last 5 years, despite the folic acid. My enzymes gradually climbed higher and higher. When I finally went off, I had one sore so big my family doc thought it was some kind of cancer. It went away when I went off mthx.

I also got mouth sores with Sulfasalazine. They all seem to work on the folic acid pathways of the liver. So if the enzymes in the liver go up, you are likely to get mouth sores. It used to be the way I could tell when it was time to get my ALT tested. This summer, it was the pain in the liver sac that made me realize I needed immediate testing. I was happy to be right, sad to be off a DMARD that worked well with my biologic.

Please get tested monthly, and keep track of it. Make your doctor tell you the numbers - get a photo copy. I have a psychiatrist who always told me where I was at. My rheumy never cared. Be pro-active and use doctors to manage your health care, is my new philosophy.

Thanks everyone for your replies and good wishes. I've been taking 10mg of Folic Acid the day after after I take Methotrexate since I started.

Yes, Anna, we do seem to tbe prescribed a much higher dose of Folic Acid in Australia.

Angela, thanks for the info. I do get blood tests every four weeks and my Rheumy rings if there's any problem. So far, my liver's been fine so I do hope that's not the reason. I've learnt, too, that you really need to be pro-active and your own best advocate.

Increasing the folic acid does seem to help with the prevention of mouth sores. But sometimes they show up anyway. I was given a RX for triamcinolone, an oral paste that works wonders on healing them. See if your doctor will write a prescription for you.

Try Leucovor. I had mouth ulcers after starting MTX and they were gone within a week. You take this the day after you take the MTX. This is given to Cancer patients that use MTX in a stronger dose to help them with mouth ulcers.

Thanks Lois and Wrench for those two names.

They have cleared up so maybe they weren't caused by the Methotrexate. I am upping the MTX to 20mg so will see if they reoccur.

Thank you, everyone, for your replies.

In addition to the folic acid, try using Orajel Antiseptic Mouth Sore Rinse. Sometimes I feel like I'm getting a sore, usually after the Orencia infusion, and I have used this and it has stopped the sore from developing. It's very important to keep healthy gums with RA. I've always brushed my teeth several times a day and now I'm even more attentive to my teeth, mouth and gums. You aren't supposed to use the Orajel more than seven consective days and I don't but I also use other mouthwashes to keep my mouth clean and hopefully bacteria free.

Thanks, too, Taterandtom's mum for this info.

Angelpuss,

Now that everyone has stated Folic Acid yes take them i used to take over the counter but it wasn't strong enough so I now take 3mg prescription strength works better.

My dentist how ever has suggested the fllowing for recurring mouth sores...

Squiggle Toothpaste (amazon.com)
Ulcer Ease (amazon.com)
Straight Floride (ou need a script for straight floride) toothpaste if you use the following.
Spry ToothPaste (amazon.com)
Spry Mouth Wash (amazon.com)

there is a Xyiltol in the above listed products that help with the acidity in your saliva to help prevent them along with the folic acid.

I also use Canker Melts they are little disc's that you attach to the sore and sleep with it and it will help heal them much quicker.

I do not recommend anything I have not already tried and have found successful for myself.

I have had major mouth sores over the past year and now i finally have them under control with the above products...

The ulcer ease is the same as the Miracle Mouth Wash you can get via prescription though it is much cheaper and not as nasty tasting... i do have and use both depending on the intensity of the mouth sores...

the last time i had a real bought with them i had 17 at once.. the only thing that worked was the above products so good luck...if you want the links or the company information let me know and i will post for you after i collect it..

Thanks, Tessa, for all that information. I'm glad you finally sorted out the mouth sores. 17 at once would have been horrific.
Hugs
Angel

FOLIC ACID FOLIC ACID FOLIC ACID!!!!! When my mouth sores start getting bad I increase it from 3 mg plus what's in my multivitamin to 4mg. I've been doing this for 14 years. I swear on my puppies lives it works!! I've been told it works for cold sores too.