Brief Answer: Explained below. Detailed Answer: Hi XXXXXXX Welcome back! I am sorry to know that you had to undergo so much of stress in the last few months. However, the good thing is that you are more stable now and trying to get back to your usual self. Mouth ulcers after cutting down or quitting cigarettes or chewing tobacco are common and occur usually in the first two weeks. The exact cause is not known but it is said to be due to the changes that occur when the body tries to adjust to a tobacco-free state and starts functioning better. They are usually gone by four weeks but since they are painful, taking some treatment would help. In my opinion, the following measures should suffice: 1) Take a B-complex vitamin tablet/capsule three times a day. Becosule or any other brand would do. 2) Maintain oral hygiene. Brush twice a day. Use an antibacterial mouthwash (like Hexidine mouthwash, which contains chlorhexidine) twice a day. This will prevent infection and worsening of the ulcers. 3) If the pain is discomforting, you can use Tantum oral rinse three to four times a day. It contains benzydamine liquid, which relieves the pain and inflammation associated with mouth sores. Use around 10 - 15 ml to rinse the mouth. Keep the liquid in contact with the affected area for at least 30 seconds and then spit it out of the mouth. 4) Avoid hot and spicy foods. Avoid being constipated. If cutting down on tobacco has caused constipation, try taking isabgul husk 3 tsf daily with half a glass of water or milk. You can continue with it for as long as you like as it has no side effects. If constipation is severe, take lactulose syrup (Duphalac) 15 ml at bedtime. You will notice an improvement in mouth ulcers when constipation is resolved. I expect these measures to show some improvement within a week, though it will take longer for all the ulcers to go away. Keep the alcohol intake under control. When you feel sad, just think of one thing. What you had to undergo was certainly painful, but there are worse things that could have happened. There is no doubt that you will survive this and also become stronger in the process. Let me know if you need any clarifications. Take care. Best wishes. Dr Preeti Parakh MD Psychiatry

---

Brief Answer: Not needed. Detailed Answer: Hi XXXXXXX I really do not feel that an antibiotic tablet would be needed. The Hexidine mouthwash contains chlohexidine which will acts as an antibiotic and kill bacteria in the mouth. Using this mouthwash twice daily should suffice. Best wishes. Dr Preeti Parakh MD Psychiatry

---