Triamcinolone Acetonide Dental Paste USP, 0.1%

46 messages in this subject.

It has been 4 days since I started using the traimcinolone paste on the inside of my upper lip.The improvement is incredible.Very little burning and it looks so much better.I don't know if it was a coincident or the traimcinolone but I'm betting it was the paste. My goodness what a relief to be able to eat and talk and even smile without that nasty burning pain.But boy is that stuff expensive.About 85dollars for a TINY tube. Thank goodness I have a terrific prescription at work as it only cost me 1 dollar a tube. To be honest I would have paid anything for this relief. I have 1 refill which I will get but I don't know if I'll need to use it.The tube is very tiny and you can use it up quickly buy using it 2-3 times a day not to mention the waste the first couple times you do it because you have to get use to the method of putting it on.I was getting low after 3 days and went to renew it but my pharmacist said it was to soon and the insurance would not cover it and I had to wait about 10 days so I started to use it more sparingly.A anyway it seems to be going very well. That's it for now, good luck to all with it and I,all keep the updates coming.
Willie, july,11th 2014 11 July 14
I was just given Triamcinolone for the inside of my upper lip which is raw and has white spots my Dr says are sores. So painful eating etc. I just applied my first application about20minutes ago. I don't know if I did it correctly but I guess I will get better with time. I hope it works as I am miserable. Thank you all for all these comments.I was afraid I was the only one with this. actually I'm received it's just sores and nothing worse. Thank uyou all for listening.
Willie July 7 July 14
This medication is the only one I have found that truly works! The key is to catch the canker sore early before it really gets going. Use the paste at bedtime and you may have to only use it on 2-3 consecutive nights. I find the easiest way to apply it is squeeze a little onto a wet q-tip and put it on the sore. The wet q-tip lets you spread it easier and it'll stick better to the sore...then go to sleep! The longer you stay awake, the more you swallow, move your tongue around, etc. If you let the medicine do its work, it will pay dividends.
jsb 2 October 13
I had an incredibly large and painful canker sore on the bottom of my gum line on the left side. When I was prescribed this, I was like, "Okay, this is strange." The paste is really different, but I like it. I also love that if you accidentally swallow some (which happened to me a few times), it won't harm you. Triamcinolone Acetonide Dental Paste USP 0.1 is amazing! WHERE HAVE YOU BEEN ALL MY LIFE WHEN I NEEDED YOU?!?!?! Good thing I discovered it. :D
Michael 13 June 13
I been in pain with a big canker sore of my bottom lip and used everything. The Dental paste helped with the pain I am in it does not look good but now more pain. Unfortunately How does it come off though?? Well its my first day and I put alot of because I want it gone. Will this pile of paste go away?
michelle 2 February 13
I have nots in my mouth went to my cancer dr and he cant do surgery for 3 months and i use a tube a week Is there anyway I can get this ointment any cheeper I will probably have to use it the rest of my life because the radiation dammaged my mouth and no cure just to keep using this to ease the pain for a few minutes any way ! please let me know how i can get this triamcinlone cheeper !
elaine mckinney 24 April 12
I've been using triamcinolone for 3months now. My tongue sore's happened after I had one canker sore. My tongue just about heals. Read other opinions and inserts about trimcinolone. I'm going to see my doctor.
N.E.I. 21 March 12
you must try dexamethasone mouthwash. it is a prescription only steroid that shortens the lenth of time these suckers last. if i catch it as it's forming then i can stop the canker sore from going full blown. this stuff is awesome. directions say to spit it out but my dr told me to swallow it so i get the steroids topically and internally. it really works. i have bottles of this stuff at home, at work, in the car and i always travel with it.
ivan 6 January 12
Hello Joe , what is the NAME of the generic antibotic???
Amy 21 November 11
I had the ulcer sores in the mouth for years until a dentist suggested a generic antibiotic, open the capsule, dissolve in a teaspoon of warm water, swish around and swallow. Once or twice and the sore goes away. this has worked for over 20 years now, despite many dentists and doctors telling me it can not possibly work.
Joe 5 October 11
i read all your post in hopes that this stuff will work. The soģes under my tongue get wet with salvia fast and comes right off. this med sticks !
in pain 02 27 July 11
This product and a swish and swallow or spit mouthwash that is by prescription are the only products that I have found that will actually get rid of the canker sores that I get. I have tried many other things some relieve the pain for a short period but they don't get rid of the sores.
Janis 22 July 11
I am 37 and have also suffered from canker sores for since I was a young teenager. I feel all your pain.

Here are my thoughts and suggestions based on my own experience and research: (and I've tried everything as well over the years!)

1. Laurie from Nov. 10 has it right I think. Aim for the cause of your sores not just the treatment. I think the two major culprits are STRESS and VITAMIN/MINERAL DEFICIENCIES - particularly zinc, B, C, and iron. I'd suggest a visit to a good nutritionist to see what your diet might be lacking. I've also found that taking lysine helps prevent recurrences. In terms of stress, well, I won't lecture anyone on that. Exercise, meditate, more sex, better rest, yoga, whatever works for you to bring the stress down it will help with these. Though medically there has been no absolute proof about what causes canker sores, the research points to stress a huge factor.

2. Definitely avoid any foods that are too acidic, especially citrus fruits. The citric acid activates sores. Sadly, tomatoes, chocolate, sugary foods, alcohol, coffee, non-diet sodas exacerbate sores as well.

3. I have no doubt now that SLS causes sores. As soon as switched to a non-SLS toothpaste years ago, I found I have FAR fewer occurrences. My favorite by far is Biotene (available at most drug stores, Target, Walmart, etc.) Not only does it help immensely with sores but it is superb for treating dry mouth. I also think the Rembrandt canker sore toothpaste works well, but haven't seen it in stores lately. Thera-breath is good as well.

4. Drink more water! Forget 8 glasses, try twice that. I've noticed the more well hydrated I am, the less I get sores.

5. Gargle with warm-salt water daily. I am not an MD, but am a professional singer and have a doctorate in voice. Not only does this old remedy work for laryngitis and other throat infections, but I've noticed it helps prevent and treat outbreaks of sores. Most likely the antibacterial properties keep the oral tissues clean. Yes, I've tried other mouthwashes people have suggested here, but find that most are more irritating than helpful to canker sores. Stick with a warm salt-water solution. Make sure to use plain non-iodized salt (not sea salt).

6. I know how bad the pain can be, but the various oral gels are pretty much useless for treatment of sores. I find the short period of relief they bring is not worth the pain of initial contact with the sore and they're not really healthy to ingest. I agree with what everyone has said. The ONLY actual medicine I have found to be amazingly helpful with both the pain/discomfort and shortening the duration of sores is the Triamcinolone Acetonide paste (formally Kenacort" target="_blank" onmouseover="overlib('Buy Kenacort from the Mouth Ulcers Shop (opens in new tab)');" onmouseout="nd();" class="mus">Kenalog). If you catch a sore especially at the beginning with the paste, sometimes it will completely stop the outbreak. It is not harmful if swallowed. Apply at night before you go to bed and after you brush of course. I place a nice sized amount directly on the sore with a finger (make sure hands are clean). I try to dry out my mouth or the are of the sore by sucking in air (this helps the paste adhere). But before I really press or spread it over the sore, I wet my finger with some cold water. Then press/cover the sore completely with the bit of paste you've put there. The water helps seal it in there. Yes, it will sometimes rub off or get on the teeth. But it's not harmful. Takes a little patience to get the technique down where it'll stay, but it's worth it. Often, I'll wake up the next day and the sore will already be healing, especially if I catch a sore early.

7. I've only had one odd outbreak of sores in my life years ago that was so severe that I needed to get a prescription for tetracycline. I had VERY large painful sores all over the back of my throat. The doctor said to take one or two pills a day, break them into a glass of water, mix, and then swish around my throat making contact with my sores for a few minutes. Then swallow. I did find that this helped heal all the sores within a week.

8. Certainly get checked for Behcet's or Crohn's if you have other symptoms, both of which cause sores. Or, if you have a sore that has never healed as some of you mentioned, GO TO A DOCTOR! But I'd bet money for those of you that are regular sufferers of the elusive canker sore, that your outbreaks are the result of the other things I mentioned.

Hope this is helpful to you all!

PS - Caitlin, I sympathize with your condition. It sounds immensely painful. But for your own health and life, quit the smoking. Perhaps there is evidence that they help with ulcers for whatever reason. But surely you can't argue that the myriad of other fatal health problems that smoking causes is not worth it.

jk 21 July 11
I suffer herpitiform ulcers almost to no end.... I consistently have at least on cluster, and around Every 3 months or so, a terrible breakout of ten or more. Dont forget that herpetiform is the most severe type of ulcer, as there can be litterally over a hundred in your mouth at a time. They cause excruciating pain and are almost always present. I've been getting them for three years, and when I first got them I wore braces... Well.... You can imagine the pain. I also have acid reflux disease but the medication does nothing at all. I've only found two things to relieve the pain.

Triamcinolone acetonide dental paste as described above: this medication successfully clings to my mouth like no other medicine could. It not only relieves pain just minutes after applied, but protects sores and clusters from further abrasion. Not only does it relieve pain though, if applied immmediately at first signs of sores and then used with consistency, it will shorten the agonizing maturity of 3-5 days of the 2 week+ ulcer down to 1 -2 days and make the rest of the progression and disappearance time bearable. Especially If you're one of the 15- 20 % of people that gets major or herpetiform ulcers which can cause pain that is literally agonizing at their maturity.

Smoking. If you don't smoke, start smoking cigars. If you smoke cigarettes, don't stop. I am a habitual smoker at best, but i smoked a pack in 5 days... Quite more than I normally would... When i was already dealing with an outbreak. They cleared up in just days, granted, they were due to heal. However, when i ran out and decided to take a break, BAM. worst outbreak of my life. I can't even describe how much pain I'm in, especially in the mornings when my mouth is dehydrated and inflamed with irritation. The amount of ulcers i have is insanity and their unmedicated maturity is an entire week. If you dont believe smoking will make your sores better and quitting will make them worse, look it up. Plenty of research done. No one yet knows why though.
Caitlin C 22 June 11
I have had these sores in my mouth for about 5 years now. I notice I get them anytime I stress or eat some type of food with acid. It starts with one sore then ends up to be around 11. They last any where from 2 - 6 weeks. They are very painful and i have tried pretty much everything. The doctor just prescribed me Triamcinolone Acetonide today and i really hope this works. I am so tired of hurting!
Nicole June 20 2011 20 June 11
I was having a hard time getting it on the sore on the tongue. I bought some First Aid COTS - protection for finger tips. They roll down the fingertip and it makes it super easy to apply the paste
RJP 2 June 11
I suffer from Sjogrens and have for years which causes a very dry mouth and eyes too, but sticking to the dry mouth I have sores. Have had them so bad they were ulcerated and had to be treated by dr. I too have this dental paste. I am glad for all the info out there on it and applying it. In recent years my lips are so dry and chapped they look red like have on lipstick. I just a couple of days ago thought I would try the dental paste on my lips. I have and it seems to have helped, not cured but helped. Does anyone have any thoughts on using it this way. I have been rubbing it in but I saw where that is not the way to use. What can anyone say about this?
Bootsy 29 May 11
In April, I got my very first canker sore and I now have another. It starts with a fat lip right dead center of my top lip and then after 2 or 3 days of being fat it turns into a sore. My doctor gave me the dental paste and it helps with the soreness but this sucks! I really don't know how I got one randomly. My diet has not changed and I haven't changed toothpaste or anything else I put into my mouth. I think something else is going on here..
Amy 19 May 11
I recently developed an canker sore inside my mouth, I love chocolate, tomatoes and eat wheat bread. I called my doctor and he gave me the medication Triamcinlone Acetonide Dental Paste USP, 0.1%. The only thing is when I apply the medication to the sore it also gets on my teeth is something I can do to help prevent that from happening?
James 2 May 11
Do anyone know if canker sores are contagious? I really don't want my toddler son to get them. Everyone in my immediate family used to get them. One thing that really helped me was changing toothpastes. I found that CREST caused me to get canker sores much more often than other pastes. I highly recommend the Triamcinolone Acetonide paste. It is WORTH THE MONEY. I also get killer headaches whenever I have canker sores and the doctors I've been to don't think the canker sores and the headaches are related, but I think they are. I recently had a lot of dental work done (preparing three teeth for a bridge and two emergency root canals) and the side the dentist worked on is covered in canker sores. I'm taking OTC meds for the pain and inflammation plus Vicodin.

KD, you definitely can sleep w/it on. I would apply it right before you go to bed.

I really hope everyone finds relief! Canker sores are so painful!
Kris 24 April 11
KD, yes you can swallow and sleep with it on, but back to the main topic. I have been dealing with huge canker sores on my tongue mostly, for around 15 years, i tried every type of home remedy, salt water, salt on the wound itself, hydrogen peroxide, milk of magnesia etc. After picking up this paste for only 15$ (because im covered) i used it the first time many years ago. i noticed it started helping the day after i put the first application on. This does not work insane miracles and heal it within hours or anything, but for me it did numb pain and get rid of the sore within 3-4 days. This stuff is good, i would pay more if i had to but it sure helps alot. i was prescribed this after seeing my dentist about the sores. He said also using warm water with salt before putting it on helps the paste stick on without bacteria getting in between. but if you have the chance get it, this stuff works very good.
Steven 28 February 11
can you swallow your saliva with it on.. and can you sleep with it on ?
KD 11 January 11
Most of my canker sores are caused by eating walnuts (and several of my children also). The triamcinolone paste works quickly and very well to ease the pain and discomfort. I have used the same tube for about 5-6 years. Guess it's about time for another one.
Mack 7 December 10
I too have had very painful mouth ulcers all my life and tried many treatments, none of which worked. I was referred to dental hospitals, had blood tests etc - nothing wrong with me and nothing can be done about ulcers!
I didn't believe the doctors and went to a nutritionist who deduced that although I was fit and had a well balanced diet I was lacking in the following minerals: Zinc, Vit B & Vit C. I also suffered from cold sores so L-lysine was recommended. Guess what - no mouth ulcers or cold sores for 10 years!

Don't bother with medicines or treatments, find out which supplements you need and try to remedy the defect with your disposition. Good luck!
laurie barnett 6 November 10
After 10 years of suffering and using the usual dental pastes to try to relieve the symptoms, I finally found a natural oral spray that actually works! This is a chamomile based product that you just spray on the ulcer and in two - three days it is gone. Fantastic! I am in Asia and have not seen it in Europe or the US so email if interested as I can get hold of it here (in fact have been selling it on Ebay): spur66@hotmail.com
Mattyg 25 September 10
Like the original poster, I am also 'prone' to canker sores. I stay away from hard objects like chips (especially tortilla chips) and anything that could possibly scratch my mouth. Thing is, that I also tend to bite my cheek or bottom lip, and it will automatically turn into a canker sore. They get so huge too! I've been dealing with this my whole life since I was probably 3 or so. It's so painful and so uncomfortable! I have been using this paste for years as well. It is the only thing that speeds up the life of these critters. And it IS hard to use, but I guess I've been using it for so long, that I have no issue applying. I actually use my nail. I just wish I never got them again. but until then, I guess the paste will do.
sunshiine 24 September 10
Alvin - could you not order it by mail-order, or is that a problem in Saudi.
Dom Walton 13 September 10
I have this cancer sore for 15 years... i am using Debacterol and its really a great help but now i am staying at saudi arabia and no medicine for cancer sore is available.. i cant smile, its painful, any suggestion what to do???
alvin 13 September 10
I have used "Pain a Lay" for many years. It used to be available over the counter for about $3.00. Now you have to ask the pharmacy to order it for you. It costs about $13.00. Apply it with a q-tip directly on the canker sore & hold it there until it feels numb. Relief will last a long time. Best product I have ever found and nobody seems to have heard of it. Great stuff.
Jill 11 August 10
I live in Denmark and have used Kenalog 0.1% for about 15 years. The producer, Bristol-Myers Squibb, discontinued it 6 months ago - just like that - and left at least the Danish patients out in the cold. It was the only available product here. What other makes are available in the US?
Chris 3 August 10
Using it right now, I have suffered from canker sores for decades and this is the first time I ever treated it with anything except Anbesol. It is very sticky and wads up in your mouth but it covers the sore and provides complete relief. I am glad my doctor thought of it and I am glad I had a canker sore when I went to my annual checkup, the pain flared and I thought to mention it and I got a prescription. Like anything else like that, the sore went away before I could fill the prescription and I didn't get another for sevral months which was great. Well, now I have two but am treating with this paste and it WORKED. Wow!
Kev 24 July 10
What's that saying? "the greatest thing since sliced bread", well this medicine is IT! I've had canker sores for 30 years and always been told there was nothing that could be done for them. Leave it to a nurse at an urgent care clinic to tell me about this paste and after trying it I would pay 39 bucks or even 390 bucks for a tube. Seriously. it will last me a year and i would actually pay hundreds for it. It's that good. thankfully I only pay 8. The pain relief lasts for about 7 hours and it cut my overall time with the sores from an average of 11 days to about 5. It's a MIRACLE!
Mike 20 July 10
Another medication I've found to be functional for these is called 'Debacterol'. It is considered a chemical treatment and normally is only applied by a doctor or dentist. It stings like you wouldn't believe for the first 10-20 seconds, but after that the pain is 100% gone. Well worth the seconds of raw pain if you know how many days you can truly suffer from a mouth sore. I normally use Orajel as temporary relief before meals, etc. then use the triamcinolone dental paste and if its still bothering me then i resort to the debacterol. I was introduced to it through my college's health center after I'd repeatedly gone there with mouth sores that would not go away. they finally used this treatment for me but informed me that I would have to come in to get it. Well once they got a new doctor in there that I would see, he decided that after the third time that quarter he would just let me take a few of them home as long as I didn't tell anyone. So you may have to visit the doctor or dentist in order to get it.
John 24 28 May 10
Rhonda 15 :
There are some other things that I have found when I did a search for canker sour or mouth ulcer medicines. 1 was herbal and one was something that the dentist applies, I don't remember offhand what they are, but if you do a web search you will find them quickly. You probably also check out Bechets as indicated in a couple prior posts.

BUT MEANWHILE, IF you can get your Dr. or a dentist to prescribe you pain pills - you will experience a great deal of relief. For some reason this is not always easy. Though most understand that you are in severe pain, they don't think narcotic type pain pills are appropriate. (Maybe it's because thaey think of it as a sore pain as opposed to pain like in a broken bone.

I discovered this by mistake. I had several current canker sores develop and I still had an old one from more then a month before that had gotten larger and was actually starting to split the side of my tongue. The pain was terrible. I was refered to an oral surgeon who performed a biopsy to check if it was cancer. While doing the biopsy actually cut the whole section around it off . He then stiched my tongue & prescribed me darvocet for the pain.

Within an hour after taking a darvocet I realized that all of the pain and most of the soreness from the other canker sores were gone. The relief was such a relief. I also think that because of the relief of stress caused by the pain, they acutally healed quicker then Usual. Fortunately, it turned out I did not have cancer.

Hope I helped.
Harry Brown 8 March 10
My daughter was prescribed this dental paste recently. Of course at first my child was scared to even try a new remedy since every other so called remedy would either intensify her pain, cause her canker sore to increase in size, or would make her gag from the nasty taste. My daughter who is now 10 years old has suffered from canker sores since she was 7yrs old. I have tried a few remedies hoping that I'd some how find the miracle cure the next time I'd try another remedy. In the meantime, my child would suffer and lose weight every time she'd get a canker sore. She would refuse to eat complaining about the intense pain. There were times that she couldn't sleep due to canker sores being on both sides of her mouth. Lately, my daughter's doctor prescribed this medication and to my surprise it worked. My daughter at the time had a canker sore on her lower lip causing her incredible pain. I put the medication as prescribed that very night. To my surprise she woke up with no pain. I didn't have to scrape the paste off in the morning b/c it had been obsorbed by her mouth. I continued to give her the medication for the next two nights and wala its gone. The tube of medication is pretty small and cost about $39. Some health/insurance plans cover this medication. Which it did in my case. I ended up paying only $9. Though if I know now it would make my child suffer one day less from a canker sore I'd glady pay the full $39. If your hesitate on trying a new treatment for your canker sores please don't be hesitant with this medication. It was by the far the less inconvenient, no abrasive, non painfull, fastest healing medication for canker sores I have ever encountered.
chelsea 21 December 09
I have cancer in 2004 and I got open sore on my touuge due the chemo I was taking. It had a huge hole in it. I went to the hospital I was in so much pain first they gave me some pills that did work then they gave me triamcinolon acetonide dental Paste, I got instant relief I can not tell you how happy I was.
cheryl McKoy 22 November 09
Get tested for Behcets! You may find that a stronger steroid works for you. ;)
Ellie 15 October 09
I have had canker sores for about close to 4 years. They will clear up some, but always lay dormaint. I have used several things for them. The doctors first thought it was viral infection, when the medication didn't clear them, then they tried magic mouthwash,then onto lidocaine for the pain and now I am on Triamcinolone 0.1% paste and that is not helping either. I am on second tube and they are still there and everything I eat and some things I drink hurt them. It like my whole side of my right cheek is inflamed in dark red with little white bumps. It has cleared a little, but again it is always laying dormaint to start back at any time. I have been now three weeks with no relief. It is very painful. Does anyone have any clues as to what this might be?
Rhonda 15 October 09
What can I say. This is bar none the best remedy I've had to remedy canker sores ever. I've tried everything and this is the only thing that Ive found to be %100 effective. Stop suffering unnessesarily and give this medication a shot. You won't be dissappointed.
john 2 September 09
Hi all. I'm glad to see I'm not the only one who has a lifetime history of suffering from canker sores. Who knew something so small can cause so much pain and misery. I have just started using Triamcinolone, and I've found that it does help. The hardest part is keeping it on...it seems to come off very easily. But thanks to all your posts, I'm gaining confidence in this med to help me with this problem.
Essaia 24 August 09
For you all that have suffer with canker sores for more than 3 times a year should get tested for behcet's disease because what we think may not be just a canker sore!!!!
t 8/20/09 21 August 09
I have been using this paste for years and found the best way to apply it is to allow the sore to air dry if possible and then applying the paste to the sore then with my tounge press the paste and smooth it with my own saliva, this minimizes the amount of paste that comes off. Also, check to see if your insurance covers this. I never knew it cost that much because mine is covered. Hope this helps.
James 28 January 09
I developed mouth sores after eating a grapefuit. My dentist said I had acid burns. I pick up a tube of this yesterday and cost was $37.00 - after trying this twice; I discovered that if you apply a small amount to your finger tip and hold in place on sore spot for a few minutes it works.
A thin film will develop over the spot. I am also on a bland diet for two weeks. No spices, soda, juices, food with any type of acids (fruits); spices. This should heal in about two weeks. Who knew a grapefuit could have cause this. Problem develop 20 minuites after eating it.
November 13, 2008
Nancy 14 November 08
THIS PROBLEM HURTS ALOT PLUS I HAVE ACIDS REFLEXS DISEASE THAT DOESN'T HAVE WITH THE TONGUE PROBLEM. AND IT IS VERY PAINFUL WITH IT GETS OUT OF CONTROL.
PETRICIE 26 October 08
The directions for use say apply after meals and at bedtime and nothing about removing the paste. I just got some today because after having two molars removed I got a bunch of canker sores. This stuff is helping but was so expensive ($38 for a little tube--5 g). I find it hard to apply because it sticks to my finger or to the q-tip and you are not supposed to rub it just lay it on as a film. Easier said than done.
Laine 31 January 08
Iíve suffered from canker sores since I was a child. Whenever I was run down or later in life when I drank too much alcohol or probably when I ate the wrong foods. Mymother swore that putting baking soda on it directly would help. After years of this torture (and therapy) I realized this was a cruel sick twisted painful action to take. At my age, 45, I have to stay away from rough foods like hard bread and also candies that are sour like Skittles. Too much of all that will end up in a cut or another wound that always turns into a canker sore. My mouth is also more sensitive to hot and cold since Ive aged. Alas, I found something about 20 years ago that my dentist recommended. It used to be called Kenalog in Orabase (sounds like a dog medicine). This is now called (see above). Before you go to bed you put it on the canker sore, just a little bit to coat it. It sticks to it and its like a bandaid for your cankersore. You should not speak so it will stay in place. This means you hace to do it literally directly before bed. The next morning you have to get the stuff off in a gentle manner or not at all but after that you have relief from pain for the day. By dinner time the pain is back but be patient becuase that night do it again. By morning it should be almost gone but pain free. You may need another day or two but at least you get to go the days without pain. This has reduced the 7 to 10 day suffering and now if I catch them before they get full blown, I rarely suffer for more than a day. You need a prescription from the dentist or doctor though. THis medication has saved me and I wanted to share it with you. I donít know of any adverse side affects.
FMcB 30 December 07

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Triamcinolone Acetonide Dental Paste USP, 0.1%

46 messages in this subject.