An ulcer is a breach in the continuity of skin or mucous membrane deeper than the erosion. Ulcers are quite commonly noted in the oral cavity probably because the mucous membrane is a thinner lining than skin. They get easily affected by mechanical, chemical, thermal, electrical and radiation insults.
Common ulcers in the mouth are:
- Traumatic ulcers
- Aphthous stomatitis
- Traumatic ulcers:
- Mechanical cause: Patients have to be watchful of any sharp part of the tooth present in their mouth leading to repeated damage to the tongue and mucous membrane leading to ulcers. Eating hard food should be done with caution.
- Thermal causes: Placing hot food and beverages in the mouth can cause damage to the oral cavity leading to the formation of ulcers.
- Chemical causes: Chemicals like Eugenol, Hydrogen peroxide and Silver nitrate used during dental procedures have to be used with caution.
- Aphthous stomatitis or Canker Sores:
These are the most commonly occurring ulcers in the oral cavity and are frequently seen. They are basically of three types
- Minor aphthous stomatitis
- Major aphthous stomatitis and
- Herpetiform major stomatitis.
The commonest of the 3 types are minor aphthous ulcers. These appear anywhere in the oral cavity from the buccal mucosa to lingual mucosa and are non-contagious. They may range from 1 to 6 in number at a time and are less than a centimeter in diameter. They are oval or round with an erythematous ring around them. They heal in about 7-10 days without leaving a scar and many a time may be recurrent.
The major aphthous ulcers are less common and are more than a centimeter in diameter and taken 15-30 days to heal and may leave a scar.
Herpetiform ulcers are not common. They may be a few hundred ulcers together to form a single large ulcer and are painful.
The exact cause for aphthous ulcers is not known and they can be attributed to stress, lack of sleep, excessive travelling, vitamin deficiency or may be attributed to heredity. Treatment is directed towards healing the pain and irritation by the administration of topical anti-inflammatory, steroids, and analgesics.
- Other causes of ulcers:
Many viral infections like Herpes, chickenpox etc., Drugs like Bisphosphonates and cytotoxic drugs, malignancies and certain hematological diseases can be the reason for ulcers.
Mainly depends on the medical history and also an examination of the location, size, number of ulcers, appearance etc will aid in diagnosis
Treatment is usually symptomatic,
- Pain control with topical analgesic and anesthetic gels
- Use of antiseptic mouth wash like chlorhexidine
- In certain case, antifungal drugs and steroids may be used
- Removal of local irritant like sharp tooth cusp may be needed
- Maintenance of good oral hygiene
- Avoiding eating hot and spicy food
Following the above guidelines would solve the problem in a span of 7-10 days. In case the ulcers persist please consult your dentist.
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