Dental care article

Common lesions of the oral cavity (mouth)

Ulcers of the mouth may be caused by

Infections

  • Viral-Herpes simplex
  • commonly known as herpes or cold sore. In children it appears as multiple vesicles(ulcers) on the inner lip or gums. Children may present with symptoms of malaise, fever, headache, sore throat and inflamed lymph nodes.

    In adults it occurs along the borders of the lips sometimes it appears on the inner part of the lip, gums or hard palate The virus is dormant in the body but it is reactivated when the immune system is compromised or weak. Treatment includes application acyclovir 200mg,5 times a day for 5 days.

  • Bacterial-Necrotising Gingivitis
  • which is a severe form of gum disease. It affects young adults and middle aged persons. It is characterised by swollen, bleeding and very red in colour gums covered with ulcerating slough along the borders of the gum. It is treated with antibiotics for gram positive and gram negative bacteria, antibacterial mouthwash, anti-inflammatories for the swelling and a good treatment of a deep scaling and polishing. It is very important for the dentist to emphasise the importance of oral hygiene as with improved oral hygiene the rate of the disease progression can be slowed down.

  • Fungal-Candida
  • also commonly known as oral thrush. It appears as white/grey patches on the tough, palate and/or cheeks and can occur in all ages. It may be caused by diabetes mellitus, taking broad spectrum antibiotics, steroids or radiation. Thrush can be treated by direct application of ointment on affected area or by using nystatin oral suspension everyday 5 times a day for 7 days and a further 3 days after. Treatment may be extended for 14 days in totality. Oral hygiene is also important in this case.

Immune disorders

  • Aphtous ulcer
  • The cause of aphtous ulcers is unknown but it is believed that it may be due to a variety of things such as stress, nutrition, autoimmune, viral/bacterial infections, allergies or hormones. It usually occurs on the inner surface of the lower lip, tongue and gums

    There are 2 types:

    Minor form- which is more common, small in size (2-10mm) and will heal in 2 weeks without leaving a scar. Major form-ulcer is bigger in size (2-4mm) it heals with a scar and usually soon after it is followed by another ulcer.

    Treatment includes application of steroids directly on the ulcer if painful, analgesics are also prescribed.

  • Traumatic Ulcers
  • Traumatic ulcers are usually caused by ill-fitting dentures, jagged tooth edges, aspirin burn, cheek biting hot and/or acidic foods. The ulcers would usually appear on the gums, lateral side of the tongue or on the cheeks.

    Ill-fitting dentures should be repaired by removing or smoothening the rough edges on the fitting surface of denture and same goes for the jagged tooth edges. Aspirin burns are caused by patient directly placing aspirin on the painful tooth to alleviate pain and leaving it there long enough can result in the gum getting burnt. Treatment is to stop placing the aspirin directly over the affected area and rather drink the tablets and rinse with warm water, the gum will normally heal itself once the irritation is removed.

Diagnosis in colour, Oral Medicine,2nd edition.Tyldesley

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