Ulcer is a break in the continuity of skin or mucous membrane. Our mouth is completely lined by mucous membrane . So any damage to the mucous membrane in the mouth is an oral ulcer, which presents with severe pain. Lesions can be single or multiple and make eating, drinking, and talking very uncomfortable.
Causes for Mouth Ulcers
- Traumatic ulcer - Traumatic injuries of the oral mucosa are quite common. They are caused by mechanical damage (contact with sharp foodstuff; accidental biting during mastication etc) and thermal, electrical, or chemical burns.
- Aphthous ulcer - The most common type of oral ulcer which occurs in otherwise healthy individuals. Lesions appear single or multiple and are associated with severe pain, The exact cause is not known . It is considered to be multifactorial including autoimmunity, hereditary and environmental factors like trauma, nutrition deficiency (iron, folic acid and vitamin B12) and stress.
- Herpetic gingivostomatitis - Pin-headed fluid filled lesions that readily rupture and give rise to painful ulcers covered by a yellowish pseudomembrane. These ulcers are caused by a type of virus called Herpes simplex Virus.
- Herpes zoster infection - Herpes zoster infection is reactivation of Varicella Zoster Virus. Lesions are painful, clustered ulcers of 1–5 mm in diameter appear on the hard palate or buccal gingivae only on one side , which is the characteristic feature.
- Herpangina - Condition presents as multiple ulcers of the oropharynx, soft palate, and tonsillar pillars. Children under 10 years of age are usually affected, and outbreaks occur in epidemics in summer. Coxsackie virus is the causative organism.
- Erythema multiformae - It is muco-cutaneous hypersensitivity reaction with different factors like drugs and infections. Certain medications such as penicillin, cephalosporins, analgesics, and nonsteroidal anti-inflammatory drugs (NSAIDs) or several infections (herpes simplex virus, Epstein-barr Virus, Cytomegalovirus, Varicella Zoster Virus, fungal agents, and parasites) can trigger these type of ulcerations.
- Hand foot and mouth disease - Hand-foot-and-mouth disease is commonly seen in children below 10 years of age characterized by the rashes on hands , feet and in the oral cavity. This is caused by Coxsackievirus.
- Pemphigus vulgaris - This is an autoimmune disease characterized by loss of cell adhesion and blister formation. Oral lesions begin as fluid filled lesions in the oral cavity which immediately burst open to leave behind painful erosions and ulcerations.
- Lichen planus - This is a chronic, autoimmune, mucocutaneous disease. There are different subtypes of OLP with different clinical presentations: reticular, atrophic, erosive/ulcerative, bullous and plaque like lesions. Reticular and plaque-like lesions are generally asymptomatic whereas bullous, erosive and ulcerative forms are generally associated with pain.
- Ulcerative squamous cell carcinoma - Squamous cell carcinoma (SCC) represents about 95% of all oral malignancies. It presents as a red - white, ulcerative lesion. SCC is a persistent ulcer in the oral cavity. SCC is often asymptomatic; therefore, patients usually are not aware of it until it has become relatively progressive.
As mentioned above, there are numerous types or causes for oral ulcers. Management will thus include identification of the type / cause for ulcer by thorough history and oral examination. Some cases may need biopsy and histopathological examination for diagnosis. The management varies according to the type of oral ulcer. Some types of ulcers are self resolving, some can be treated with medical line of management (oral paste and tablets) and some might need surgical intervention.
Doctors at 4 Senses Clinic take history patiently, examine the patient thoroughly and diagnose the condition with minimal and necessary investigations. After finding out the root cause of problem, they provide accurate treatment. The doctors also counsel on how to prevent further recurrences. If you are looking at treatment for ulcers, contact Call:6366494494