Oral Ulcers

ORAL ULCERS

A mouth ulcer is the loss or erosion of part of the delicate tissue that lines the inside of the mouth (mucous membrane). Some of the causes include certain drugs, chemicals and infectious diseases such as herpes or thrush. The most common cause is mechanical injury, such as accidentally biting your cheek.

In most cases, mouth ulcers are harmless and resolve by themselves in a few days without the need for medical treatment.

Symptoms

Symptoms vary and depend on the specific cause of the mouth ulcer. In general, symptoms may include:

• Open sores in the mouth

• Pain or discomfort in the mouth

• Swollen skin around the sores

• Problems with chewing or toothbrushing because of the tenderness

• Irritation of the sores by salty, spicy or sour foods

• Loss of appetite

Causes:

1. SMOKING

Smoking which is the most common cause for almost all the dental problems also accounts to be the main factor in causing oral ulcer.

2.INFECTION

Oral ulcers are caused by bacterial, fungal and viral infections.

Bacterial processes leading to ulceration can be caused by Mycobacterium tuberculosis(tuberculosis) and Treponema pallidum (syphilis).Other bacterial flora like streptococi, Neisseria, Actinomyces, spirochetes, and Bacteroides species can prolong the ulcerative process.

Coccidioides immitis causing valley fever, Cryptococcus neoformans causing cryptococcosis, are some of the fungal processes causing oral ulceration.

Mouth ulcers are often caused by protozoans like Entamoeba histolytica.

HIV creates immunodeficiencies which allow opportunistic infections or neoplasms to proliferate

3. PHYSICAL INJURIES

• Accidental biting by sharp edge of a tooth  

• Excessively salty food,and hot drinks

• Poorly fitting dentures or trauma from a toothbrush

These may injure the inner lining of the mouth resulting in an ulcer.Healing of the ulcer depends on the removal of source of injury.

4.CHEMICAL INJURIES

Chemicals such as aspirin or alcohol come in with the oral mucosa causes necrosis of the tissues resulting in the formation of ulcer. 

5. DIET

 Deficiencies of iron,vitamin C(scurvy),vitamin B12,zinc can contribute to ulcer formation.

 Citrus fruits like orange may cause mouth ulcers.

6.IMMUNITY

Immune system:Aphthous ulcers as a common end product of many different disease processes, each of which is mediated by the immune system.

Immunodeficiency:Low levels of immunoglobulins in the oral mucous membranes causes mouth ulcers.

Oral ulcers are common in conditions of immunodeficiency like chemotherapy and HIV.

Autoimmunity: Mucous membrane pemphigoid is an autoimmune reaction to the oral epithelium causing ulceration of the oral mucosa.

7. ALLERGENS

Allergens such as amalgam can cause mouth ulcers.

Complications

• Tooth abscesses

• Oral cancer

• Spread of contagious disorders to other people

Treatment

 Adequate oral hygiene  is the key point in treatment of oral ulcers.

 Topical antihistamines, antacids, corticosteroids, meant to soothe painful ulcers may be helpful, as may be oral analgesics such as paracetamol or ibuprofen and local anesthetics,mouth rinses etc.

Avoid hot or spicy foods, which often increase the pain of mouth ulcers.

Prevention

Good oral hygiene may help prevent some types of mouth ulcers, as well as some complications from mouth ulcers. Good oral hygiene includes brushing the teeth at least twice per day, flossing at least daily, and getting regular professional dental cleanings and examinations.

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