Oral Ulceration Flashcards
What is an ulcer?
An ulcer is a breach in the oral epithelium, which typically exposes nerve endings in the underlying lamina propria, resulting in pain or soreness.
What are the 4 types of trauma oral ulcerations?
- Mechanical
- Chemical
- Thermal
- Factitious
Give 2 examples of chemical trauma:
- Aspirin
- Hydrogen peroxide
What is factitious trauma usually a consequence of?
Typically, a disturbed mental state - a cry for help
-some people self-extract teeth
Ulcers caused by trauma can resemble which type of cancer?
Ulcers caused by trauma look similar to squamous cell carcinoma
Give 3 facts about Aphthous ulcers
- Mildly painful, more annoying heal within 7 to 10 days
- Typically occur on dorsal surface of tongue
- Can occur from childhood to around 40 years
What are the 3 main types of RAS?
List 3 things all types consist of:
- Minor
- Major
- Herpetiform
For all types:
1. All have localised burning or pain
2. All are painful
3. All reoccur with variety of intervals
Minor Aphthae:
1. What does it consist of?
2. Where can they occur?
3. How long do they take to heal?
- Minor Aphthae consists of small, well-defined shallow ulcers with slightly raised erythematous borders
- Central area covered by yellow/white pseudomembranous - Occur on lips, cheeks, sulci in clusters of 1-5
- Takes 10-14 days to heal without scarring
Major Aphthae:
1. How long does it take to heal?
2. What pain is experienced in relation to minor aphthae?
3. When in isolation, what should be considered?
- 10-40 days with scarring
- More painful than minor aphthae
- In isolation, by suspicious of malignancy
List 4 relations to RAS
- Haematinic deficiency states i.e. iron, folate
- GI disturbances - coeliac, crohn’s
- Drugs - NSAIDs
- Bechet’s disease
What is Bechet’s Disease?
List 3 main symptoms of Bechet’s Disease?
Bechet’s - rare chronic disease, results in inflammation of blood vessel and tissues
Main symptoms:
1. Red, painful eyes and blurred vision
2. Genital and mouth ulcers
3. Acne-like spots
Herpetiform Aphthae (HU):
1. Who is it most common in?
2. Do they appear in several numbers?
3. How long to heal?
4. Is there any relation to Herpes Virus?
- Less common out of all types but seen in elderly people
- In numbers of up to 150
- Take around 7-10 days to heal
- Nothing to do with Herpes Virus at all!
How is RAS diagnosed?
There is no specific test - full blood count and serum ferritin, B12 and folate tested and biopsy is of little value.
In terms of oral ulcers and their relation to malignancy, when would you refer to a specialist?
If there is a single ulcer, often painless, which has persisted for more than 3 weeks or is indurated (thickening and hardening of the tissues.
List 3 areas of concern which might indicate a malignant ulcer:
- Indurated boarder of ulcer
- Raised boarder
- Lesion appears red with a white centre
