Oropharynx

Question 1

Mouth ulcers

Answer 1

Painful sores on the inside of the mouth

Question 2

Causes of mouth ulcers

Answer 2

Infection
Trauma
Iron, folate, zinc, B12 deficiency -> may lead to glossitis

Question 3

Mouth ulcers symptoms

Answer 3

• lesions with a white/yellowish centre with an inflammed outer ring

Question 4

Mouth ulcers referral

Answer 4

• Ulcer present for longer than 3 weeks
• Painless ulcers
• Ulcers greater than 10mm in diameter (common in patients with ulcerative colitis)
• Herpetiform ulcers
• Ulcers associated with weight loss

Question 5

Mouth ulcers treatment

Answer 5

Chlorhexidine
Can be used to prevent bacterial infection 12+

Local analgesics
Adult Bonjela - choline salicylate (salicylate cannot be given to individuals under 16 years due to risk of reyes syndrome)

Difflam oral rinse - benzydamine 12+

Local anaesthetics
Lidocaine, benzocaine (iglu, bonjela, oragel)

Question 6

Mouth ulcers lifestyle advice

Answer 6

Avoid spicy, salty, acidic, hot food until the ulcer heals

Brush teeth before using chlorhexidine but rinse mouth thoroughly as toothpaste can inactivate chlorhexidine