Ulceration Flashcards
definition of ulceration
localised defect seeing a break in the continuity of epithelium exposing the underling connective tissue
name 5 potential causes of ulceration
trauma, allergy, infection, idiopathic, neoplastic, gastrointestinal (crohns, UC) , immunological (apthous, LP, SLE)
describe the appearance of typical traumatic ulcer
keratinised gingiva (white) periphery with a connective tissue centre (yellow). surrounding mucosa may be normal or have erythmatous change
no induration
induration
thickening / hardening of epithelium
describe the appearance of a crohns disease ulcer
linear fissure ulcer along depth of sulcus
lesions can persist for months
name 4 ulcer red flags
lasts >3 weeks
margins are rolled and/ or irregular
hard consistency (indurated)
immoveable from surrounding tissues
what are the 4 steps in treatment of aphthous ulcers according to SDCEP guidelines
1 - simple mouthwash
2 - antimicrobial mouthwash
3 - local analgesics
4 - topical corticosteroids
discuss the simple mouthwash treatment for ulceration detailed by the SDCEP guidelines
1/2 teaspoon of salt dissolved in warm water and rinsed around mouth
- helps pain and swelling
discuss antimicrobial mouthwash treatment for ulceration detailed by the SDCEP guidelines
chlorhexidine 0.2% mouthwash - 1 min with 10ml 2x daily
hydrogen peroxide 6% - 15ml diluted in half glass water, 2 mins 3x day
discuss local analgesic treatment for ulceration detailed by the SDCEP guidelines
benzydamine mouthwash 0.15% - every 1.5 hours or as needed (for up to 7 days)
benzydamine spray 0.15% - 4 sprays every 1.5 hours
discuss topical corticosteroid treatment for ulceration detailed by the SDCEP guidelines
beclometasone MDI (accessible and localised lesions) - 1-2 puffs direct to ulcer 2x daily
betamethasone soluble tablets - dissolved in 10ml water to create a mouthwash , 4 x daily
