ORAL ULCERATION Dr. Shahzadi Tayyaba Hashmi [email protected].
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Transcript of ORAL ULCERATION Dr. Shahzadi Tayyaba Hashmi [email protected].
• Oral mucosa is composed of stratified squamous epithelium, which covers and protects the underlying connective tissues from the oral cavity
• An ulcer is formed when there is a break or defect in the epithelial covering and the underlying connective tissue is exposed to saliva and microorganisms of the oral cavity
• The surface of the ulcer is covered by a white-grey slough
ORAL ULCERATION
Trauma
Idiopathic Apthous ulceration
Causes of oral ulceration
• There are many causes of trauma in the oral cavity and these include mechanical, chemical and thermal trauma
Mechanical trauma:• May be caused by sharp cusps, orthodontic appliances and ill-
fitting dentures• Diagnosis of this type of ulceration is not difficult• Once the cause is removed, the ulceration usually starts to heal
within 10 days
Traumatic ulceration
Ulcers caused by ill-fitting dentures and orthodontic appliances
Chemical ulceration:• Relatively uncommon• May be caused by the drugs and other oral medications taken by the patient• Aspirin tablets placed in the oral cavity can cause this type of ulceration
Thermal trauma:• Relatively common• Caused by the ingestion of very hot food or drinks• The oral cavity heals quickly without scarring
Traumatic ulceration
• Also known as recurrent Apthous stomatitis• Apthous ulcers are relatively common• Their characteristic feature is recurrence and typically they start in
childhood and tend to decrease in frequency with age• Exact cause of Apthous ulceration is unknown but there is family
history in 45% of patients• Other causes are stress, trauma and menstruation
Apthous ulceration
• Three clinical types have been identified:
1. Minor apthae
2. Major apthae
3. Herpetiform ulcers
Types of Apthous ulceration
• Most common type of ulceration• Ulcers are typically small, about 2-5mm across, oval and covered
by a grey slough• Surrounding mucosa may be Erythmatous• They affect non- keratinized mucosa ,for example they are present
on the lateral border of tongue, floor of the mouth, buccal mucosa and lips
• Lasts about 10-14 days• May be very painful and pain increases towards the end of the 14-
day period
TREATMENT:• Symptomatic treatment
Minor apthae
• These ulcers are not common• Larger and usually greater than 5-10mm in diameter• They are often multiple and affect keratinized as well as non-
keratinized mucosa• Lips, cheeks and soft palate are common areas• They last between 4 and 6 weeks and may be very painful• Heal with scarring
Major apthae
• Systemic and topical steroids• Antimicrobial rinses to prevent secondary
infection
TRATMENT
THANK YOU