Oral ulceration (mouth ulcers)

Mouth | General Practice | Oral ulceration (mouth ulcers) (Disease)


Oral ulceration is a common oral mucosal disorder arising from a range of aetiologies but, apart from being associated with discomfort or pain, rarely results in complications apart from occasional scarring. Most are self-resolving and transient (e. g. , after a simple cheek bite). However, some may require the intervention of a medical or dental practitioner. For example, the serious and potentially life-threatening condition oral carcinoma often initially manifests as a solitary oral mucosal ulceration.

Causes and Risk factors

An oral ulcer or ulceration is caused by the complete loss of epithelium accompanied by variable loss of the underlying connective tissue, which results in a crateriform appearance. It may be augmented by oedema and/or proliferation of the surrounding tissue. Ulcers that do not heal within 2 weeks may be considered persistent or chronic.

A classification system based on distinguishing whether the ulceration is simple: a single ulcer without the involvement of the remaining mucosa; complex: a single or multiple ulcers with changes to the surrounding mucosa, skin, and/or systemic manifestations. The lesion may be white, red, or vesiculobullous; destroying: diffuse lesion with tissue destruction and severe systemic involvement.

Diagnosis and Treatment

The diagnosis of the more common oral ulcerations, in an otherwise healthy patient, is straightforward and determined from the medical history and clinical examination. However, patients with impaired immunological function (e. g. , HIV, chemotherapy, malnutrition) may present with more severe, widespread, atypical presentations that require a comprehensive assessment. ...