Mouth (Aphthous) Ulcer
Mouth (Aphthous) Ulcer
Small whitish painful sore on soft tissue areas within the mouth.(Any shallow breach of the skin or mucous membrane is called an ulcer.
What to look for
The skin lining of the mouth or on the tongue is broken appearing like a white spot and the area around the ulcer looks much redder than the unbroken skin beyond it. Most common ulcers heal within 10 days. If a generally painless ulcer has not healed after 3 weeks, this could be an early sign of cancer and the patient requires specialist referral.
Treatment
Keep the area clean using a simple salt mouthwash or Chlorhexidine ( see Teeth Relief manual page 53). to control infection and enable it to heal.
No medicine will give complete relief so make sure the patient is aware of this.
If the skin around the ulcer is very swollen AND you can feel the lymph glands (soft lumps just underneath the lower jaw bone) a suitable antibiotic may be required – e.g. 500 mg amoxycillin 3 x daily x 7 days (see Teeth Relief manual page 52).
Risk Factors
Stress – they often occur as a sign of being run down or under stress
Age – they occur more often in teenagers and young adults and more common in females
Trauma – e.g. biting side of mouth, using toothbrush carelessly, eating food which is too hot
Diet – deficiencies of B vitamins and nutrients such as zinc, folic acid, iron as well as irritation from acidic and spicy food and by cigarette smoke
Infections – human papilloma virus (HPV), human herpes virus-8 (HHV-8), Epstein-Barr virus (EBV), human immunodeficiency virus (HIV) and herpes simplex virus (HSV-1). HIV ulcers will take much longer to heal and the sore area(s) may get enlarged, especially when taking one of the medicines used to weaken HIV e.g. AZT (zidovudine)
Medications – use of nonsteroidal anti-inflammatory medications (NSAIDs), beta blockers chemotherapy drugs
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