can interfere with smiling, eating, and look unsightly.
They can be
Ill fitting dentures
Sharp edge of a broken tooth
Fungal or viral infection
Symptom of a
disease and/or disorder
Mouth sores are common and rarely cause
complications. The most
1. Canker sores
are small white or gray based ulcer with a red border IN the mouth.
They are very common but not contagious.
Fatigue, stress or allergies can increase the
likelihood of getting canker sores.
Sore Self Test
Canker Sores Expanded
2. Cold sores
are called fever blister or herpes simplex because they are usually
caused by herpes virus type 1 which is very contagious and occur
OUTSIDE the mouth.
Most often found around
the mouth but sometimes occur on the
gums or roof of the mouth
Inside the mouth
Valtrex for herpes
outside the mouth||
| In severe
cases, topical-based steroids|
Dec 12/03 Academy of General
It is defined as a whitish plaque that
cannot be characterized as any other
disease and is not associated with any
physical or chemical causative agent except
the use of tobacco *** A thick, whitish
or gray color
patch that forms on the inside of cheeks, gums or tongue and is caused by excess
cell growth. It is the mouth's reaction to
chronic irritation of the mucous membranes
of the mouth. It is found among tobacco users, or those wearing ill
fitting dentures or have a habit of chewing on their check. It
is more common in men than in women, however
women with leukoplakia have a higher risk
of developing squamous cell cancer.***
The growth can occur at any
time in life but it most common in the
of the mouth is an unusual form of
leukoplakia that is seen only in people
who are infected with HIV, have AIDS, or
AIDS-related complex. It consists of
corrugated, fuzzy, hence the name "hairy," white
patches on the lateral borders of the tongue and less
frequently elsewhere in the mouth. It
may resemble thrush, an infection caused
by the fungus Candida which, in adults,
usually occurs if your immune system is
not working properly, and may be one of
the first signs of infection with the
HIV virus. Unlike thrush, it is
not easily scrapped off.
is painless, but patients occasionally
complain of its appearance and texture.
rough teeth, fillings, crowns, or
ill-fitting dentures that rub
against your cheek or gum
pipe smoking, or other tobacco use
body's reaction to
the Epstein-Barr virus (responsible
|Sun exposure to
the lips |
although rare |
|HIV or AIDS
|White or gray
colored patches on your tongue,
gums, roof of your mouth, or the
inside of the cheeks of your mouth.
|This patch may
have developed slowly over weeks to
months and be thick, slightly
raised, and may eventually take on a
hardened and rough texture.
|Painless but may
be sensitive to touch, heat, spicy
foods, or other irritation.|
will likely be taken to rule out
other causes. |
Treatment may involve:
source of irritation i.e. rough
tooth or an irregular surface on a
denture or filling the tooth will be
smoothed and dental appliances
smoking, you will be asked stop
smoking or using other tobacco
requires treatment with an antiviral
is usually harmless, and lesions
usually clear in a few weeks or months
after the source of irritation is
removed. If eliminating the source of
irritation is ineffective in reducing
leukoplakia, the lesion may need to be
surgically removed. The lesion can be
removed either by your general dentist
or by an oral surgeon in their office
under local anesthesia.ADA
New Discovery-Sanguinarine, a natural
anti-bacterial agent, was once a key
ingredient in the Viadent line of
toothpastes and mouth rinses.Researchers suspect that sanguinarine causes
the formation of white
lesions, called oral leukoplakia. The
current study suggests that users of the
former Viadent formulation were eight to 11
times more likely to develop leukoplakia
than were those who had never used the
Patients who used the old formulation of
Viadent develop lesions two, three, four, even five years
after they stopped using the product". Patients with
leukoplakia should be alert for oral
Oral lycopene - An efficacious treatment for
A total of 58 patients
received either 8 mg oral lycopene in two
doses daily (n=20), 4 mg oral lycopene in
two doses daily or placebo capsules
for a 3-month period. Progress of patients
was followed for a further 2 months.
There was no significant difference in the
clinical response of people who took 8 mg
lycopene compared with those taking 4 mg
lycopene. The clinical responses measured in
both these groups were significantly
greater, however, than those in the control
group. The response, assessed histologically,
after the 8-mg
lycopene treatment was significantly better
than that from 4 mg lycopene and than the
response seen in the control group, Patients
taking 4 mg lycopene also responded
significantly better than those in the
control group .
Oral lycopene appears, from this small
RCT conducted over 5 months, to be effective
in the treatment and management of oral
lycopene — an efficacious treatment for oral
leukoplakia? Joanna M Zakrzewska1
Singh M, Krishanappa R, Bagewadi A, Keluskar
V. Efficacy of oral lycopene in the
treatment of oral leukoplakia. Oral Oncol
4. Oral lichen
is a mouth
rash of unknown cause.
contagious and not inherited.
painless or cause pain.
may be more
severe at times of stress.
and scalp may be affected .
caused or aggravated by medicines, tooth
filling materials, or toothpastes.
is usually necessary to confirm the
area wipes off and leaves a bleeding
Lichen Planus of
Lichen planus of the mouth and tongue most commonly
affects 1-2% of the population, most of whom
are middle aged women. The condition is less
common in the very young and the very old.
It appears on the inside of the cheeks, gums and
tongue. Oral lichen planus is more difficult
to treat and typically lasts longer than skin
lichen planus. Fortunately, many cases of
lichen planus of the mouth cause minimal
problems. About one in five people who have oral lichen planus also have
skin lichen planus.
Oral lichen planus typically appears as
patches of fine white lines and dots. These
changes usually do not cause problems.
Dentists during routine checkups often find
them. More severe forms of oral lichen planus
can cause painful sores and ulcers in the
mouth. Often a biopsy of affected tissue is
needed to confirm a diagnosis of lichen
planus. Your doctor may have to make sure that the sores
are not caused by a yeast or an infection and
are not canker sores. Sometimes, several
biopsies are needed at various times, along
with blood tests.
knows what causes lichen planus, although
some experts suspect that it is an abnormal
immune reaction following a viral infection,
probably aggravated by stress. Occasionally,
lichen planus in the mouth appears to be an
allergic reaction to medications, filling
material, dental hygiene products, chewing
gum, or candy.
The cases of lichen planus-type
allergic reactions to dental materials are very rare. When an allergy by dental
material has been proven, removing dental
material is recommended.
planus in the mouth occurs in six different
forms with a variety of symptoms:
white plaques, or eroded
gums are affected, so
that the surface of the gum peels off,
leaving the gums red and raw.
There is no known cure for oral lichen planus
although there are many treatments that
eliminate the pain of sores. When the disease
causes no pain or burning, treatment may not
be needed. More severe forms of lichen planus
- those with pain, burning, redness, blisters,
sores and ulcers - can be treated with a variety of medications, both
applied to the sores (topical) and taken by
mouth (oral). As with any disease of the
lining of the mouth, lichen planus can lead to
poor dental hygiene and gum disease.
2. Compounds with potential to cause
contact stomatitis include1,2
(especially those containing
cinnamonaldehyde, formalin and herbal
materials (amalgam, steel wires,
beryllium, palladium, platinium,
4. Drugs that have potential to cause
danger is that it can progress to cancer.
This condition often
needs a biospy.
identifying the factors that may cause the
lesions. An examination and a biopsy are done in order to
determine how to individually manage your care. The cause of this condition
must be removed . The lesion must be examined
at three to six month intervals depending on
its type, location and size. Fluocinonide
(Lidex) - 60g
apply to affected areas four times a day.
Also try using milder toothpastes instead of
tartar control products also seems to lessen
the number of ulcers and makes them less
often know as oral thrush is a fungal infection that occurs when they
yeast Candida albicans reproduce in large numbers. It
can also be called angularchelitis. It
results in red and cream or while colored,
slightly raised patches on the mucous membrane
of the tongue, mouth and throat that form
on the mouth's moist surfaces. The
mucous membrane beneath the patches is usually
raw and bleeding. The overgrowth of this
fungus results when the balance in the normal
oral microbe population is disturbed by
antibiotic therapy or disease.
the patch can be painful It can cause
difficult in swallowing and diminish the sense of taste.
most frequently in infants, in adults suffering
from chronic illnesses, in the debilitated, in
is a common condition in very young, elderly or debilitated by disease or
with improperly functioning immune system, denture wears who are over closed , babies,
or after antibiotic
treatment and in individuals
on long-term antibiotic, corticosteroid, or
antineoplastic therapy. It
is often an early symptom of HIV infection.
People with dry
mouths also have a higher occurrence of Candidiasis.
Treatment consists of controlling the conditions
that caused the outbreak. Because candidiasis is common
among denture-wearers, a thorough daily cleaning
of dentures is important. Removing dentures
at night also allows the denture-bearing tissues
to regenerate. Saliva substitutes or
prescription medication can help. Good
oral hygiene is essential. It can also be
treated with antifungal/anti-inflammatory
ointment. Also try hard not to lick your lips
especially when the corners are cracked. Fluconazole
is very helpful along with rigorous daily oral
200 mg oral
100 mg tabs
B 100 mg/ml suspension
10 mg troches
Treatment for these conditions are provided through your dentist on an individual basis
depending on your condition. Any ulcer which becomes increasingly painful
or is persistent should be seen by a specialist.^Be
sure to get new toothbrush, floss holder,
anything else you would put in your put in
your mouth.....bathroom cup?
If a denture or your mouth
can carry the fungus (which would be soaked
in a nystatin mixture) than other items you
use in your mouth can carry the fungus and
you can reinfect your mouth by not cleaning
these items or using new mouth care items.
are recommending patients to consume aloe
vera juice to treat various internal
ulcerations of the mouth, including aphthous
ulcer, a common condition usually caused
by stress and/or may be precipitated by trauma; and lichen planus a disease of
unknown origins affecting the skin and oral
mucus membranes. Recent findings will show
that aloe vera cleared up oral lesions
associated with lichen planus better than any
other traditional treatments.**
is a common side
effect of Advair.
the mucosa and works well. You can
also use the Mycelex troches.
oint (15gm)applied to inside of denture
after cleaning and to corners of mouth and
misolex troches (disp 70) 1 tab in mouth
until gone 4-5Xday for 14 days.
(CHX) will kill the
planktonic bugs, but
wont do much for the biofilm. Even if you
can kill all the bugs in the biofilm, unless
you remove the remnants of the
polysaccharide matrix new bugs can
re-populate and re-form the biofilm
very rapidly. IDF
for severe mouth ulcers .
can and does manifest itself intraorally in
the form of ulcerations, erythema (red
lesions), and keratosis (thickened dermal
layer, whitish in color). The vermilion
border of the lip, the inner cheek, gums,
and roof of the mouth are areas which are
Hairy tongue — A hairy tongue is
due to a profuse overgrowth of a particular type of taste bud —
the filiform papillae — which gives the appearance of thick fur
on the tongue. This can result from:
• Antibiotic treatment
• Excessive use of mouthwashes, which liberate oxygen from the
• Reduction in salivary flow due to problems with the salivary
Brown papillae are usually due to tobacco staining or overgrowth
of a particular type of chromogenic bacteria.
There are no symptoms associated with a hairy tongue. Treatment
is of the underlying cause, such as stopping antibiotics or
mouthwashes or dealing with the salivary gland problems.
Geographic tongue —
Geographic tongue (benign migratory glossitis) is a benign
condition that occurs in up to 3 percent of the general
population. Most often, it is asymptomatic; however, some
patients report increased sensitivity to hot and spicy foods.
The cause and the pathogenesis are still poorly understood. The
condition affects males and females and is noted to be more
prominent in adults than in children.
Classically, it appears as an area of erythema, with atrophy of
the filiform papillae of the tongue, surrounded by a white,
hyperkeratotic border. The patient often reports spontaneous
resolution of the lesion in one area, with the return of normal
tongue architecture, only to have another lesion appear in a
different location of the tongue. Lesion activity may wax and
wane over time, and patients are occasionally free of lesions.
If lesions occur at other mucosal sites, the condition is termed
Oral warts can occur anywhere in
the mouth, including the tongue. The causative agent is the
human papillomavirus (HPV). These growths generally are not
painful and can be ignored unless they interfere with appearance
or function. It is estimated that 40 million Americans are
infected with one or more of the 80 strains of HPV. HPV has been
implicated in some oral cancers and is contagious.
This literature review article examines the
increase in incidence of Acute Necrotizing Ulcerative
Gingitivitis (ANUG) as a result of the increasing incidence of
severe immunodeficiency states such as Acquired
Immunodeficiency Syndrome (AIDS)
in the presence of poor nutrition. This review provides an
understanding of the etiology, pathophysiology, and management
of ANUG with malnutrition.The
Epidemiology, Etiology, and Pathophysiology of Acute Necrotizing
Ulcerative Gingivitis Associated with MalnutritionFolayan MO
Angioneurotic edema (Allergy related). Find allergen
causing the lip to swell.
Although rare, it presents with oral ulcers - a summary follows:
Sores in the Mouth are painful canker sores that can overlap
and take days or weeks to heal. Look for white or yellow
centers, with a red edge. They are especially painful on the
tongue, but can be found anywhere inside the mouth. Gum lesions
are not very common, but do occur. If they predominate, then
consider another diagnosis. These sort of ulcers are quite
common amongst perfectly healthy people and they have to be
linked with some other symptoms to be part of Behcet's Syndrome.
may be given for this condition. IDF 10/05
Pain relief for generally sore
Rincinol by Butler
Medical Update for
Dental Professionals on Mouthsores
***Pennsylvania Dental Journal, September/October
2002; Dentistry Today February 2003 pg 46.
**Academy Of General Dentistry,
Plant Aloe Vera: Relieve a Cold Sore 9/01.
~Common Mouth Sores, JADA, Vol. 132, November 2001
*Legacy of discontinued ingredients in patients' mouths, 27 Dec
2001 20:15:04 -0000, the research was supported by a grant from
the American Cancer Society.
^VOLUME 192, NO. 3, PAGES 139-140, Oral ulceration: a new and
#Picture courtesy of Dentalcare.
Mouth Ulcers Homepage
February 06, 2008
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