Mouth Ulcers: Causes and Treatments

I had a patient from India who suffered from a burning sensation in his mouth when eating spicy foods. He complained of an ulcer that had not healed over a long period of time. He had taken multivitamins for some time, but they didn’t seem to help.

Oral ulcers are the result of a break in the continuity of epithelium or mucous membrane in the oral cavity. There can be various causes for oral ulcers: trauma, cheek chewing, chemical injury, vitamin deficiency, systemic diseases, or an idiopathic cause. Other than the common factors, like a fractured tooth and sharp cusps of teeth, traumatic ulcers can be caused by ill-fitting dentures or a cheek bite.

The patient in question developed an ulcer as a result of trauma. Due to continued irritation, the superficial layer of oral mucosa eroded and hyperkeratinisation presented around the eroded mucosa, which it appears white in the photo.  This is why he experienced a burning sensation.

Treatment involved removal of the underlying cause, which in this case meant extraction of a fractured and decayed tooth. In the case of a minor chipped tooth, a filling/crown or coronoplasty could be performed to restore the smooth contour. However, this particular cases required extraction. After removal of the underlying cause, the ulcer generally healed in a couple of weeks.

Xray image – Upper, last molar (wisdom tooth) is shown to have extensive decay and sharp chipped edges, which caused an oral ulcer.


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