| ID | 34 |
|---|---|
| Name | Oral Ulceration: Aphthous Ulcer |
| Cause | Cause: The cause of aphthous ulcer remains uncertain. |
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| Management | Treatment: Treatment is usually nonspecific. 1. Local hygiene to be maintained. 2. Steroid preparations: i. Triamcinolone acetonide, 0.1%, or fluocinonide ointment 0.05% in an adhesive base (orabase) may give some symptomatic relief. ii. Hydrocortisone hemisuccinate lozenges 2.5mg thrice daily may be given in early phase. iii. A one week tapering course of prednisone 40-60mg daily can be found useful. 3. Topical anaesthetics can be used for acute pain. Or, 4. Boroglycerine preparation- topical use may give some symptomatic relief by soothing action. 5. Topical use of diclofenac 3% in hyaluronan 2.5% preparation may help in reducing pain. 6. Amlexanox (5%) oral paste- Apply the paste as soon as possible after noticing the symptoms of an aphthous ulcer. Continue to use the paste 4 times daily, preferably following oral hygiene after breakfast, lunch, dinner, and at bedtime. 7. Secondary infections- should be treated with proper antibiotic e.g penicillin or cephalosporin group of drugs &/or antiseptic mouth wash. 8. Cimetidine maintenance therapy may be useful in patients with recurrent aphthous ulcers. |
| Introduction | Recurrent superficial and painful ulcers occur in any part of the mouth, known as aphthous ulcers. These are very common, affecting 20-30% of the population and easy to recognize. Found on nonkeratinized mucosa (e.g buccal and labial mucosa and not gingiva or palate). They may be single or multiple, small (usually 1-2 mm, sometimes may be 1-2 cm) and round ulcerations with yellow-gray fibrinoid centers surrounded by red halos. The painful stage usually lasts 7-10 days; healing is completed within 1-3 weeks. |
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