Oral Medicine - Chapter 2: Oral Ulcers
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Questions and Answers

What is one common local cause of ulceration mentioned?

  • Genetics
  • Infection
  • Autoimmune disorders
  • Trauma (correct)

Which area is typically affected by thermal trauma?

  • Mandibular gingiva
  • Maxillary and palatal gingiva (correct)
  • Buccal mucosa
  • Tongue

Which of the following is a possible chemical cause of ulceration?

  • Vinegar
  • Hydrogen peroxide
  • Saline solution
  • Bleaching agents (correct)

Which type of trauma is not listed as a cause of ulceration?

<p>Mechanical trauma (A)</p> Signup and view all the answers

Which chemical substance is indicated as a contributor to ulceration?

<p>Aspirin (D)</p> Signup and view all the answers

What is the outcome once the source of trauma causing an ulcer has been identified and resolved?

<p>The ulcer will usually resolve spontaneously. (B)</p> Signup and view all the answers

Which of the following types of recurrent lesions is mentioned in relation to oral ulcers?

<p>Aphthae (D)</p> Signup and view all the answers

What are the classifications of Recurrent Aphthous Stomatitis mentioned?

<p>Minor, Major, Herpetiform (A)</p> Signup and view all the answers

Which therapeutic approach is typically unnecessary once the trauma causing an ulcer is addressed?

<p>Spontaneous healing (D)</p> Signup and view all the answers

What is the relationship between trauma resolution and ulcer healing?

<p>Resolving trauma typically leads to spontaneous resolution of the ulcer. (C)</p> Signup and view all the answers

Which laboratory tests are essential for diagnosing anemia?

<p>FBC (CBC), hemoglobin level, red cell folate and B12 (B)</p> Signup and view all the answers

Aphthous like ulceration can be associated with which of the following conditions?

<p>Behcet syndrome (A)</p> Signup and view all the answers

Which immune deficiency conditions may lead to aphthous like ulceration?

<p>HIV and cyclic neutropenia (C)</p> Signup and view all the answers

What skin condition might be suggested by the presence of white striation?

<p>Lichen planus (D)</p> Signup and view all the answers

Which of the following conditions is primarily characterized by skin lesions?

<p>Pemphigus vulgaris (C)</p> Signup and view all the answers

What does a low WBC count suggest in the context of immune deficiencies?

<p>Higher risk for systemic diseases (D)</p> Signup and view all the answers

Which of the following reflects a possible condition that can manifest with mucosal changes?

<p>Lichen planus (C)</p> Signup and view all the answers

Which gastrointestinal condition could potentially manifest as aphthous like ulceration?

<p>Crohn's disease (B)</p> Signup and view all the answers

Which disease is associated with both skin lesions and mucosal involvement?

<p>Bechet disease (C)</p> Signup and view all the answers

What is a key characteristic of pemphigus vulgaris?

<p>Development of skin lesions (A)</p> Signup and view all the answers

What do the diseases referred to in the content primarily cause?

<p>Periodic or episodic fever (D)</p> Signup and view all the answers

How is the fever described in relation to these diseases?

<p>It occurs in episodes or periodically (D)</p> Signup and view all the answers

Which statement best describes the origin of the fevers mentioned in the content?

<p>The fevers have a non-infectious origin (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of the diseases described in the content?

<p>They have infectious origins (A)</p> Signup and view all the answers

What is a notable characteristic of the fevers caused by these diseases?

<p>They do not have an infectious origin (A)</p> Signup and view all the answers

Which of the following drugs is used in chemotherapy and is known to cause cytotoxic effects?

<p>Methotrexate (B)</p> Signup and view all the answers

Which medication is mentioned as an agent to treat angina that may lead to oral ulceration?

<p>Nicorandil (D)</p> Signup and view all the answers

Which of the following drugs is classified as a non-steroidal anti-inflammatory drug (NSAID)?

<p>Ibuprofen (A)</p> Signup and view all the answers

What common condition can be treated with Nicorandil, aside from its potential to cause oral ulceration?

<p>Angina (D)</p> Signup and view all the answers

Which of the following is NOT a potential side effect of methotrexate?

<p>Increased appetite (C)</p> Signup and view all the answers

Flashcards

Mucosal changes

Changes in the mucous membranes of the body.

Skin Changes

Alterations in the appearance or texture of the skin.

White striation

White stripes or lines on the skin.

Lichen planus

Skin condition causing skin and mucosal issues.

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Pemphigus vulgaris/Behçet's disease

Specific skin diseases causing lesions

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Local cause of ulceration

Trauma is a common local cause of ulceration.

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Common site of thermal trauma

Maxillary and palatal gingiva are common sites of thermal trauma.

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Thermal trauma

Burns or injuries caused by heat.

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Chemical trauma ulceration

Chemical agents, including bleaching agents, cocaine, and aspirin, can cause ulceration.

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Bleaching agents

Chemical substances used to whiten teeth.

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Aphthae

Small, painful ulcers that appear in the mouth. They are usually white or yellowish in color and are surrounded by a red halo.

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Recurrent Aphthous Stomatitis

A condition characterized by recurring episodes of aphthae, or painful mouth ulcers.

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Minor Aphthous Ulcers

The most common type of aphthous ulcer. They are small, shallow, and usually heal within 10-14 days.

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Major Aphthous Ulcers

A larger and deeper type of aphthous ulcer that can take several weeks to heal. They can be quite painful and leave scars.

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Herpetiform Aphthous Ulcers

A type of aphthous ulcer that appears in clusters of tiny, pinhead-sized ulcers. They can be quite numerous and painful.

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Aphthous-like Ulceration

Mouth sores resembling aphthous ulcers, but may indicate a larger health issue.

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HIV and Aphthous-like Ulcers

People with HIV may experience mouth ulcers as a symptom of the weakened immune system.

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Cyclic Neutropenia

A condition where the number of neutrophils (white blood cells) in the blood fluctuates, causing recurring infections and mouth ulcers.

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Behcet's Syndrome

An autoimmune disease causing inflammation in blood vessels, leading to mouth ulcers, skin lesions, and other symptoms.

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Periodic Fever Syndromes

Conditions characterized by recurring episodes of fever, inflammation, and various symptoms, including mouth ulcers.

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Fever of Unknown Origin (FUO)

A condition characterized by recurrent or persistent fevers that don't have a clear infectious cause.

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Episodic Fever

Fever that comes and goes in distinct episodes, often with periods of normal temperature in between.

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Non-Infectious Fever

Fever that is not caused by an infection, meaning it's not due to bacteria, viruses, or other pathogens.

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Methotrexate

A cytotoxic drug used during chemotherapy that can cause oral ulceration.

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Periodic Fever

Fever that recurs at regular intervals, like every few days or weeks.

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What are some examples of non-infectious causes of fever?

Non-infectious causes of fever include autoimmune diseases, inflammatory conditions, and certain medications.

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NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can cause oral ulceration as a side effect.

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Nicorandil

A medication for angina, a type of chest pain, that can cause oral ulceration.

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Oral ulceration causes

Oral ulceration can be caused by certain medications like methotrexate, NSAIDs, and nicorandil.

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Chemotherapy side effects

Chemotherapy, using drugs to treat cancer, often has side effects including oral ulceration due to drugs like methotrexate.

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Study Notes

Oral Medicine - 2

  • Oral mucosal ulcers are common, potentially reflecting a local or systemic cause.
  • A thorough clinical exam and history are crucial for diagnosis.
  • Complete loss of epithelium exposes underlying connective tissue (ulcer).
  • Partial loss of epithelium results in an erosion.
  • Common oral lesions include ulcers.
  • Ulcers can be a manifestation of numerous factors (local or systemic).
  • Clinical features aid diagnosis: number of lesions, location, and duration.
  • A single ulcer might indicate trauma, while multiple ulcers suggest recurring issues (e.g., stomatitis, herpes).
  • Location is significant (e.g., non-keratinized mucosa likely aphthous ulcer).
  • 2-3+ weeks of ulceration may point to more severe causes.
  • Trauma-related ulcers can be thermal (e.g., maxillary/palatal gingiva), chemical (e.g., bleaching agents), or mechanical (e.g., dentures, parafunctional habits).

Clinical Features of Oral Ulcers

  • Number of lesions (single vs. multiple).
  • Location (keratinized vs. non-keratinized tissue).
  • Duration (> 2-3 weeks could indicate a more serious cause)

Local Causes

  • Trauma: thermal (e.g., hot foods), chemical (e.g., aspirin), and mechanical (e.g., ill-fitting dentures).
  • Parafunctional habits: overuse of teeth.
  • Poor denture fit.

Recurrent Aphthous Stomatitis (RAS)

  • Common oral condition.
  • Typically starts in childhood or adolescence.
  • Minor, major, or herpetiform types.
    • Minor RAS is the most common type, characterized by small, round ulcers, <5mm, with a yellowish base and erythematous halo. Heals in 7-10 days. No scar.
    • Major RAS is larger, >1 cm, occurs less frequently.
    • Herpetiform ulcers are smaller (<5mm), multiple (frequently >10), and may coalesce.

Systemic Diseases

  • Some systemic diseases can manifest as oral ulcers (e.g., Behcet syndrome, HIV, etc)
  • Hematologic deficiencies, immunodeficiencies and other systemic diseases can cause ulceration as a symptom.
  • Some types of leukemia frequently include gum tissue enlargement, open sores in the mouth, and bleeding.

Infections

  • Viral infections (e.g., Herpes simplex virus, Coxsackievirus).
  • Bacterial infections (e.g., ANUG, syphilis, tuberculosis).

Drug-Induced Ulceration

  • Medications can cause oral ulcerations (e.g., cytotoxic drugs, NSAIDs).

Lichen Planus

  • An immunologically mediated mucocutaneous disorder.
  • Often appears as reticular, plaque-like, or erythematous lesions or patterns in the mouth.
  • Commonly affects the buccal mucosa, tongue, and gingiva.

Oral Lichen Planus

  • Affects buccal mucosa, tongue, and gingiva.
  • Possible malignant change, less than 1-3%.

Pemphigus and Pemphigoid

  • Similar autoimmune disorders, but differ in blistering locations.
    • Pemphigus presents with intraepithelial blistering (intraepithelial separation from skin or mucous)
    • Pemphigoid is subepithelial blistering (usually affects the skin and mucosal surfaces.

Erythema Multiform

  • Characterized by painful oral ulcers.
  • Can be triggered by infections or medications like NSAIDS.

Malignant Neoplasms

  • Oral cancers and lymphomas can present as persistent non-healing ulcers with irregular borders.

Other

  • Other potential causes for oral ulceration include lupus erythematosus, chronic inflammatory diseases, etc.

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Oral Medicine 2 PDF - University of Jordan Dentistry 019

Description

This quiz focuses on the clinical features and causes of oral mucosal ulcers. It covers diagnosis methods, including the importance of lesion number, location, and duration. Understanding trauma-related ulcers and their manifestations is crucial for identifying potential systemic issues.

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