Mouth ulcer on the lower lip

A mouth ulcer (from Latin ulcus) is the name for the appearance of an open sore inside the mouth caused by a break in the mucous membrane or the epithelium on the lips or surrounding the mouth. The types of mouth ulcers are diverse, with a multitude of associated causes including: physical or chemical trauma, infection from microorganisms or viruses, medical conditions or medications, cancerous and sometimes nonspecific processes. Once formed, the ulcer may be maintained by inflammation and/or secondary infection. Two common mouth ulcer types are aphthous ulcers (canker sores) and cold sores caused by the herpes simplex virus.^[1][2] Taken 21 April 2005. ... Taken 21 April 2005. ... Endoscopic images of a duodenal ulcer. ... The mucous membranes (or mucosae; singular: mucosa) are linings of mostly endodermal origin, covered in epithelium, and are involved in absorption and secretion. ... Look up Mouth in Wiktionary, the free dictionary. ... A microorganism or microbe is an organism that is so small that it is microscopic (invisible to the naked eye). ... Stop editing pages god ... An aphthous ulcer or canker sore is a type of mouth ulcer which presents as a painful open sore inside the mouth caused by a break in the mucous membrane. ... This article is about the virus. ...

Symptoms

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The symptoms preceding the ulcer may vary according to the cause of the ulcerative process. Wikipedia does not have an article with this exact name. ... Image File history File links Circle-question-red. ... Wikipedia does not have an article with this exact name. ... An aphthous ulcer or canker sore is a type of mouth ulcer which presents as a painful open sore inside the mouth caused by a break in the mucous membrane. ...

Some mouth ulcers may begin with a tingling or burning sensation at the site of the future mouth ulcer. In a few days, they often progress to form a red spot or bump, followed by an open ulcer. Sometimes this takes a little bit longer, depending on the cause of the ulcer.

The mouth ulcer appears as a white or yellow oval with an inflamed red border. Sometimes a white circle or halo around the lesion can be observed. The grey, white, or yellow coloured area within the red boundary is due to the formation of layers of fibrin, a protein involved in the clotting of blood. The ulcer, which itself is often extremely painful, especially when agitated, may be accompanied by a painful swelling of the lymph nodes below the jaw, which can be mistaken for toothache. Fibrin is a protein involved in the clotting of blood. ... Structure of the lymph node. ... A toothache, also known as odontalgia or, less frequently, as odontalgy, is an aching pain in or around a tooth. ...

Causes

There are many processes which can lead to mouth ulceration. In some cases they are caused by an overreaction by the body's own immune system. Factors that appear to provoke them include stress, fatigue, illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies and deficiencies in vitamin B12, iron and folic acid. Some drugs, such as nicorandil, have been linked with mouth ulcers.^{[citation needed]} Stress (roughly the opposite of relaxation) is a medical term for a wide range of strong external stimuli, both physiological and psychological, which can cause a physiological response called the general adaptation syndrome, first described in 1936 by Hans Selye in the journal Nature. ... Hormone is also the NATO reporting name for the Soviet/Russian Kamov Ka-25 military helicopter. ... Menstrual cycle. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... General Name, Symbol, Number iron, Fe, 26 Chemical series transition metals Group, Period, Block 8, 4, d Appearance lustrous metallic with a grayish tinge Atomic mass 55. ... Folic acid and folate (the anion form) are forms of the water-soluble Vitamin B9. ... Nicorandil is a drug used to treat coronary heart disease. ...

Trauma

Minor physical injuries

Trauma to the mouth is a common cause of mouth ulcers. A sharp edge of a tooth, accidental biting (this can be particularly common with sharp canine teeth), sharp food, poorly fitting dentures, dental braces or trauma from a tooth brush may injure the mucosal lining of the mouth resulting in an ulcer. These ulcers usually heal rapidly if the source of the injury is removed (for example, if poorly fitting dentures are removed or replaced).^[1] In mammalian oral anatomy, the canine teeth, also called cuspids, dogteeth, fangs, or (in the case of those of the upper jaw) eye teeth, are relatively long, pointed teeth. ... Braces Dental braces (also known as orthodontic braces or brackets) are a fixed appliance used in orthodontics to correct alignment of teeth and their position with regard to bite. ...

Chemical injuries

Chemicals such as Aspirin or alcohol that are held or that come in contact with the oral mucosa may cause tissues to become necrotic and slough off creating an ulcerated surface. Sodium Lauryl Sulfate (SLS), one of the main ingredients in most toothpastes, has been implicated in increased incidence of mouth ulcers. Aspirin or acetylsalicylic acid (acetosal) is a drug in the family of salicylates, often used as an analgesic (against minor pains and aches), antipyretic (against fever), and anti-inflammatory. ... Functional group of an alcohol molecule. ... Sodium dodecyl sulfate (SDS or NaDS) (CH3(CH2)11OSO3Na) (FW 288. ...

Infection

Viral, fungal and bacterial processes can lead to oral ulceration.^[1]

Viral

The most common is Herpes simplex virus which causes recurrent herpetiform ulcerations preceded by usually painful multiple vesicles which burst. Herpes Zoster (shingles), Varicella Zoster (chicken pox), Coxsackie A virus and its associated subtype presentations, are some of the other viral processes that can lead to oral ulceration. HIV creates immunodeficiencies which allow opportunistic infections or neoplasms to proliferate.^[2] This article is about the virus. ... Herpes zoster, colloquially known as shingles, is the reactivation of varicella zoster virus, leading to a crop of painful blisters over the area of a dermatome. ... Chicken pox, also spelled chickenpox, is a common childhood disease caused by the varicella_zoster virus (VZV), also known as human herpes virus 3 (HHV_3), one of the eight herpesviruses known to affect humans. ... Coxsackie (virus) is a cytolytic virus of the Picornaviridae family, an enterovirus (a group containing the polioviruses, coxsackieviruses, and echoviruses). ...

Bacterial

Bacterial processes leading to ulceration can be caused by 'Mycobacterium tuberculosis' (tuberculosis) and Treponema pallidum (syphilis).^[2] Tuberculosis (abbreviated as TB for Tubercle Bacillus) is a common and deadly infectious disease caused by the mycobacterium Mycobacterium tuberculosis or Mycobacterium bovis, which most commonly affects the lungs (pulmonary TB) but can also affect the central nervous system, lymphatic system, circulatory system, genitourinary system, bones and joints. ... Syphilis is a sexually transmitted disease (STD) caused by a spirochaete bacterium, Treponema pallidum. ...

Opportunistic activity by combinations of otherwise normal bacterial fauna, such as aerobic streptococci, Neisseria, Actinomyces, spirochetes, and Bacteroides species can prolong the ulcerative process.^[3] According to small-scale experiments by at least one patent applicant (Hau, US Patent No. 6,248,718), topical preparations of high doses of penicillin resulted in accelerated healing of mouth ulcers.

Fungal

Coccidioides immitis (valley fever), Cryptococcus neoformans (cryptococcosis), Blastomyces dermatitidis ("North American Blastomycosis") are some of the fungal processes causing oral ulceration.^[2] Coccidioidomycosis, also called Valley Fever, is caused by the fungus Coccidioides spp. ...

Immune system

Many researchers view the causes of aphthous ulcers as a common end product of many different disease processes, each of which is mediated by the immune system.^[2] An aphthous ulcer or canker sore is a type of mouth ulcer which presents as a painful open sore inside the mouth caused by a break in the mucous membrane. ...

Aphthous ulcers are thought to form when the body becomes aware of and attacks chemicals which it does not recognize. The presence of the unrecognized molecules garners a reaction by the lymphocytes, which trigger a reaction that causes the damage of a mouth ulcer.^{[citation needed]}

Immunodeficiency

Repeat episodes of mouth ulcers can be indicative of an immunodeficiency, signaling low levels of immunoglobulin in the mucous membrane of the mouth. Chemotherapy and HIV are both causes of immunodeficiency with which mouth ulcers become a common manifestation. In medicine, immune deficiency (or immunodeficiency) is a state where the immune system is incapable of defending the organism from infectious disease. ... Chemotherapy is the use of chemical substances to treat disease. ... Human immunodeficiency virus or HIV is a retrovirus that causes Acquired Immunodeficiency Syndrome (AIDS), a condition in which the immune system begins to fail, leading to life-threatening opportunistic infections. ...

Autoimmunity

Autoimmunity is also a cause of mouth ulceration. Mucous membrane pemphigoid, an autoimmune reaction to the epithelial basement membrane, causes desquamation/ulceration of the oral mucosa. Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... Mucous membrane pemphigoid is an autoimmune reaction that occurs at the level of the basement membrane. ... ... Desquamation is the shedding of the outer layers of the skin. ...

Allergy

Contact with allergens can lead to ulcerations of the mucosa. An allergen is any substance (antigen), most often eaten or inhaled, that is recognized by the immune system and causes an allergic reaction. ...

Dietary

Vitamin C deficiencies may lead to scurvy which impairs wound healing, which can contribute to ulcer formation.^[2] Similarly deficiencies in vitamin B12, iron^{[citation needed]}, zinc^[4] and folic acid have been linked to oral ulceration. Too much ascorbic acid (Vitamin C) or citric acid may cause ulcers. In this case the sores disappear after intake decreases (for example, by substituting ascorbate salts for ascorbic acid).^{[citation needed]} Scurvy (N.Lat. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... General Name, Symbol, Number iron, Fe, 26 Chemical series transition metals Group, Period, Block 8, 4, d Appearance lustrous metallic with a grayish tinge Atomic mass 55. ... General Name, Symbol, Number zinc, Zn, 30 Chemical series transition metals Group, Period, Block 12, 4, d Appearance bluish pale gray Atomic mass 65. ... Folic acid and folate (the anion form) are forms of the water-soluble Vitamin B9. ... Vitamin C is a nutrient required in very small amounts to allow a range of essential metabolic reactions in the body. ... Citric acid is a weak organic acid found in citrus fruits. ...

A common cause of ulcers is Coeliac disease, in which case consumption of wheat, rye, or barley can result in chronic mouth ulcers. If gluten intolerance is the cause, prevention means taking most breads, pastas, cakes, pies, cookies, scones, biscuits, beers etc. out of the diet and substituting gluten-free varieties where available. Artificial sugars, such as those found in diet cola and sugarless gum, have been reported as causes of mouth ulcers as well. Coeliac disease or celiac disease is an autoimmune, inflammatory disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. ...

Cancer

Oral cancers can lead to ulceration as the center of the lesion loses blood supply and necroses. Squamous cell carcinoma is just one of these. Biopsy of a highly differentiated squamous cell carcinoma of the mouth. ...

Medical conditions associated with mouth ulcers

The following medical conditions are associated with mouth ulcers:

• Behçet's disease
• bullous pemphigoid
• coeliac disease (gluten sensitivity)
• Crohn's disease
• gingivostomatitis
• leukoplakia
• oral lichen planus
• Lupus erythematosus
• oral thrush
• ulcerative colitis

Behçets disease, is a chronic condition due to disturbances in the body’s immune system. ... This page meets Wikipedias criteria for speedy deletion. ... Coeliac disease or celiac disease is an autoimmune, inflammatory disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. ... H&E section of non-caseating granuloma seen in the colon of someone affected by Crohns disease. ... Stomatitis is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, and roof or floor of the mouth. ... Leukoplakia is a condition of the mouth that involves the formation of white leathery spots on the mucous membranes of the tongue and inside of the mouth. ... Lichen planus is an inflammatory disease that usually affects the skin, the mouth, or sometimes both. ... Oral thrush is an infection of yeast fungus, Candida albicans, in the mucous membranes of the mouth. ...

Palliative treatment for severe cases

Treatments based on antibiotics and steroids such as Dexamethasone Elixir are reserved for severe cases, and should be used only under medical supervision. The topical steroid Lidex can be quite effective at speeding healing as well. Tetracycline suspension is a common antibiotic prescribed for mouth ulcers. Some doctors may also prescribe a local anesthetic, such as lidocaine, for cases of multiple or severe mouth ulcers. If it does not heal within a week, a doctor or dentist may cauterize it using a silver nitrate applicator or laser. This procedure immediately burns off the ulcer, causing it to completely disappear within a few hours or two to three days. Staphylococcus aureus - Antibiotics test plate. ... Steroid skeleton of lanosterol. ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ... A local anesthetic is a drug that reversibly inhibits the propagation of signals along nerves. ... Lidocaine (INN) (IPA: ) or lignocaine (former BAN) (IPA: ) is a common local anesthetic and antiarrhythmic drug. ... Cauterization is a medical term describing the burning of the body to remove or close a part of it. ... R-phrases , S-phrases , , , , Flash point non-flammable Supplementary data page Structure and properties n, εr, etc. ... A LASER (acronym for Light Amplification by Stimulated Emission of Radiation) is an optical source that emits photons in a coherent beam. ...

Laser treatments with a dental laser(such as the Waterlase)give immediate, lasting pain relief and result in healing within a few days.

In very severe cases, a doctor may prescribe a steroid treatment. One such steroid is methylprednisolone (usually in a dose-pack), taken orally for a period of 7 days. Alternatively, the doctor may directly inject a steroid into the site of the ulcer (this treatment is performed with kenalog. Between 0.2 and 0.4 cc of kenalog is injected into the site of the ulcer, which will usually be completely healed 72 to 96 hours after the injection).

Some dentists recommend a sulfuric acid solution for treating mouth ulcers, such as debacterol. A Dentist and Dental Assistant perform surgery on a patient. ... Sulfuric acid (British English: sulphuric acid), H2SO4, is a strong mineral acid. ... Debacterol is a liquid topical agent that is used in the treatment of ulcerating oral mucosal lesions. ...

Another choice doctors have is to prescribe Aphthasol (amlexanox oral paste, 5%), the only Food and Drug Administration (FDA) approved (in the United States) treatment specifically indicated for Aphthous ulcers. The Food and Drug Administration (FDA) is an agency of the United States Department of Health and Human Services and is responsible for regulating food (humans and animal), dietary supplements, drugs (human and animal), cosmetics, medical devices (human and animal) and radiation emitting devices (including non-medical devices), biologics, and...

The miracle cures that are advertised should be viewed with skepticism. However, aqueous sulphuric acid products as listed above can provide significant pain relief, if not treating the underlying causes.

One home remedy is to wet a tea bag and use it as a compress on the area. Cooled chamomile tea offers quick relief - in between painful swallowings of food - with its anti-inflammation properties. Gargle with it, or swish it around your mouth and drink it. Try adding natural honey (the propolis in some honey could help in healing) if you prefer the taste, or need the calories.

Some people benefit from using the over-the-counter topical gel Bonjela, which contains choline salicylate. Choline salicylate is a local analgesic that helps to reduce the pain and inflammation associated with mouth ulcers. Bonjela is an oral gel, aimed to cure mouth ulcers and denture sores. ...

Chinese food remedies have said that Lychees have effects on sore throats and many people claim that eating just a few lychees will allow you to eat normally without discomfort. Binomial name Litchi chinensis Sonn. ...

Some people have reported great benefit from eating milk products such as yogurt and buttermilk that contain the active cultures L. Acidophilus.

Prevention

The majority of the types of ulceration, require treatment of the underlying cause of the oral ulceration for successful prevention; Controlling imbalances in vitamins and minerals related to ulceration, managing or restricting the disease processes has shown to reduce the ulcerative process. For trauma related cases, avoiding the offending source will prevent ulceration, but since such trauma is usually accidental, this type of prevention is not usually practical.

See also

• Aphthous ulcer
• Herpes simplex virus
• Squamous cell carcinoma
• Ulcer

An aphthous ulcer or canker sore is a type of mouth ulcer which presents as a painful open sore inside the mouth caused by a break in the mucous membrane. ... This article is about the virus. ... Biopsy of a highly differentiated squamous cell carcinoma of the mouth. ... Endoscopic images of a duodenal ulcer. ...

References

2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... June 18 is the 169th day of the year in the Gregorian Calendar (170th in leap years), with 196 days remaining. ... Mosby can refer to: John S. Mosby, a Confederate partisan ranger in the American Civil War, leader of the famed Mosbys Rangers. Mosby, Missouri Mosby, Eric, Billiards player Mosby, Norway Mosby (Mosbyd)- euphemism for ejaculation. ...

External links

• Mouth Ulcers, Cold Sores, etc.
• MayoClinic.com: Canker sore
• MedlinePlus Encyclopedia: Canker sores
• Management of Aphthous Ulcers, American Family Physician