An oral ulcer is a break in the mucous membrane of the mouth that causes loss of surface tissue and cell death. A study found oral ulcers in 21.7% of patients examined, most commonly affecting women and those in their third and fourth decades of life. Symptoms include pain, sores or ulcers in the mouth, fever, irritability, drooling, and foul breath. Oral ulcers can be classified and differentiated from traumatic, aphthous, or carcinomatous ulcers. Diagnosis involves examinations, blood tests, and biopsies. Treatment includes maintaining oral hygiene, topical analgesics, anti-fungal drugs, corticosteroids, antibiotics, and homeopathic remedies

1. TOPIC:
ORAL ULCER

2. DEFINITION
• An ulcer, is a break in the skin or mucous
membrane with loss of surface tissue and the
disintegration and necrosis of epithelial
tissues. A mucosal ulcer is an ulcer which
specifically occurs on a mucous membrane.

3. EPIDEMIOLOGY
• 705 patients of the total 3244 patients
presented with recurrent aphthous ulcers at
the time of examination, giving an overall
prevalence of 21.7% Patients in the third
(20.7%) and fourth (26.5%) decade were most
commonly affected. Females (56.3%) were
more commonly affected than males (43.7%).

5. SYMPTOMS
1. Pain or discomfort in the mouth.
2. The presence of open sores or ulcers in the
mouth.
3. Fever ,sometimes as high as 101– 104°F .
4. Irritability and restlessness 5. Blisters in the
mouth
6. Swollen gums , which may be irritated and bleed.
7. Drooling.
8. Dysphagia.
9. Foul-smelling breath.

6. CLASSIFICATION

7. DIFFERENTIAL DIAGNOSIS
• Traumatic ulcer
• Aphthaous ulcer
• Carcinomatous ulcer
• Recurrent aphthous ulcerations

8. DIAGNOSIS
• Endoscopy
• CBC
• Serum ferritin
• Serum folate
• Serum vitamin B12

9. GERNERAL MANAGEMENT
• Maintain oral hygience and antiseptic mouthwash
administered
• Topical analgesics – benzydamine mouthwash
• Antifungal drugs
• Topical corticosteroids – hydrocortisone hemisuccinate,
betamethasone sodium phosphate
• Topical tetracyclines
• Anti inflammatory agents- benzydamine hydrochloride
mouthwash for pain relief
• Thalidomide – 50- 100 mg daily.

10. AUXILIARY MEASURES

11. HOMOEOPATHIC MANAGEMENT
• Mercurius Solubilis
Merc Sol is indicated for ulcers on the tongue,
inside of cheeks, and on the gums. The ulcers are
white colored with undefined borders,
surrounded by a dark margin. Along with ulcers, a
sweet metallic taste in the mouth and increased
production of saliva may be present. Offensive
odor from the mouth may also be noticed. These
symptoms may be accompanied by an increased
thirst for large quantity of water.

12. • Borax Veneta
It is used to treat aphthous ulcers in the
mouth, tongue, and inside the cheeks.
Aphthae are extremely tender and can cause a
feeling of heat in the mouth. The mouth ulcers
are extremely sore and painful to touch.
• Nitricum Acidum
Ulcers on the soft palate may cause peculiar,
sharp splinter-like pains. The ulcers may have
irregular, zig-zag edges and produce a putrid
odor. The pain gets worse from contact.

13. • Muratic Acidum
It is a medicine used to treat mouth ulcers
where the mouth is studded with ulcers that
tend to perforate. The ulcers usually have a
dark or black base, and there is excessive
redness inside the cheeks and the palate.