Circuit 3, station 1

Classification of Different Ulcers
Minor ulcers: small, round, or oval-shaped ulcers that are white or yellow in the centre and have a red border. These are the most common type of mouth ulcer and usually, heal on their own within 1-2 weeks.
Major ulcers: larger than minor ulcers, and have a diameter of over 1 cm. These ulcers are deeper and can take several weeks (up to six weeks) to heal. They may leave scars behind and are more likely to recur than minor ulcers.
Herpetiform ulcers: these are tiny, multiple ulcers that occur in clusters of 10-100. They are more common in women than men and can be painful. They are not caused by the herpes virus, despite the name.
Causes of Mouth Ulcers
Trauma: accidentally biting your cheek or tongue, rough brushing, dental procedures, ill-fitting dentures, and other physical injuries can cause mouth ulcers.
Infection: viral, fungal, and bacterial infections can all cause ulcers.
Allergic reaction: certain foods or medications can cause an allergic reaction that leads to mouth ulcers.
Stress: emotional stress can weaken the immune system and lead to ulcers.
Hormonal changes: women may experience ulcers due to hormonal changes during their menstrual cycle or menopause.
Nutritional deficiencies: deficiencies in vitamin B12, iron, and folate can cause mouth ulcers.

Viral Causes of Ulcers:
Herpes simplex virus: this virus causes cold sores or fever blisters, which are painful ulcers that occur on or around the lips.
Varicella zoster virus: this virus causes chickenpox and shingles, and can also cause ulcers in the mouth.
Coxsackie virus: this virus causes hand, foot, and mouth disease, which can cause ulcers in the mouth as well as a rash on the hands and feet.

Fungal Causes of Ulcers:
Candida albicans: this fungus can cause thrush, a condition in which white patches form on the tongue and inside the mouth. These patches can sometimes become ulcers.
Aspergillus: this fungus can cause a condition called aspergillosis, which can lead to ulcers in the mouth.

Bacterial Causes of Ulcers:
Streptococcus: Streptococcus is a common bacterial cause of mouth ulcers, and can cause painful, red sores in the mouth.
Haemophilus: Haemophilus can cause both minor and major mouth ulcers, and may also lead to severe infections like pneumonia or meningitis.
Mycobacterium: Mycobacterium infections can cause painful, ulcerative lesions in the mouth, and are more common in immunocompromised patients.
Helicobacter pylori: this bacterium is associated with stomach ulcers, but it can also cause ulcers in the mouth.

Other Causes of Ulcers
• Trauma or injury to the mouth, such as accidentally biting the tongue or cheek, or using dental appliances that irritate the mouth.
• Nutritional deficiencies, such as deficiencies in iron, vitamin B12, folic acid, or zinc.
• Hormonal changes, such as those that occur during menstruation or pregnancy.
• Allergic reactions to certain foods or medications.
• Emotional stress or anxiety.
• Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), beta-blockers, or chemotherapy drugs.
• Smoking or using other tobacco products.
Management Options
Mouth ulcers can be treated through symptomatic and specific treatments, depending on the underlying cause. One strategy for managing mouth ulcers is to avoid trigger foods, such as citrus fruits, spicy or salty foods, and chocolate, which can exacerbate the condition in some individuals.
Maintaining good oral hygiene, including regular brushing and flossing, can also help prevent mouth ulcers from developing. Over-the-counter pain relievers like acetaminophen or ibuprofen can be used to manage discomfort associated with mouth ulcers. Additionally, prescription medications like corticosteroids or antimicrobial mouthwashes may be recommended by a doctor to treat more severe cases of mouth ulcers. Systemic treatments are typically reserved for severe cases due to potential side effects.
In addition to conventional treatments, some people have reported feeling better after using natural remedies such as vitamins, herbs, and dietary supplements. However, there is little scientific evidence to support their efficacy.
Types of mouth ulcers from systemic disease
Behcet’s disease: Behcet’s disease is a rare autoimmune disease that can cause multiple types of mouth ulcers, as well as genital ulcers, skin lesions, and other symptoms.
Inflammatory bowel disease: conditions such as Crohn’s disease can cause ulcers in the mouth. Crohn’s disease is a type of inflammatory bowel disease that can cause mouth ulcers, as well as abdominal pain, diarrhoea, and other symptoms.
Coeliac disease: Coeliac disease is an autoimmune disorder in which the body cannot tolerate gluten, and can cause mouth ulcers, as well as gastrointestinal symptoms and other symptoms.
Lupus erythematosus: Lupus erythematosus is a systemic autoimmune disease that can cause different types of mouth ulcers, as well as joint pain, skin rashes, and other symptoms.
Reiter’s syndrome: Reiter’s syndrome is a type of reactive arthritis that can cause mouth ulcers, as well as joint pain and inflammation.