I spent the early part of the morning on the way to the surgery sulking about my perceived injustice involving Manchester city football club in the recent Champion League match involving the team and the Barcelona football Club. In my own opinion Barcelona football team were a decent enough side and did not need the assistance of a twelfth man, the official in playing a good soccer match. The referees decision to award a dubious enough penalty kick and compound it with an ill deserved red card was too much for me to bear. Despite the most spirited efforts of the 10 man Manchester city side, the game was literarily killed off leaving them a mountain to climb in the second leg.
Now to the matter of dentistry, my first patient was one with ulcers which brings us to today’s topic.
An ulcer can occur in any part of the human body. They are named after the part in which they occur. We have peptic, duodenum, gastric, skin, foot, oesophageal, mouth ulcers, etc.
The word ulcer is a descriptive word for a discontinuation (open) in the skin or mucous membrane. Its depth, diameter varies, it could be infected, inflamed, painful, painless.
Skin ulcers develop mostly in the extremities and hidden areas of the body whereas the mucous membrane ulcers are common in the mouth and the gastro intestinal tract.
In cases of venereal disease the ulcers can affect the mucous membrane of the mouth and genitalia for those that engage in adventurous sexual practices. Ulcers can occur in the corneal of the eye. Ulcers can be chronic or acute.
A recurrent apthous ulcer is a form collectively used by a wide group of conditions characterised by recurrent oral ulceration. They may be classified into sub groups. They sometimes occur as part of a generalised condition involving other organs like the cornea and the genitalia.
Apthous ulcers are inflammatory in nature; these ulcers appear roundish and occur repeatedly. They are seen on the lips, Cheeks and soft palate. These ulcers can be very painful and they become reddened (erythematous).
The area may extend in size and the central region starved of minerals and becomes necrotic or dead. The ulcers can heal with or without scarring.
The ulcers could form a single lesion to several lesions. They could be classified as minor major and herpetiform.
Minor apthous ulcers affect a sizeable part of the population and could affect just about any age group. Symptoms may precede the development of ulcers. Apthous ulcers could be as a result of stress, local trauma, lack of iron, vitamin B12 or even foliate deficiency.
Major apthous ulcers are a more severe variants, the ulcers formed are larger from the descriptive characteristic They could be seen in HIV- AIDS affected individuals.
Herpetiform is a descriptive word; it has no direct relationship with the herpes simplex virus infection.
Whenever ulcers occur in the oral cavity, the duration, location and number determines the approach to be taken. Is it recurrent, is it preceded by a blister, immune suppression, illness, etc? The presence or absence of pain.
The dentist will ask a history of the ulcer and based on the response and investigation give the appropriate cause and treatment mode.
The dentist may use palliative treatment to prevent infection, avoid peppery things and biopsy whereby part or all the part of the ulcers are taken for microscopy and histology in the laboratory. This will assist in the diagnosis.
Should you be having any ulcers in the mouth please contact your dentist.
See you next week.
