Saturday, May 24, 2008

Mouth ULCERS-------Apthous

Commonly among Mouth Ulcers, Apthous ulcers are seen. It is a common disease and is characterized by the development of the painful, recurring solitary or multiple ulcerations of the oral mucosa. Apthous Ulcer is also known as Canker Sores.

Causes of apthous cancer
There are various causative factors for Apthous Ulcers. It is mainly caused due to bacterial infection. The chief causative organism is (alpha) haemolytic streptococci or Streptococcus sanguis. The administration of Streptococcus to guinea pigs and rabbits has produced lesions of the skin and oral mucosa which appear clinically similar to apthous ulcers in the human. Recurrent aphthous ulcers have also been though to occur as a result of an autoimmune response of the oral epithelium.
During a fluorescent antibody technique, both IgG and IgM are seen binded to the spinous layer of the oral epithelium in patients suffering from Apthous ulcer. While no such binding is seen in normal healthy persons. Iron, Vitamin B12 or Folic acid deficiency may also lead to development of Apthous Ulcer are greater during the premenstrual period. While in some cases women may get relief from ulcers during pregnancy but shows rapid ulcer development after delivery. Any Psychological problem may also lead to ulceration. Patients with Recurrent Apthous Ulcer may also show a history of Asthma, Hay fever or food or drug allergies.

Clinical Features of Apthous Ulcer

It is seen more commonly in women than in men. The disease develops between the ages of 10 to 30 years. The apthous ulcer starts developing as single or multiple superficial erosion caused by a gray membrane. It generally has a well circumscribed margin surrounded by on erythematous halo

The lesion is commonly very painful, so it interferes with eating for several days. Sometimes, it was though that the apthous ulcer begins with the formation of a vesicle, but it was not as such in general. Major Apthous ulcer are characterized by the occurrence of large painful ulcers, usually one to ten in number and are present commonly on the lips, cheeks, tongue, sot palate, etc.

Herpetiform Ulcer: There are numberous small lesions found on any intraoral mucosal surface. These lesions begin as small pinhead sized erosions that slowly enlarge and unite with each other. Lesions are very painful and are present continuously for one to three years. The patient receives immediate but temporary relief from symptoms with a 2 percent tetracycline mouthwash.

Treatment of Apthous or Herpetiform Ulcers: There is a no specific treatment, although various drugs have been used. A steroid ointment about 1.5 percent cortisone acetate, applied locally shows good effect. Antibiotic mouthwashes are also helpful. For egr Tetracycline Mouthwash (250 mg per 5 ml), used four times daily for 5 to 7 days, produced a good response in near about 70% of the patients. Chemical cautery reduces pain but had no other beneficial effects. Levamisole, have been used and found to increase the immune response in a variety of ways.

Traumatic Ulcer- It has been observed that the Traumatic Ulcer may also develop of the oral mucous membrane.It is a caused by some sort of trauma. This may be an injury such as biting the mucosa, denture irritation, toothbrush injury, exposure of the meious membrane to a sharp tooth or carious lesions, or it may be injury to the mucosa by some other external irritant. The traumatic ulcers are also known as sore spots.

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