Oral ulceration (Part 2)

Ulceration is probably the oral mucosal condition seen most frequently by general dental practitioners. It is almost always painful and therefore sufferers are prompt to seek advice. An important exception to this generalisation is the occurrence of oral squamous cell carcinoma, which is often painless in its early stages. Definitive diagnosis, which requires mucosal biopsy, is mandatory for any persistent area of oral ulceration. Key points Oral ulceration may be due to viral or bacterial infection, immune-mediated disease or the presence of malignancy. The presence of mouth cancer needs to be suspected for any ulcer persisting longer than three weeks and such a case should be referred urgently for specialist assessment. The initial management of oral ulceration involves identifying the cause and provision of topical anti-inflammatory or antiseptic agents.