An oral lesion (which includes aphtous ulcers) is an ulcer that occurs on the mucous membrane of the oral cavity. They are very common, occurring in association with many diseases and by many different mechanisms. They can be recognized by a break in the skin or mucous membrane with loss of surface tissue and the disintegration and necrosis of epithelial tissue.
The most common causes of oral lesions are localised trauma (i.e. rubbing from a sharp edge on a broken filling), infections, systemic conditions, associated dermatological diseases and recurrent aphtous ulcers (canker sores).
Oral lesions may form individually or multiple lesions may appear at the same time. Once formed, it may be maintained by inflammation and/or secondary infection. Rarely, an oral lesion that does not heal may be a sign of oral cancer.
Associated Dermatological Diseases
• Lichen Planus
• Hypersensitivity to acidic food
• Irritating agents: SLS, Triclosan
• Physical trauma
• Radiotherapy or chemotherapy
Recurrent Aphtous Ulcers
• Canker sores
• Gastrointestinal: Celiac disease, Crohn’s disease, IBS
• Nutritional deficiency : vitamin B12 or folic acid
• One to 5, shallow, round ulcers
• Less than 10 mm in diameter and have a greyish base with a erythematous margin. They usually heal in 7-10 days and occasionally reoccur at 1-3 monthly intervals
• Greater than 10 mm in diameter and vary in number from one to ten.
• Occur at the site of minor ulcers on the oral mucosa, palate and back of the throat
• Extend deeper and have crater like appearance with rolled margins and fibrosis of the underlying tissue
• Tend to occur in cycles or a short intervals
High molecular weight hyaluronic acid (HA) is a natural physiological constituent of connective tissues. It is the most abundant high molecular weight glycosaminoglycan of healthy soft periodontal tissues.4