Oral Ulcers - A Review

Review Article

J Dent & Oral Disord. 2018; 4(4): 1098.

Oral Ulcers - A Review

Sivapathasundharam B¹*, Sundararaman P¹ and Kannan K²

¹Department of Oral Pathology, Meenakshi Ammal Dental College, Chennai, India

²Department of Oral Medicine and Radiology, College of Dentistry, Majmaah University, Saudi Arabia

*Corresponding author: Sivapathasundharam B, Department of Oral Pathology, Meenakshi Ammal Dental College, Chennai, India

Received: April 11, 2018; Accepted: May 22, 2018; Published: May 29, 2018


Ulcer is a break in continuity of the epithelium brought about by molecular necrosis. Ulcers are most common in the oral region, for which the patient seeks help from their physician/dental surgeon. The presenting complaints are usually redness, burning sensation and/or pain. They can present in any part of the oral cavity but may be painful if it occurs in the movable area [1].

Keywords: Ulcers; Necrosis; Malignant



Based on the duration ulcers can be broadly classified into acute (short term) or chronic (long term). Acute ulcers persist no more than three weeks and regress spontaneously such as traumatic ulcers, aphthous ulcers, herpetic ulcers and chancres. Chronic ulcers persist for weeks and months such as major aphthous ulcers, ulcers from odontogenic infection, malignant ulcers, gummas, ulcers secondary to debilitating systemic disease and some traumatic ulcers (with a persistent traumatic element) [2].

In addition, they can also be typed as single or multiple depending on their presentation. The solitary lesions may result from a trauma, infection or it could be a carcinoma and can present as a single ulcerative lesion. Multiple lesions may be seen in viral infections or autoimmune diseases and can present with several ulcerations [3]. Recurrent ulcers may present with a history of similar episodes along with intermittent healing. The size of the ulcers can vary from a few millimeters to centimeters and occasionally may present with fever and regional lymphadenopathy [4].

Diagnosis of oral ulcers at times may be challenging and therefore it is important to consider the differential diagnosis. History taking should include duration, associated symptoms, pattern of occurrence or recurrence and associated systemic conditions.

Acute ulcers

Traumatic ulcers: Traumatic ulcers are quite common and acute in nature. The ulcers are caused usually by physical, thermal or chemical trauma to the oral mucosa causing tissue damage and resultant ulceration. Physical trauma can be caused during regular activities like tooth brushing (Figure 1a) or flossing, sharp edges of denture or tooth (Figure 1b), oral piercings and sometimes can be self-inflicted by the patient when he/she is under local anesthesia during a dental procedure [4].