eMedicine Specialties > Dermatology > Diseases of the Oral Mucosa

Traumatic Ulcers: Follow-up

Author: Glen Houston, DDS, MSD, Chair, Professor, Department of Oral and Maxillofacial Pathology, University of Oklahoma Health Sciences Center
Contributor Information and Disclosures

Updated: Jun 17, 2009

Follow-up

Deterrence/Prevention

  • The best treatment for chemical injuries is preventing the exposure to caustic materials.
  • Traumatic ulcers can be prevented by correction of the etiology, for example, by restoring carious, fractured, or malpositioned teeth.
  • Traumatic ulcers can also be prevented by replacing ill-fitting maxillary and mandibular dentures to minimize irritation of the oral mucosa.
  • Parents can prevent their children from having access to electrical cords and wires and thereby minimize the potential for electrical and thermal injuries.

Complications

  • In severe ulcers, secondary infection, scarring, contracture, and disfigurement are potential problems.13
  • Severe ulcers may remain for longer than 10-14 days.

Patient Education

  • Instruct parents about how to childproof their homes to prevent electrical burns.
  • Remind patients to be careful when eating hot foods.
  • Inform patients that many over-the-counter medications for mouth pain can compound the traumatic injury.
    • Mucosal damage from many topical medications sold as treatments for mouth sores or toothaches has been reported.
    • Products containing eugenol, phenol, or hydrogen peroxide have produced adverse reactions.
    • In addition, aspirin can cause mucosal necrosis if it is held in the mouth.
    • Silver nitrate remains a popular treatment for aphthous ulcerations (canker sores), but its use should be discouraged because of the extent of mucosal damage that may result.
  • For excellent patient education resources, visit eMedicine's Teeth and Mouth Center and Burns Center. Also, see eMedicine's patient education articles Canker Sores and Thermal (Heat or Fire) Burns.

Miscellaneous

Medicolegal Pitfalls

  • Failure to perform biopsy with microscopic evaluation to exclude more serious conditions (eg, squamous cell carcinoma, granulomatous diseases) is a pitfall.10,14,15
  • If the cause of the mucosal ulceration is not obvious at clinical examination or if no response to local therapy is observed on follow-up examination, biopsy should be performed.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.



More on Traumatic Ulcers

Overview: Traumatic Ulcers
Differential Diagnoses & Workup: Traumatic Ulcers
Treatment & Medication: Traumatic Ulcers
Follow-up: Traumatic Ulcers
References
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References

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  2. Bouquot JE. Common oral lesions found during a mass screening examination. J Am Dent Assoc. Jan 1986;112(1):50-7. [Medline].

  3. Baroni A, Capristo C, Rossiello L, Faccenda F, Satriano RA. Lingual traumatic ulceration (Riga-Fede disease). Int J Dermatol. Sep 2006;45(9):1096-7. [Medline].

  4. Ceyhan AM, Yildirim M, Basak PY, Akkaya VB, Ayata A. Traumatic lingual ulcer in a child: Riga-Fede disease. Clin Exp Dermatol. Mar 2009;34(2):186-8. [Medline].

  5. Maron FS. Mucosal burn resulting from chewable aspirin: report of case. J Am Dent Assoc. Aug 1989;119(2):279-80. [Medline].

  6. Rees TD, Orth CF. Oral ulcerations with use of hydrogen peroxide. J Periodontol. Nov 1986;57(11):689-92. [Medline].

  7. Shetty K. Hydrogen peroxide burn of the oral mucosa. Ann Pharmacother. Feb 2006;40(2):351. [Medline].

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  9. Ozcelik O, Haytac MC, Akkaya M. Iatrogenic trauma to oral tissues. J Periodontol. Oct 2005;76(10):1793-7. [Medline].

  10. Hirshberg A, Amariglio N, Akrish S, et al. Traumatic ulcerative granuloma with stromal eosinophilia: a reactive lesion of the oral mucosa. Am J Clin Pathol. Oct 2006;126(4):522-9. [Medline].

  11. Ganesh R, Suresh N, Ezhilarasi S, Rajajee S, Sathiyasekaran M. Crohn's disease presenting as palatal ulcer. Indian J Pediatr. Mar 2006;73(3):229-31. [Medline].

  12. Edlich RF, Farinholt HM, Winters KL, Britt LD, Long WB 3rd. Modern concepts of treatment and prevention of electrical burns. J Long Term Eff Med Implants. 2005;15(5):511-32. [Medline].

  13. Hashem FK, Al Khayal Z. Oral burn contractures in children. Ann Plast Surg. Nov 2003;51(5):468-71. [Medline].

  14. Hitchings A, Murray A. Traumatic ulceration mimicking oral squamous cell carcinoma recurrence in an insensate flap. Ear Nose Throat J. Mar 2004;83(3):192, 194. [Medline].

  15. Gallego L, Junquera L, Llorente S. Oral carcinoma associated with implant-supported overdenture trauma: a case report. Dent Traumatol. Feb 2009;25(1):e3-4. [Medline].

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Further Reading

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Keywords

traumatic oral ulcers, oral ulcers, oral ulcerations, sublingual ulcerations, Riga-Fede disease, electrical burns, thermal burns, bruxism, food sensitivity

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Contributor Information and Disclosures

Author

Glen Houston, DDS, MSD, Chair, Professor, Department of Oral and Maxillofacial Pathology, University of Oklahoma Health Sciences Center
Glen Houston, DDS, MSD is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Academy of Oral Medicine, and American Dental Association
Disclosure: Nothing to disclose.

Medical Editor

Daniel Mark Siegel, MD, MS, Director, Procedural Dermatology Fellowship Program, Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate
Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American Academy of Facial Plastic and Reconstructive Surgery, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American College of Physician Executives, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, American Society for MOHS Surgery, and International Society for Dermatologic Surgery
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Drore Eisen, MD, DDS, Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati
Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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