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Traumatic Ulcers Treatment & Management

  • Author: Glen Houston, DDS, MSD; Chief Editor: William D James, MD  more...
 
Updated: Nov 06, 2014
 

Medical Care

The treatment of ulcerated lesions varies depending upon size, duration, and location.

  • With ulcerations induced by mechanical trauma or thermal burns from food, remove the obvious cause. These lesions typically resolve within 10-14 days.
  • Ulcerations associated with chemical injuries will resolve. The best treatment for chemical injuries is preventing exposure to the caustic materials.
  • With electrical burns, verify status and administer the vaccine if necessary. Patients with oral electrical burns are usually treated at burn centers.[14]
  • Antibiotics, usually penicillin, may be administered to prevent secondary infection, especially if the lesions are severe and deeply seated. Most traumatic ulcers resolve without the need for antibiotic treatment.
  • Treatment modalities for minor ulcerations include the following:
    • Removal of the irritants or cause
    • Use of a soft mouth guard
    • Use of sedative mouth rinses
    • Consumption of a soft, bland diet
    • Use of warm sodium chloride rinses
    • Application of topical corticosteroids
    • Application of topical anesthetics

A study by Jivanescu et al evaluated the effectiveness of a hydrogel patch to treat wounds of the oral mucosa caused by dentures in edentulous persons and found that the patch was an effective treatment for accelerating healing of traumatic ulcers and reducing the pain associated with them. In 23 adult patients with newly fabricated, complete sets of dentures, from baseline to day 1, the lesions treated with the hydrogel patch decreased in size by 25%; by day 7, they decreased by 75%. Lesions receiving usual care decreased in size by 10% (day 1) and 50% (day 7). Significant reductions in pain were reported as 65% for lesions treated with the hydrogel patch, versus 30% with usual care.[15]

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Consultations

Patients with repeated factitial ulcerations may be considered for referral to a psychiatrist or psychologist.

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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 Medicine, American Academy of Oral and Maxillofacial Pathology, American Dental Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

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, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Daniel Mark Siegel, MD, MS Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate Medical Center

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Association for Physician Leadership, American Society for Dermatologic Surgery, American Society for MOHS Surgery, International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

References
  1. Butler J, Fleming P, Webb D. Congenital insensitivity to pain--review and report of a case with dental implications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jan. 101(1):58-62. [Medline].

  2. Bouquot JE. Common oral lesions found during a mass screening examination. J Am Dent Assoc. 1986 Jan. 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. 2006 Sep. 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. 2009 Mar. 34(2):186-8. [Medline].

  5. Padmanabhan MY, Pandey RK, Aparna R, Radhakrishnan V. Neonatal sublingual traumatic ulceration - case report & review of the literature. Dent Traumatol. 2010 Dec. 26(6):490-5. [Medline].

  6. Gilvetti C, Porter SR, Fedele S. Traumatic chemical oral ulceration: a case report and review of the literature. Br Dent J. 2010 Apr 10. 208(7):297-300. [Medline].

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

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

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

  10. Rawal SY, Claman LJ, Kalmar JR, Tatakis DN. Traumatic lesions of the gingiva: a case series. J Periodontol. 2004 May. 75(5):762-9. [Medline].

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

  12. 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. 2006 Oct. 126(4):522-9. [Medline].

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

  14. 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].

  15. Jivanescu A, Borgnakke WS, Goguta L, Erimescu R, Shapira L, Bratu E. Effects of a Hydrogel Patch on Denture-Related Traumatic Ulcers; an Exploratory Study. J Prosthodont. 2014 Jul 8. [Medline].

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

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

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

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