which oral lesion is self limiting without the treatment

Full Answer

What is a classic oral lesion?

The classic oral lesion presents as a solitary ulcer usually with an undermined edge most commonly on the tongue, followed by gingivae, floor of the mouth, palate, lips, and buccal mucosa. Meanwhile, it may be ragged and indurated and is often painful [24, 25].

What is the treatment for common oral lesions?

Treatment of Common Oral Lesions. These lesions are asymptomatic and do not have a malignant etiology. Management comprises monitoring and surgical excision. A mucocele develops when a minor salivary gland duct in the inner part of the lip (usually lower lip) is severed and the secretions spill into the tissues.

What is an oral lesion excision?

An oral lesion excision is surgery to remove a sore, ulcer, or patch (lesion) from inside your mouth. This includes the inner lip or cheek lining, gums, tongue, and floor and roof of the mouth. Removal may be the only treatment needed for the lesion, or may be part of your treatment plan. How do I prepare for surgery?

What are ulcerative lesions of the mouth?

Ulcerations are characterized by defects in the epithelium, underlying connective tissue, or both. Due to diversity of causative factors and presenting features, diagnosis of oral ulcerative lesions might be quite challenging [ 1 – 4 ].

How long does a Sutton ulcer last?

Major-type (Sutton ulcer) is usually 1–3 cm in size, and lasts for 10 days to 6 weeks or even longer. More than 60% of Sutton ulcers heal with scarring. Major type accounts for about 10% of RAS. Herpetiform aphthae appears as very small (1-2 mm), extremely painful, and numerous ulcers (up to 100 lesions).

What is a recurrent aphthous stomatitis?

Recurrent Aphthous Stomatitis. Recurrent aphthous stomatitis (RAS) is the most common inflammatory disease of the oral mucosa with a global prevalence of 0.5% to 75% and female predilection [ 70 ]. The first episode of RAS most frequently commences in the second decade of life. The lesions usually begin with prodromal burning sensation 2 to 48 hours before an ulcer appears [ 3 ]. Oral aphthous ulcers typically occur as painful, symmetrically round fibrin-covered mucosal defects with an erythematous border and most commonly on nonkeratinized mucosa in healthy patients ( Figure 10 ). However, it can be seen on the keratinized mucosa especially in patients with immune deficiency. Three clinical types of RAS have been identified: minor-type (Mikulicz) is smaller than 1 cm in diameter (usually 2-3 mm) and heals spontaneously in two weeks. This type constitutes 80–90% of all aphthous ulcers. Major-type (Sutton ulcer) is usually 1–3 cm in size, and lasts for 10 days to 6 weeks or even longer. More than 60% of Sutton ulcers heal with scarring. Major type accounts for about 10% of RAS. Herpetiform aphthae appears as very small (1-2 mm), extremely painful, and numerous ulcers (up to 100 lesions). About 32% of lesions heal with scarring [ 70, 71 ]. Diagnosis is based on patient's history and pattern of ulcers. Laboratory evaluation is mandatory when (a) episodes of lesions become more severe, (b) lesions begin after the age of 25, and (c) general symptoms are accompanied by lesions [ 3 ]. RAS is self-limiting, but in severe cases topical or systemic corticosteroids are recommended [ 70, 71 ].

What is primary herpetic gingivostomatitis?

Primary Herpetic Gingivostomatitis. Primary herpetic gingivostomatitis is the most common pattern of symptomatic herpes simplex virus (HSV) infection. Over 90% of cases are caused by HSV type 1, and the remainder are caused by HSV2 [ 12 ]. It can be asymptomatic or very mild in young patients but is associated with more severe general symptoms in the elderly [ 1 ]. Most cases occur between the ages of six months and 5 years, with peak prevalence between 2 and 3 years [ 11 ]. Fever, nausea, anorexia, and irritability are initial symptoms. Oral manifestations consist of a generalized gingivitis followed, after 2-3 days, by pin-headed vesicles that readily rupture and give rise to painful ulcers covered by a yellowish pseudomembrane. They often coalesce into larger ulcers. Keratinized and nonkeratinized mucosa can be affected, and the number of the lesions is quite variable [ 13 ]. In many cases, punched-out erosions along the free gingival margin have been reported [ 11 ]. Submandibular lymphadenitis, halitosis, and difficulty in swallowing are noted in most cases [ 13, 35 ]. Noteworthy, some adult patients may present with pharyngotonsillitis. In addition, involvement of the oral mucosa anterior to Waldeyer's ring is encountered in roughly 10% of patients [ 11 ]. The ulcers usually heal spontaneously after 5 to 7 days, with no scarring, but may persist for two weeks in severe cases [ 13, 35, 36 ].

What causes a traumatic ulcer on the tongue?

Traumatic Ulcer. Traumatic injuries of the oral mucosa are quite common. They are caused by mechanical damage (contact with sharp foodstuff; accidental biting during mastication, talking, or even sleeping) and thermal, electrical, or chemical burns [ 11 ]. Traumatic ulcers are most common on the tongue, lips, and buccal mucosa [ 5 ]. According to Chen et al., traumatic lesions of the oral cavity were mostly seen on the buccal mucosa (42%), followed by the tongue (25%) and the lower lip (9%) [ 12 ]. Noteworthy, traumatic ulcers are more common in men than women (male : female ratio of 2.7 : 1) [ 12 ]. These lesions may persist for a few days or even several weeks, especially in the case of tongue ulcers due to repeated insults to the tissues [ 5, 33 ]. The borders of traumatic ulcers are usually slightly raised and reddish, with a yellowish-white necrotic pseudomembrane that can be readily wiped off ( Figure 3 ). Ulcers on the lip vermilion usually have a crusted surface [ 5 ]. Traumatic ulcers normally become painless within three days after the injury had been eliminated and, in most cases, heal within 10 days [ 5 ].

Where are traumatic ulcers most common?

Traumatic ulcers are most common on the tongue, lips, and buccal mucosa [ 5 ]. According to Chen et al., traumatic lesions of the oral cavity were mostly seen on the buccal mucosa (42%), followed by the tongue (25%) and the lower lip (9%) [ 12 ].

Can traumatic ulcers be chronic?

Sustained Traumatic Ulcers. Chronic injuries of oral mucosa may lead to solitary long standing ulcerative lesions; therefore, traumatic ulcer can also be classified as a chronic solitary ulcer. This entity has been reported by Pattison as a self-inflicted gingival lesion in patients who were seeking prescriptions for narcotic drugs [ 50 ]. Chronic traumatic ulcerations usually occur on the tongue, lips, and buccal mucosa [ 11] as ulcerative areas surrounding a central removable, yellow fibrinopurulent membrane. In many cases, the lesion develops a raised, rolled border of hyperkeratosis immediately adjacent to the area of ulceration [ 11, 51, 52 ]. Most traumatic ulcers become painless and heal within 10 days. However, some lesions persist for several weeks because of continued traumatic insults, irritation by the oral liquids, or secondary infection. There are different treatment modalities, but coating the ulcerated surface with fluocinonide or triamcinolone acetonide in an emollient base after meals and before bed time usually relieves pain and decreases duration of healing [ 5 ].

What is the most common lesion in the mouth?

An amalgam tattoo is the most common localised pigmented lesion in the mouth, Other malignancies that can present in the mouth include Kaposi's sarcoma (discoloured patches, and occasionally nodules, that are usually red or purple and look similar to bruises), and adenocarcinoma of a salivary gland.

How long does an oral ulcer last?

There are many causes of oral ulcers, as highlighted in the 'overview of oral lesions' at the top of this section. Any solitary ulcer lasting more than three weeks needs to be referred urgently (two-week wait) as it could represent a squamous cell carcinoma.

How many episodes of Behçet syndrome?

The international criteria for classification of Behçet syndrome defines the condition as at least 3 episodes of recurrent oral ulcers in a 12-month period plus at least two or more of the following: Genital ulcers.

Where are aphthous ulcers found?

Ulcers are usually 2–4 mm in diameter and found mainly on the mucosa of the lips, cheeks and floor of the mouth, sulci or ventrum of the tongue. They are uncommon on the gingiva, palate or dorsum of the tongue.

How long can you use Betamethasone as a gargle?

A number of topical anti-inflammatories can be used as a gargle for 2-4 minutes, 3-4 times a day. Betamethasone 500 microgram soluble tablet dissolved in 10 ml of water.

What causes hairy tongues?

Hairy tongue. Accumulation of excess keratin on the filiform papillae of the dorsal tongue leads to the formation of elongated strands that resemble hair. The colour of the tongue can range from white or tan to black. Darker coloration results from the trapping of debris and bacteria in the elongated strands.

Why do I have a fissured tongue?

Fissured tongue. In a fissured tongue, deep grooves develop due to physiologic deepening of normal tongue fissures. Typically occur with aging and require no treatment unless trapping of food and bacteria leads to inflammation of the fissures.

What is an oral lesion excision?

What do I need to know about an oral lesion excision? An oral lesion excision is surgery to remove a sore, ulcer, or patch (lesion) from inside your mouth. This includes the inner lip or cheek lining, gums, tongue, and floor and roof of the mouth.

Can you refuse treatment?

You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Can a lesion be removed with stitches?

This helps make sure that as much of the lesion as possible is removed. Your surgeon may have the lesion tested to find out if it is benign (not cancer) or malignant (cancer). The area where the lesion was removed may need to be closed with stitches. This depends on where it was and how large an area was removed.

What is the name of the growth that contains abnormal cells confined to the lining of the oral cavity?

Facebook. Opens in a new tab Twitter. Opens in a new tab. An oral precancerous lesion, also called dysplasia, is a growth that contains abnormal cells confined to the lining of the oral cavity, or mouth. This lining is called the mucosa.

How to remove dysplasia?

If you have moderate or severe dysplasia, which has a greater chance of becoming cancerous, doctors remove the lesion and a small margin of healthy tissue using a small scalpel or laser beam. They may use a local anesthetic to perform the surgery. You may return home the same day.

What is the NYU Langone biopsy?

After your NYU Langone doctor performs a biopsy, a pathologist can determine whether you have mild, moderate, or severe dysplasia based on how unusual the cells appear.

Can you be observed for oral cancer?

Doctors may recommend observation if you have mild dysplasia, which has a low risk of becoming cancerous. Observation may involve frequent visits to an oral cancer specialist, who can examine the precancerous growth for any changes. These visits occur on a schedule determined by your doctor.

Is oral cancer a high risk?

People with severe dysplasia have a high risk of developing oral cancer. Those with mild dysplasia have a low risk. Knowing whether someone has mild, moderate, or severe dysplasia can help doctors determine the best way to manage these precancerous growths.

What causes oral mucosal lesions?

Oral mucosal lesions are a common occurrence and very often dentists are called upon to see such patients. Among many causes trauma is one of the leading for oral mucosal diseases. Oral traumatic lesions are diverse in which some present as acute lesions while the majority are chronic lesions. Clinical presentation of traumatic lesions vary significantly and most of the occasions the cause and the effect can be established with thorough history and clinical examination. Although, biopsy of such lesions are not required in most of the occasions some may warrant histological investigations to exclude conditions which clinically mimic traumatic lesions. This paper provides an overview of common and some rare traumatic conditions of the oral mucosa.

What is NS in dentistry?

Necrotizing Sialometaplasia (NS) is first described by Abrams et al. as an uncommon inflammatory necrotizing process involving minor salivary glands predominantly affecting the hard palate [20]. Although the exact aetiology is not known, the mostly suspected and generally accepted underlying mechanism is ischaemia of minor salivary gland tissues [20-22]. Several predisposing factors which lead to ischaemia have been proposed by these authors. Brannon and coworkers reported that they observed after NS 8 days on average following a surgical procedure in 36% of their case series. Other traumatic episodes such as dental injection and wearing ill-fitting dentures were also been implicated in some cases [21]. In addition to trauma, smoking and alcohol consumption, allergy and upper respiratory tract infections were also considered as predisposing to NS [21]. Clinically NS presents as a solitary unilateral ulcer on the hard palate (Figure 5) [20-22]. However, a number of cases were also reported as non-ulcerated swelling or mass [21]. Lesions could accompany with pain or numbness while some may be asymptomatic [5,21-23]. Although a wide variation of