Ulcerative Lesions of the Oral Cavity

From a clinical point of view, it is convenient to classify oral ulceration in three groups: acute oral ulceration, chronic oral iikeration antI recurrent oral ulceration (ROU) (Table I]. Obviously, there will be overlap between these different groups but the classification is helpful in establishing the diagnosis anci trcatmeni. Vesiculobullous lesions of the oral cavity, when Ihey rupture, leave ulcerated areas and frequently, patients with these lesions complain of oral ulceralion or a sore moulh. Extensive ukeralive oral lesions, bleeding from the gingivae, hypertrophy ot the gingivae or unexplained enlargement ot the submandibular and cervical lymph nodes may occur in hematologic disorders. Oral ulceralion may also occur in uremia. In the invesligaiion of the etiology of .in oral ulcer, it may be necessary to take a smear from the ulcer for microbiological examination to exclude an infective cause. A complete blood count will exclude a blood dyscrasia and the VDRL or RPR tests will exclude syphilis. A chest radiograph will exclude a tuberculous ulcer secondary to pulmonary tuberculosis. Exfoliative cytological examination is useful in determining whether an ulcer is herpetic or carcinomatous. Biopsy is essential to establish the definitive diagnosis.