Traumatic oral lesions are a fairly common finding in dental practice. A wide range of mucous membrane disorders are caused by acute and chronic trauma. They appear as acute or chronic ulcers, white or red lesions, in the oral mucosa. Such lesions, particularly chronic lesions, significantly impair oral functions and pose some diagnostic challenges. However, early diagnosis and removal of the causative factor ensure a cure. Physical, chemical, or thermal trauma could all cause damage to the oral mucosa.
For example, they could be caused by accidental dental biting, sharp or pointing food, sharp teeth edges, hot food, or vigorous tooth brushing.
In addition, injuries caused during dental treatment or other oral cavity procedures, such as intubation during general anesthesia, could cause some injuries. Similarly, unnecessary or careless handling of chemicals and dental instruments during dental treatment procedures could result in chemical or physical harm.
Physical, Thermal, or Chemical injuries can all cause traumatic ulcers. Traumatic ulcers are likely the most common type of ulcer encountered in clinical practice.
Accidental biting during food chewing results in acute traumatic ulceration. These ulcers usually heal in a few days with no complications. Chronic trauma from sharp edges of teeth, restorations, particularly ill-fitting dentures, can, on the other hand, cause chronic ulcers. Most of these injuries are unintentional; however, self-inflicted wounds are also common.
Chronic traumatic ulcers are most commonly present on the buccal mucosa, lateral border of the tongue, or lips. Other types of irritation, such as trauma from toothbrushes or food, have been linked to lesions in the oral mucosa and gums. A white or yellowish fibrin clot covers the ulcer's floor. Ulcers caused by repeated trauma can be symptomatic or asymptomatic. They frequently have an elevated border that is firm to the touch. After the causative factor elimination, the ulcer often heals, depending on the extent of the damage.
Most ulcers heal up on their own. However, if they don't heal within three weeks you should visit your dentist.Oral Health Foundation
Yes, Accidental mucosal biting is common, and it can lead to mucosal bleeding and painful ulceration. However, these lesions usually heal within a few days with no complications. On the other hand, chronic habitual biting of the oral mucosa may result in transient or persistent white patches. Furthermore, chronic biting of the buccal mucosa often results in loose threads on the mucosal surface, such as keratin shreds, tissue tags, or desquamative areas.
Although the Buccal mucosa and lateral border of the Tongue are the most commonly affected sites, followed by the inner lining of the lips, it usually results from a conscious act of habitual biting or even subconsciously.
In most cases, the clinical presentation is sufficient to make a diagnosis and does not necessarily require histological examination. Therefore, there is no need for treatment. Patient education and counseling can often solve the problem. However, using an acrylic shield to cover the facial surfaces of teeth may eliminate the lesion in some patients by restricting access to the lesion sites.
Denture Associated Mucosal Trauma:
Wearing dentures can result in various acute or chronic oral mucosal problems ranging from histological to gross clinical changes. Keratotic, hyperplastic, inflammatory, and ulcerative lesions are gross clinical changes.
Hyperkeratosis is a normal function adaptation that will resolve once the irritation is removed. Traumatic ulcers usually appear shortly after the placement of new dentures. They frequently appear over the sharp bony ridges where the mucosa is sandwiched between the denture and bone and under spicules or high denture spots; careful removal of such trauma results in the complete resolution of the problem.
Inflammatory Papillary Hyperplasia (IPH) is a reactive form of tissue overgrowth that appears clinically as a nodular mass covering the entire or a portion of the palate area covered by the denture. Although the cause is unknown, the condition is most commonly associated with the continuous wearing of ill-fitting dentures with poor hygiene. It frequently causes trauma and susceptibility to Candidal infection.
Furthermore, lesions are directly related to the patient's age and the length of time wearing dentures. IPH is typically asymptomatic and is discovered during a routine clinical examination. When combined with antifungal agents, early lesions may go away once the irritation is gone. More advanced lesions, on the other hand, may necessitate surgical removal, curettage, electrosurgery, or cryotherapy. Excision of the lesion with vestibulopathy and denture correction are common treatments.
Bilateral raised white line on the buccal mucosa that extends from the commissure (corner of the mouth, where the upper lip meets the lower lip) to the last molar teeth along the occlusal line. This white line develops along the occlusal plane as the cheeks suck in due to negative pressure. Linea alba is asymptomatic and generally regarded as a normal variation rather than a pathological one; thus, no treatment is required.
Traumatic ulcers due to Chemical Injuries.
Many chemicals and drugs come into contact with the oral mucosa, and due to their acidic nature, some may cause direct mucosal trauma. Some people use chemicals to treat their oral problems, such as aspirin, to relieve toothache. Healthcare practitioners are also in charge of administering certain mouth chemicals for treatment or investigational purposes. Some of these chemicals, if misused, can be hazardous. However, since the introduction of rubber dams in dental practice, such injuries have become less common.
Oral ulcers may be a long-standing problem. It usually resolves spontaneously, yet a clinical follow-up is necessary !Dr. Kothai Arunan, BDS.
Removal of irritant or cause.
Stay away from spicy and hot foods until the ulcers heal.
gargle regularly with warm salt water, keeping the rinse in your mouth for at least 2 minutes.
Drink plenty of water.
Maintain a clean mouth.
Apply an antibacterial gel to the ulcers.
Finally, rinse your mouth with an alcohol-free mouthwash.
If the ulcer persists for a long period of time then consult the dentist for a proper diagnosis.