Ulcerations in the oral cavity are relatively common in general practice, with estimates suggesting that up to 4% of the population in the United States suffer from some form of ulcerative lesion, and the tongue is one of the sites where they may develop [1] [2]. The reason for this rather high prevalence rate is the diverse etiology [1] [3] [4] [5] [6] [7]:

• Trauma - Mechanical trauma (for example tongue biting) or chemical/thermal irritation [1] [4].
• Infectious agents - Herpes simplex virus type 1 (HSV-1, responsible for both primary herpetic and recurrent herpes stomatitis) and Varicella zoster virus (VZV) are rather common causes of ulcerative lesions in the oral cavity, and the clinical presentation involves the initial appearance of vesicular lesions followed by their ulceration [1]. Actinomyces, Mycobacterium tuberculosis, Treponema pallidum (responsible for syphilis), and human immunodeficiency virus (HIV) are less frequent but still important pathogens responsible for ulcerative lesions [1] [4] [7].
• Autoimmune conditions - Aphthous stomatitis is described as a separate entity of tongue and oral lesions due to their rather frequent occurrence, and studies estimate that up to 25% of the world's population may develop this type of lesion [1] [6]. They have a recurring pattern in many patients, and the term recurrent aphthous stomatitis (RAS) is used to denote the appearance of multiple, small, ovoid or round ulcers in the first few decades of life that spontaneously resolve within a few weeks [1] [6] [7]. They possess a gray to yellowish floor and are encircled by a red halo [6]. The pathogenesis remains unknown, but systemic lupus erythematosus (SLE), Crohn disease, and Behçet syndrome have been associated with their appearance [7]. In all of the mentioned conditions, oral ulcers are one of the key presenting signs [1] [3] [4]. In SLE, the "discoid lesions", hallmarks of this autoimmune disorder, are observed as painful erythematous erosions and ulcers, which is also the case in Pemphigus and Pemphigoid (bullous dermatoses that also cause ulcerations of the tongue and oral cavity), but also Crohn's disease [1] [4]. In addition, Lichen planus is also an important autoimmune etiology or tongue ulcers, having a similar clinical picture to SLE, but a diffuse pattern of ulceration is seen in this disorder [1] [4] [7].
• Malignant diseases - The lateral border of the tongue is the predominant location of the squamous carcinoma of the oral cavity, the single most important malignant etiology of tongue ulcers [1] [8]. The presence of risk factors such as cigarette smoking, alcohol abuse, increased age, male gender, and the absence of other conditions to which ulcers can be attributed, significantly increases suspicion toward a neoplasia [1] [3]. A painless, non-healing ulcer that persists for several weeks is highly suggestive of a tumor [1] [4] [7].
• Drug-induced - Aspirin, chemotherapeutic drugs, bisphosphonates and nicorandil (a vasodilatory drug) are known to cause ulcers in the oral cavity and tongue [1] [7].

In most cases, tongue ulcers have a benign and self-limiting course with spontaneous resolution within several days or a few weeks [1], but in the setting of persistent, more severe damage to the tongue and oral mucosa, the cause of ulceration may require specific treatment.

• Pain

  This is a painful mouth lesion that usually takes 7 – 10 days to heal. So what causes these pesky tongue ulcers? There is no particular cause for these painful spots. [boldsky.com]

  Some people find dabbing a liquid antacid alone onto a mouth ulcer provides sufficient pain relief. [livestrong.com]

  Clove oil contains eugenol which works great for numbing and relieving the pain due to the sore. [wowremedies.com]

  Mouth ulcers located on the tongue takes time to heal, making chewing and talking painful and uncomfortable. This pain will fade within days, while the ulcer itself needs more time before healing completely. [woundcaresociety.org]

• Swelling

  This reaction causes swelling that causes damage to the lining of the small intestine. [newhealthguide.org]

  […] ulcerative eosinophilic granuloma, Riga-Fede disease, traumatic granuloma Clinical images Images hosted on other servers: 70 year old woman: Painful ulcer of tongue Ill fitting prosthesis Healing after removal of prosthesis 6 month old boy: Ulcerative swelling [pathologyoutlines.com]

  When a tongue swells very suddenly, the likely reason is usually an allergic reaction. This may lead to difficulty breathing. Difficulty breathing due to the tongue swelling is a medical emergency. [lightskincure.org]

  The swelling can even occur on the back of the tongue or throughout the tongue. Here are some of the remedies to treat tongue ulcers. Coconut Firstly try to grate the coconut and make sure to extract its milk by squeezing it. [boldsky.com]

  Corticosteroids A corticosteroid is a type of medicine that reduce inflammation (swelling). Mouth ulcer medications contain a low dose of corticosteroid, which is usually enough to lower the inflammation. [hse.ie]

• Weakness

  Ulcerative tinea pedis occurs most frequently in people with diabetes and others with weak immune systems. [skinsight.com]

  It's basically a virus we all have in ourselves but when we are "weak" it can manifest itself. There is something he can take but I am not going down that road as it always dissapear within 3-4 days. [mumsnet.com]

  No fever or other symptoms When to Call for Mouth Ulcers Call 911 Now Not moving or too weak to stand You think your child has a life-threatening emergency Call Doctor or Seek Care Now Chemical in the mouth could have caused ulcers Dehydration suspected [seattlechildrens.org]

  When to see a Doctor Call 911 Now Not moving or too weak to stand You think your child has a life-threatening emergency Call Doctor or Seek Care Now Chemical in the mouth could have caused ulcers Dehydration suspected. [stlouischildrens.org]

  Compare: Intraoral herpes With herpes, a person may experience malaise (bodily weakness or discomfort), fever, joint pain or swollen lymph nodes in the neck. Although, these symptoms may be slight enough that they're not readily noticed. [animated-teeth.com]

• Fatigue

  Find Primary care-doctors near you Canker sores are small painful ulcers that occur in the mouth and that do not have any clear source, although they are often linked to stress and tend to flare up when you are fatigued and under the weather. [zocdoc.com]

  After a seizure, the person may feel fatigue, confusion and disorientation, which may last from five minutes to several hours or even days. Rarely, this disorientation may last up to two weeks. [epilepsyontario.org]

  Symptoms: The most common signs are diarrhea, constipation, anemia, bone density loss, joint pain, dental enamel damage, fatigue, headaches, tongue ulcers and weight loss. Treatment: Avoid taking foods with gluten. [newhealthguide.org]

  Trouble swallowing ↬ Swollen tongue ↬ Inconvenience while speaking ↬ Bruising and bleeding ↬ Ulcers on other parts of the mouth Lesser occurring symptoms related to the bodily systems accompanied by ulcers are: Body pain Fever Rashes Diarrhea Extreme fatigue [buzzle.com]

  Radiotherapy has side effects like: sore skin ulcers in the mouth fatigue dry mouth loss of, or changes in, taste loss of appetite nausea bad breath etc. [news-medical.net]

• Pathologist

  Have seen neurologist, oral pathologist and psychiatrist.Any ideas what I can do? Find a professional to answer your question Find a professional to answer your question Search Now Am currently trying botox to tongue and jaw. [healthshare.com.au]

  Mouth cancer is treated by a team of specialists ranging from: oncologists (cancer specialists) radiotherapists oncosurgeons cosmetic surgeons and plastic surgeons for reconstruction after surgery oncology nurses pathologists dental surgeons dieticians [news-medical.net]

• Overeating

  Over-the-counter and home remedies can be useful in reducing discomfort and potentially promoting healing of tongue ulcers. [livestrong.com]

  (Medicine for adults over the age of 16) Always read the label. [bonjela.co.uk]

  If you use an electric toothbrush, it may be advisable to switch to a regular one until the ulcer heals, since they give more control over force and speed. [doctorshealthpress.com]

• Lesion of the Tongue

  Autoimmune conditions - Aphthous stomatitis is described as a separate entity of tongue and oral lesions due to their rather frequent occurrence, and studies estimate that up to 25% of the world's population may develop this type of lesion. [symptoma.com]

  Some medical ailments Herpes simplex infection can cause painful sores on the tongue. Painful red lesions on the tongue are one of the classic symptoms of hand, foot and mouth disease too. [thehealthsite.com]

  Mary, my wife, has some lesions on her tongue that don't hurt. They are on the tip and top surface in the middle and one side. Irregular shapes, with light (not white) edges, and of various sizes. About 6 lesions. [medhelp.org]

  Because soreness or painful lesions on the tongue can have a wide variety of causes, treatment and outlook depend upon the particular condition that is responsible. [medicinenet.com]

• Poor Oral Hygiene

  Oral thrust is common among people who are on medication, especially those taking inhaled steroids. Sores can also result from poor oral hygiene, smoking, or a weakened immune system. [monitor.co.ug]

  Poor oral care: tongue ulcers can occur due to poor oral care. A recent injury to the tongue can cause a blister to form as the infection heals. [md-health.com]

  oral hygiene burns from eating hot food irritation from strong antiseptics, such as a mouthwash oral thrush infection viral infections such as the herpes simplex viral infection (cold sore) reaction to certain medications skin rashes in the mouth (for [betterhealth.vic.gov.au]

• Dental Caries

  She also had multiple dental caries. The patient was treated with a liquid steroid taken by mouth and a topical steroid cream. Two years later she was asymptomatic without a recurrence. [entusa.com]

• Ulcer

  Mouth ulcers often make eating uncomfortable. (Image: sunabesyou/iStock/Getty Images) Tongue ulcers occur commonly, especially among adolescents and adults younger than 40. Most are aphthous ulcers, or canker sores. [livestrong.com]

  In addition, Lichen planus is also an important autoimmune etiology or tongue ulcers, having a similar clinical picture to SLE, but a diffuse pattern of ulceration is seen in this disorder. [symptoma.com]

  Tongue ulcers appear as raised round or small bumps with a white center bounded by red border. Referred to as Canker Sores or Apthous stomatitis, tongue ulcers are caused by virus and these ulcers can appear at some point in our lives. [boldsky.com]

  Most of the time, mouth ulcers are harmless, not contagious and clear up in 10 days to two weeks. There are 3 types of mouth ulcers: Minor ulcers. These are usually 2-8 mm in size and clear up in 10 to 14 days. Major ulcers. [wowremedies.com]

• Eruptions

  The pathogenesis may involve an immunologic reaction to fungal antigens similar to a delayed-type hypersensitivity response.26 Patients typically present with pruritic, papulovesicular eruptions that can be quite distant from the site of infection. [podiatrytoday.com]

  The word is derived from the Greek word aphtha meaning "eruption" or "ulcer". [8] The lesions of several other oral conditions are sometimes described as aphthae, including Bednar's aphthae (infected, traumatic ulcers on the hard palate in infants), [ [en.wikipedia.org]

  Click on Pictures to Enlarge Stomatitis: The pictures on the right show a 47 year old male with an intraoral viral eruption which occurred 24 hours after exposure to caustic chemicals. [entusa.com]

• Skin Ulcer

  Radiotherapy has side effects like: sore skin ulcers in the mouth fatigue dry mouth loss of, or changes in, taste loss of appetite nausea bad breath etc. [news-medical.net]

  ulcerated, ulcerating, ulceration, ulcerative frenum K14.0 (tongue) tongue K14.0 (traumatic) ICD-10-CM Codes Adjacent To K14.0 K13.24 Leukokeratosis nicotina palati K13.29 Other disturbances of oral epithelium, including tongue K13.3 Hairy leukoplakia [icd10data.com]

• Chancre

  Secondary syphilis with intraoral chancre and mucous patches. Photo 16. Crohn’s disease. Photo 17. Erythema multiforme. Photo 18. Stevens–Johnson syndrome with toxic epidermal necrolysis due to griseofulvin. Photo 19. Lymphomatoid papulosis. [medical-photographs.com]

• Urticaria

  Terbinafine is associated with some potentially serious adverse effects, although these are uncommon.15 Patients taking oral terbinafine may experience gastrointestinal disturbance (e.g. nausea, dyspepsia and diarrhoea), allergic skin reactions (e.g. urticaria [bpac.org.nz]

• Fracture

  […] eruption Neonatal teeth Pulp calcification Pulp stone Pulp canal obliteration Pulp necrosis Pulp polyp Pulpitis Regional odontodysplasia Resorption Shovel-shaped incisors Supernumerary root Taurodontism Trauma Avulsion Cracked tooth syndrome Vertical root fracture [en.wikipedia.org]

• Burning Sensation

  Needless to add, avoid having spicy and hot foods as they tend to worsen the pain and burning sensation of Tongue Ulcers. [speedyremedies.com]

  Butter to soothe the pain - Applying Butter on the lesions of tongue will certainly have effect in reducing the tingling and burning sensation. [tongue-ulcer.50webs.com]

  This is when ulcers become painful causing a burning sensation in affected areas of the tongue. Patients suffering from tongue ulcers often complain about discomfort and irritation while eating or talking. [ic.steadyhealth.com]

  Suck on an ice cube or ice pop if you have pain and/or burning sensation on your tongue. The cold will help to numb any feelings of pain, reduce swelling, and make your tongue feel more comfortable. [wikihow.com]

  Mouth Burning mouth syndrome is a painful burning sensation that occurs in the mouth, tongue, palate, gums, inside of cheeks and throat areas. [colgate.com]

• Confusion

  After a seizure, the person may feel fatigue, confusion and disorientation, which may last from five minutes to several hours or even days. Rarely, this disorientation may last up to two weeks. [epilepsyontario.org]

  Mouth ulcers aren't contagious and shouldn't be confused with cold sores. Cold sores appear on the lips or around the mouth and often begin with a tingling, itching or burning sensation. [nhs.uk]

  I'm just confused as to what's considered "lupus mouth ulcers" as that is one the 11 on the list of major symptoms (you're supposed to have at least 4 to be diagnosed with lupus according to that list). [mdjunction.com]

  Although cold sores and canker sores are often confused with each other, they are not the same. Cold sores, also called fever blisters or herpes simplex type 1, are groups of painful, fluid-filled blisters. [m.webmd.com]

  Canker sores are often confused with cold sores, which are caused by a herpes virus. [colgateprofessional.com]

• Forgetful

  […] yun so manhid dila mo walang pain. corsodyl (chlorhexidine digluconate)mouthwash -use it 5 minutes after brushing as toothpaste may stop corsodyl working properly im prone to singaw and when i learned how to prevent it. maybe once a year na lang if i forget [glocktalk.com]

  Don’t forget to dilute the hot oils that have been mentioned in the above list. Use such carrier oils as olive, coconut or grapeseed oils to dilute them. To dilute, mix 1-2 drops of essential oils with 1 tbsp of any one carrier oil. [rapidhomeremedies.com]

• Seizure

  Roll the child on his/her side after the seizure subsides. If a seizure lasts longer than five minutes or repeats without full recovery, seek medical assistance immediately. Talk gently to the person after the seizure. [epilepsyontario.org]

  Medication reaction or side-effect Medication side effect include nausea, vomiting, stomach upset, weakness, dizziness, seizures, and more. [healtreatcure.org]

The diagnostic workup of tongue ulcers must be detailed and comprehensive. The physician must obtain a thorough patient history, which will encompass the onset, course, and progression of ulcers [1] [5] [6] [7]. Furthermore, patients should be asked about their sexual habits (to exclude syphilis and HIV), recent dental or medical procedures in the oral cavity (to exclude trauma), and the use of drugs such as aspirin and cytotoxic agents [1] [7]. Conversely, a full inspection of the oral cavity, and not only the tongue, will warrant visualization of oral ulcers that might be missed without appropriate illumination and clinical suspicion. The size, shape, location, and the appearance (color, induration, and other associated features) should be assessed [1] [7]. The initial diagnosis is made based on clinical criteria, but laboratory studies might be employed to assist in determining the underlying pathology, including a complete blood count (CBC), serum inflammatory markers (C-reactive protein and erythrocyte sedimentation rate, or CRP and ESR, respectively), anti-nuclear antibodies (ANA), and a basic biochemical panel. Vitamin deficiencies (primarily B12 and folate, but also iron) are well-established risk factors for ulcers of the tongue and oral cavity [1], and their levels should be evaluated as well. Biopsy of the tongue ulcer, however, and subsequent histopathological examination is quite useful, and is recommended whenever possible [1] [5] [6].

Treatment: Different treatments work differently for every patient. Treatment works to reduce swelling. Anti-inflammatory drugs include mesalamine, sulfasalazine and corticosteroids will be prescribed. 4. [newhealthguide.org]

He responded to treatment with amphotericin B. [ncbi.nlm.nih.gov]

Tongue Ulcer Treatment • Application of butter for Tongue Ulcers treatment is one of the best natural remedies for this irritating problem. Items like butter and glycerin tend to ease the burning sensation and facilitate the process of healing. [speedyremedies.com]

This question featured in : Tongue ulcers treatment Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. [practo.com]

Prognosis The type of tinea pedis infection and underlying conditions (eg, immunosuppression, diabetes) affect the prognosis; however, with appropriate treatment, the prognosis is generally good. [emedicine.medscape.com]

Prognosis Most canker sores clear up without treatment and do not leave scars, although they usually return. [colgateprofessional.com]

Prognosis Prognosis is good provided preventive precautions be taken. Hyperhidrosis is a predisposing factor for tinea infections. Because the disease often starts on the feet, the patient should be advised to dry the toes thoroughly after bathing. [ncbi.nlm.nih.gov]

Cancers of the lower lip have a better prognosis than those of the upper lip. Chronic sun exposure is the most common cause, but smoking can also be an etiology. [entusa.com]

The reason for this rather high prevalence rate is the diverse etiology: Trauma - Mechanical trauma (for example tongue biting) or chemical/thermal irritation. [symptoma.com]

Aphthous ulcers that occur in conjunction with symptoms of uveitis, genital ulcerations, conjunctivitis, arthritis, fever or adenopathy should prompt a search for a serious etiology. [ghorayeb.com]

The etiology of RAS is still unknown; the condition may in fact manifest from a group of disorders of quite different etiologies rather than from a single entity. [3] Despite many studies trying to identify a causal microorganism, RAS does not appear [emedicine.medscape.com]

In addition to the causative dermatophytes and yeasts, NDMs have been described as etiological agents of foot mycoses. [hindawi.com]

Etiology Mainly, Trichophyton rubrum causes tinea pedis. Trichophyton interdigitale and Epidermophyton floccosum are also involved. Other occasional agents include Tricholosporum violaceum. [ncbi.nlm.nih.gov]

Epidemiological studies can be useful to eradicate these infections and to provide further measures of hygiene and education. 1. [hindawi.com]

Tinea pedis: the etiology and global epidemiology of a common fungal infection. Crit. Rev. Microbiol. 2015;41(3):374-88. [PubMed: 24495093] 13. Bowman J. Investigate all the options in skin care. Prof Nurse. 2004 Jul;19(11):43. [ncbi.nlm.nih.gov]

Cutaneous id reactions: A comprehensive review of clinical manifestations, epidemiology, etiology, and management. Crit Rev Microbiol 2012;38:191–202. DermNet NZ. Palmoplantar psoriasis. DermNet NZ, 2014. [bpac.org.nz]

For a discussion of the epidemiology of aphthous stomatitis, see the epidemiology of aphthous stomatitis. References [ edit ] ^ a b c Vorvick LJ, Zieve D. "Mouth ulcers on MedlinePlus". A.D.A.M., Inc. [en.wikipedia.org]

Epidemiology Frequency Tinea pedis is thought to be the world's most common dermatophytosis. Reportedly, 70% of the population will be infected with tinea pedis at some time. Race Tinea pedis has no predilection for any racial or ethnic group. [emedicine.medscape.com]

Temperature and serum factors, such as beta globulins and ferritin, appear to have a growth-inhibitory effect on dermatophytes; however, this pathophysiology is not completely understood. [emedicine.medscape.com]

The mean age of onset was 15 years in one study.[4][6] Pathophysiology Occlusion of toe clefts, maceration, and wet conditions with a simultaneous increase in the bacterial flora probably contribute to tinea pedis infection. [ncbi.nlm.nih.gov]

This commonly occurs in elderly people on the lip and may be associated with ulceration. [9] Pathophysiology [ edit ] The exact pathogenesis is dependent upon the cause. [en.wikipedia.org]

Still, preventing outbreaks has value for others as well as yourself. How to Prevent Oral Herpes Outbreaks Herpes becomes contagious from the prodrome stage. [authoritydental.org]

Centers for Disease Control and Prevention [medlineplus.gov]

How can canker sores be prevented? Most of the time the cause of canker sores is unknown. Unless you know what causes your canker sores, you cannot prevent them from happening. [northshore.org]

Oral Hygiene: The best way to prevent any tongue ailment is to maintain oral hygiene. [momjunction.com]

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6. Preeti L, Magesh K, Rajkumar K, Karthik R. Recurrent aphthous stomatitis. J Oral Maxillofac Pathol. 2011;15(3):252-256.
7. Flint S. Oral ulceration: GP guide to diagnosis and treatment. Prescriber. 2006;17(5).
8. Monteiro LS, do Amaral JB, Vizcaíno JR, Lopes CA, Torres FO. A clinical-pathological and survival study of oral squamous cell carcinomas from a population of the north of Portugal. Medicina Oral, Patología Oral y Cirugía Bucal. 2014;19(2):e120-e126.