A critical aspect of every patient intraoral examination is the observation of all the oral mucosae. The goal is to identify any changes that would not normally be expected. Once a change is identified a process should be initiated to achieve a final diagnosis. One change that is commonly seen in the oral mucosa is an ulceration. There are many different etiologies that can lead to the appearance of an oral ulcer and identifying the etiology is critical to instituting the appropriate course of clinical intervention.

The objective of this presentation is to review different causes of an oral ulceration, the diagnostic steps to identify the etiology, the clinical course typically seen with ulcers of different etiology and recommendations for procedures to definitively diagnose and treat the ulcer. The outcome of the material should help to provide a more comprehensive strategy to evaluate an oral ulcer and develop a differential diagnosis.

This course will review the different causes of oral ulcerations and the changes that occur in the oral mucosa. Images from actual clinical cases will be used to present examples and discuss the mechanism of ulceration. Specific diagnoses that are linked to oral ulcerations will be discussed and different clinical features associated with the specific diagnoses presented. The approaches that can be used in questioning the patient’s chief complaint and history of present illness will be presented to assist in the assignment of potential etiologies and generate a differential diagnosis. Specific diagnostic procedures will be presented to achieve a final diagnosis for the ulcer leading to a specific recommendation for treatment. There will be an emphasis on the normal physiology of the tissue and the changes that contribute to the signs and symptoms seen in the patient. The importance of developing a differential diagnosis will be stressed and based on the clinical examination strengths of the oral health professional.

EDUCATIONAL OBJECTIVES:

1. To recognize changes oral mucosa associated with an oral ulceration
2. To evaluate the clinical history of the oral ulceration and identify factors that contribute to either the etiology or prognosis
3. To develop a process to achieve a definitive diagnosis for an oral ulceration and develop a plan for treatment

Course Available until March 1, 2024