DDX - Oral Ulceration - Mucositis, Stomatitis


Definition

Inflammation of mucous lining of any of the structures in the mouth, cheeks, lip, tongue, gingiva, and floor or roof of the mouth. 

Differential Diagnosis

  • Infectious
  • Autoimmune 
    • Recurrent aphthous stomatitis, may be associated with colitis, celiac
    • Erythema multiforme/Stevens-Johnson syndrome
    • Behçet disease 
    • Pemphigus vulgaris
    • Bullous pemphigoid
    • Oral lichen planus
  • Metabolic
    • Angular stomatitis
    • Uremic stomatitis
  • Neoplastic
    • Cyclic neutropenia
    • Cancers of oral mucosa, for example, squamous carcinoma (90% of oral cancers)
  • Other - unknown etiology
    • Burning mouth syndrome
    • Periodic Fever, Aphthous ulcers, Pharyngitis, and Adenopathy Syndrome (PFAPA)

Mouth Anatomy

Management


  • Pain Control 
    • Such on ice chips or ice pops 
    • Magic Mouthwash -  2% viscous lidocaine, Benadryl, and Maalox
    • Ibuprofen 
  • Dietary Modifications 
    • Eat moist or soft foods 
    • Avoid foods that require a lot of chewing 
    • Avoid acidic, spicy, salty, and hot foods 
  • Oral Care
    • rinse mouth 5-6 times per day
    • brush teeth with soft tooth brush


Works Consulted

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