The recognition and diagnosis oral lesions is an essential part of any dental practice, regardless of scope. Ulcerative lesions of the oral and maxillofacial region are fairly common and run the gamut from benign nuisances such as the common aphthous to serious life threatening malignancies such as squamous cell carcinoma. Ulcerative conditions may arise as part of the continuum of vesiculobullous lesions, as a result of localized soft tissue trauma as a manifestation of systemic conditions or viral infections; as a response to allergy or reaction to chemotherapeutics; or as a result of a neoplastic process.
In general, ulcerative lesions tend to be painful, and may be accompanied by other somatic subjective and objective manifestations such as lymphadenopathy, malaise, difficulty in eating, difficulty with speech and in some cases, systemic manifestations such as fever. These often prompt the patient to seek consultation with his or her dentist or physician but perhaps more ominous are the ulcerative lesions that are asymptomatic, and thus unnoticed by the patient. The dental practitioner is in unique position to discover these during routine dental appointments. Because of broad etiologic possibilities, prompt recognition and diagnosis are essential in determining the mode of management and necessity of referral to specialists.
Theodore Nicholoff Dr. DMD, MD
Section Chief, Oral and Mxillofacial Surgery & Oral Medicine,
Makati Medical Center and Asian Hospital & Medical Center
Fellow, American College of Oral & Maxillofacial Surgeons
Fellow, International Association of Oral and Maxillofacial Surgeons