Treatment planning & seminar I

By: Omar Rakeen Ahmed-200811060 Ahmad AL Saadi-200820174

3rd week
A 27 years old Sudanese writer presented with 1 cm painless ulcer on the later border of the tongue. The history of ulcer was noted during the dental examination, no history of smoking or drinking habits. The clinical examination revealed no other lesions on the mouth, Throat or Neck.

What causes ulcers

Systemic causes Local causes Malignancies Psychological Emotional

Differential diagnoses
squamous cell carcinoma. major or minor ulcers. traumatic ulcer ulcer due to a secondary systemic disease due to wedging of tongue between teeth.

Squamous cell carcinoma

It is the most common tumor condition of the oral cavity. Usually affects men of old age. Ulcers are extremely painful Smoking and drinking are predisposing factors.

Apthous ulcers
They are very painful ulcers. The cause is unknown but usually associated with emotional distress, iron deficiency and or other systemic diseases like GIT disorders.

Traumatic ulcers
Traumatic ulcers usually have a definitive causative factor. Like an irritation from a denture, sharp border of a restoration and an injury from a foreign body. Traumatic ulcers and extremely painful and it is usually a chief compliant by it self.

Diagnosis
Medical history. The most possible cause of this kind of ulcers could be wedging of the tongue between the posterior teeth or a local irritation from an adjacent tooth or restoration. These kind of ulcers are usually painless and hence, patients are usually unaware of the condition.

 Final diagnoses should be obtained after a

biopsy and a histopathological examination to rule out malignancies. Patient should be assured and adviced to keep the oral cavity clean and avoid any factors that provokes the condition like spicy foods.

Investigations
Blood tests, to reveal any iron, hemoglobin and immune deficiencies and liver functions. Biopsy to confirm that the ulcer is benign. Glucose test Imaging

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Goals of treatment
To confirm that the ulcer is benign. (early diagnoses) To reassure the patient. To determine the causative factor and reverse the condition.

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 Supportive treatment to avoid any possible complications. Close multiple checkups to avoid any late complications. To Educate the patient about the condition and the possible complications.
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Treatment
Mouthwashes with saline. Keeping the oral cavity clean. Avoid spicy and acidic foods. Regular check ups.

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 Thank you

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