72 years old patient come with c/0 ulcers on tongue she is diabetic & ulcers from last 6 months. Plz tell me treatment.thank you


This is a case of 78 years old lady with type 2 diabetes and chronic ulcers on tongue. causes for ulcers on tongue could be 1 Vitamin B complex deficiency 2 GERD 3 Mouth breathing results in dry tongue as in cases of chronic asthmatics. 4 Use of Antidiabetic drugs like Metformin . 5 Any artificial dentures. 6 Poor eating habits. 7 Stress induced ulcers. 8 Age related factors. Burning mouth indicates vitamin B complex deficiency. Treatment is 1 Psychological reassurance 2 Advice vitamin B complex rich foods like Milk Milk products like yogurt, and cheese. Chicken Fish Eggs Green leafy vegetables like spinach, broccoli, asparagus, etc. legumes Nuts ,etc. 3 Vitamin B complex supplements especially vitamin B2 4 Vitamin C supplements 5 Correction of any underlying cause. 6 Triamcinolone oral paste 0.1% 7 Mild Anxiolytics if there is associated stress. 8 Control of diabetes meticulously.

dx oral thrush rx accordingly with local application of antifungal like clotrimazole lotion & systemic antifungal like fluconazole 150mg wkly for 6 wks & antihistamines & antioxidant. .

GERD Oral thrush Oral candidiasisi Vit b complex deficiency Mouth opening excerise Burning mouth vit b co.plex Artificial denture Maintain oral hygiene Antidiabeti drug Chronic asthmatics Psychological reassurance Ointment Mouthwash Soft food Stop spicy oily food Antabiotics Analgesics Multivitamins

denture?? or sharp teeth? hx of convulsions ?? constipation? low dose b12 for long time!!

Does patient having GERD a reflux disorder... Add cap.pan d 1od 1hr before dinner.. Multivitamin syp. 2 TSF bid Oracep-LA gel tds before meal Lexanox gel i.e. amlexanox gel tds after meal Tab.Ribagen i.e. ribamipid od or bid..

Thank you

The information you have provided is insufficient. Does she have any remaining natural teeth? Is she completely edentulous in both jaws? Is she a denture wearer, partial or complete? These questions need to be addressed if we have to find a solution. You have mentioned that sharp tooth is not the cause. In that case also eliminate the possibility of an Ill fitting denture, poor oral hygiene, leading to denture stomatitis and possible Candida infection. Burning sensation on the tongue is usually indicative of a vit b12 deficiency. In vit b complex, the strength of vit b12 is low, and may not be sufficient to manage her issues. She needs to take pure form of vit b12, such as mecobalamine tabs. Along with it, vit C, and folic acid tabs will definitely help. Being diabetic Is not the main issue. Rather is she being treated for diabetes and most importantly is her blood sugar under control? What is her sugar level on fasting and PP? If she is an uncontrolled diabetic, no amount of vit b12 will help in completely curing the lesion (healing of any sort of ulcer is markedly delayed when sugar levels are high). If that is the case, first she needs to get her sugar under control. Other things will fall into place. Also if she has any remaining natural teeth, perform thorough oral prophylaxis and curettage wrt to those teeth, to reduce the over all infection level. You have also not mentioned what her oral hygiene is like. If poor, then Clohex mouth wash BD for at least a month.

Considering diabetes and her age it may be vitamin deficiency and bad oral hygiene, try candida oral gel application tab metronidazole 400mg bd And vitamin b complex..

Vit B12 deficiency/ folic acid deficiency/ oral fungal infection due to immunocompramise .due to age and dm2.

Might be due to denture irritation Also check for constipation..

Looks oral thrush. Treatment With candida gel and wait and see,and follow up.

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