A 56 year old female patient complaining of pain, irritaion in the gum and lower lip for last 3 to 4 days.. On examination ulcerative lesion is seen in the lip and gum..and there is staining of teeth what is the diagnosis and treatment...

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Any history of trauma ? drug history? Nutrition status, oral hygiene ask for these. 1) Lignocaine(2%) applied locally 2) Vit-B complex 3) Oral hygiene should be maintained These are symptomatic treatment, but if cause is found then treat accordingly.

No trauma or drug history Bt there is history of recurrent gum pain for last 1 year
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An ulcer of lower lip! Rx-lignocaine gel(topical application) Topical corticosteroids 2% tetracycline mouth wash is the standard treatment known. It will heal in 4-5 days!! REGARDING THE stains, Scaling and root planing will be done. Bleaching of teeth further, if required. Maintenence of oral hygiene! Warm saline rinses after scaling!! Refer her to a dentist!!!

D/D Apthous ulcer Traumatic ulcers Vit. Deficiency Malnutrition Herpetuc ulcer Rx Multuvitamine capsule limcee Candid mouth paint Betadine gargale Oral hygiene maintaine

Thank you doctor
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mucopain gel for pain relief and hexigel(Chlorhexidine) for topical application. give vit c supplement along with metrogyl 200 thrice daily for 7-10 days... maintainance of oral hygiene.... proper brushing technique need to be demonstrated to the patient as gingival recessions also present there.

Ok.. And what about staining of teeth?
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The ulcer on the lip may be due to so many reasons 1. Malnutrition 2, vitamin deficiency 3, apthous ulcers 4. Hepees ulcers ( herpetic ulcers). 5, traumatic ulcers . 6,.syphilitic ulcers ( chonkroid) 7, drug induced ulcers . Like that many ulcers on the lip in this healing and non healing ulcers r common . Any sexually transmitted diseases also induce oral ulcers on the tongue . First complete blood picture for any blood count abnormalities , Rx multivitamin capsule once daily for 9.days candid mouth paint for topical application is very helpful R aloe Vera ulcer gel is very good antioxidant for ulcer healing and reducing burning sensation .

it looks like an developing aphthous ulcer with induced trauma.. doesnot look like herpes manifestation. mucopain before food, vitamin supplements and kenacort over the lesion 4times a day.. analgesic if needed

There are 2 possibilities 1) Aptthous ulcer 2) ptn has lip bitting habit... Kindly check Treatment is simple go for mucopain gel BD and star with vitamin B complex

No lip bitting habit
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Aphthous ulcers

R/O verucose ulcer due to tobacco.

Sir there is no history of it...she does not take tobacco or tobacco like things..
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Appears to be major apthous ulcer. Prednisone will cure it.. These are recurring. Immune mediated etiology. Make sure she has no underlying deficiencies. Symptomatically any gel with LA will do.

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