Ulceration of the oral cavity

Ulceration represents a full-thickness breach in the oral epithelium. This can result in pain and difficulty with eating, drinking, speech and maintaining oral hygiene. Ulcers are common and can solely involve the oral cavity or can represent localized changes associated with an underlying medical condition. Oral ulceration has a wide range of causes, including trauma, recurrent aphthous stomatitis, immunobullous disease, manifestations of systemic disease, infection and malignancy. Diagnosis can be challenging because of similarities in clinical presentation between the different conditions. The priority with localized persistent oral ulceration is to exclude carcinoma, as early detection and treatment significantly decreases morbidity and mortality. This article reviews the most important types of oral ulceration and their distinguishing features, with a focus on the importance of history taking, clinical examination and further investigation in making a definitive diagnosis.