Oral mucosal lesions – clinical problem with many faces
The causes of oral mucosal diseases are diverse. The oral mucosa itself is continuously subject to various effects from various factors (mechanical effects of food, dental anomalies, inconvenient dentures or broken teeth, thermal, infectious, acidic effects, etc.) that can cause mucosal lesions. Depending on their connectivity and the presence of concomitant diseases or predisposing factors, the lesions of the oral mucosa can be divided into primary (effects of isolated factors – trauma, thermal effects, etc.) or secondary (when resulting from systemic diseases, medications, allergies, etc.).Decreasing the body’s protective powers, and above all, local immune disorders, combined with the virulence of infectious agents, are one of the leading causes of mucosal lesions. In some of the oral mucosal diseases with chronic flow, genetic anomalies are also found, making them more difficult to diagnose and treat.In most cases, despite the causative factors, the macroscopic picture of the lesions present is characterized by the signs of inflammation – swelling, redness and pain, expressed to varying degrees, the major changes being similar to each other and therefore difficult to distinguish. There are disturbances in the functions of both the mucosa itself and other functions such as eating, swallowing, speech, loss of taste, etc. Pain is a leading symptom that creates discomfort for the patient and is a contributing factor to the pathological process. Mucosal lesions may be characterized by single or multiple lesions, and may extend to a particular area or entire oral mucosa. In numerous cases, the differential diagnosis of oral mucosal diseases is difficult. In case of persistent aphthae and in the history of chronic use of cigarettes, alcohol and other harmful substances, a neoplastic process should be excluded.
The treatment of oral mucosal diseases must be complex, above all, aimed at controlling pain syndrome and inflammation, strengthening the body’s defense, enhancing local immunity and removing the etiological reasons. In this case, both topical and systemic drugs can be administered. In the presence of infectious agents, as the primary cause for the lesions, treatment is etiological by conducting antibiotic therapy. In severe and complicated cases, the interdisciplinary approach to treatment should not be excluded. Natural moisture in the oral cavity is a factor causing difficulty in the treatment of the lesions due to the natural maintenance of inflammation, the creation of a favorable environment for the development of certain microorganisms and the effect of drug washout. Sometimes treatment is difficult and can take a long time and could pose a serious challenge for the physician.