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Burns of oral mucosa - Oral Mucosal Lesion
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Burns of oral mucosa - Oral Mucosal Lesion

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Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed

Synopsis

A chemical burn of the oral mucosa occurs as a result of a noxious agent placed in direct contact with the mucosa either by the patient or a dentist. Mild lesions (less irritating agents and/or shorter duration of contact) usually present as an alteration in texture, while more severe lesions (more irritating agents and/or longer duration of contact) usually present with symptoms ranging from sensitivity and soreness to outright pain. Some chemicals used by patients include aspirin (placed next to an aching tooth) and OTC preparations that contain phenols, peroxides and sulfuric acid. Chemicals used by dentists in the course of routine dental treatment include methylmethacrylate, formaldehyde, formocresol, sodium hypochlorite and others used during root canal treatment. This generally occurs within minutes (if the agent is more caustic) to hours after exposures and heals within a few days.

Thermal burns are ulcers of the oral mucosa cause by contact of hot foods with the oral mucosa. The biggest culprits are hot cheese in pizza and hot coffee/tea. Microwaved food may also cause burns because the food may be hotter in the middle than on the surface.

Electrical burns in the oral cavity are usually of the arc type, where the saliva conducts an electric arc from the source to the mouth. Most cases occur in young children biting live wires at the end of extension cords.

Codes

ICD10CM:
T28.0XXA – Burn of mouth and pharynx, initial encounter

SNOMEDCT:
286547006 – Burn of oral cavity

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Recurrent aphthous ulcers are recurrent and do not occur on the gingiva.
  • Herpes simplex virus (HSV) infection in the immunocompromised host
  • Local anesthetic ischemic ulcers (from epinephrine) occur at the site of the injection. Such patients may have underlying vasculopathies.
  • Chronic factitial injury is usually associated with a history of a chronic parafunctional habit or a psychiatric disorder.
  • Behçet's disease
  • Syphilis

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 01/22/2015
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Burns of oral mucosa - Oral Mucosal Lesion
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Burns of oral mucosa : Mouth pain, Oral erosions, Oral white plaque, Painful oral ulcers
Clinical image of Burns of oral mucosa
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