A guide to oral ulceration for the medical physician

The clinical presentation of oral ulcers is varied, reflecting the diverse aetiological processes that can be involved in their development. However, all ulcers represent a breach in the epithelium that extends to the underlying lamina propria. In contrast, erosions are more superficial lesions, where there is an incomplete break in the epithelium which does not extend to the underlying connective tissue. Oral ulceration may arise entirely in isolation or in combination with systemic features. A thorough history, in conjunction with appropriate clinical examination, is vital to reach the correct diagnosis and thus enable appropriate management. In particular, it is important to distinguish between recurrent and non-recurrent ulceration as this guides further investigations and management.