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Management of Erythematous Oral Lesions


Many conditions can cause oral erythema, including localized trauma, infection, contact allergy, cancer, and other causes of inflammatory changes, as well as systemic diseases such as those that produce vesiculoerosive lesions or oral ulceration. For purposes of this discussion, which involves therapy for oral erythematous lesions, the presented conditions are arbitrarily divided into the following categories: local infection, contact allergy, oral cancer, and localized vesiculoerosive and ulcerative disease.

See Clues in the Oral Cavity: Are You Missing the Diagnosis?, a Critical Images slideshow, to help identify the causes of abnormalities of the oral cavity.

This article focuses on dental management of oral erythema, but, in cases of systemic disease, a more comprehensive medical approach to therapy is necessary. For a complete description of each condition discussed in this article, including etiology, epidemiology, signs and symptoms, and diagnosis, the reader is encouraged to assess the published literature.

The general rationale for dental treatment of oral erythematous lesions is to relieve symptoms, to prevent problems that arise from the disease (eg, secondary infection, tissue morbidity), and to support the patient’s general health.

For all the conditions listed below, home care should be an integral component of therapy and should include recommendations for fluid and nutritional support, adequate rest, and over-the-counter (OTC) or prescribed pain control. In cases involving severe disease or worsening symptoms in the face of initial intervention, medical referral and comanagement should be recommended, with patient follow-up by appointment or phone to prevent potential systemic complications or morbidity due to patient noncompliance or other patient reasons for a lack of follow-up.

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