Oral damage from eating too hard food
Introduction
Introduction It is common in the clinic to eat overheated or hard foods. When chewing or swallowing, it can damage the soft palate, buccal mucosa, or parapharyngeal mucosa, and blood blisters can be formed immediately, thus causing oral damage. At this time, the patient feels a local abnormal feeling or tingling, and the mucosal blood blister can be seen here, which is purple-red, the blister wall is thin, the size is not limited, and the shape is different. After the rupture of the blisters, the herpes is necrotic and shedding, showing a bright red ulcer surface with a clear edge. There is a little secretion on it, and the surrounding mucosa is congested. The patient feels burning pain, and the pain is aggravated when talking and eating. If the damage range is too large, the healing is slow, and the granulation tissue grows gradually on the ulcer surface, and the fresh epithelium covers and heals. Traumatic ulcer refers to the ulcer formed by long-term chronic mechanical damage such as the residual crown of the oral cavity, the sharp edge of the tooth, the dislocated tooth, and the defective prosthesis; or caused by long-term bite, bite cheek, bite lip and other self-injury habits. Ulcers. The shape of the ulcer fits perfectly with the stimulating factor.
Cause
Cause
According to the time of mechanical stimulation, it can be divided into persistent and non-persistent stimuli.
1. Persistent mechanical stimuli such as residual crowns, residual roots, sharp edges, sharp cusps, and poor prostheses formed in the oral cavity due to rickets.
2. Non-persistent mechanical stimuli such as hard and brittle food irritations, chewing inadvertent bites, brushing damage, improper use of instruments when the dentist is diagnosed and treated, etc., can cause trauma to the mucosa and cause ulcer damage.
Examine
an examination
Related inspection
Oral endoscopic oral X-ray examination
There is a history of mechanical irritation or the presence of mechanical stimuli near the lesion. The shape of the ulcer coincides with the shape of the stimulating factor. If the stimulating factor is removed, the ulcer can heal in a short period of time. If the ulcer does not heal after removal of the stimulating factor, the diagnosis should be further examined.
(1) Physical damage. This is the most common traumatic ulcer. For example, the residual roots caused by smashing, the sharp edges of the crown, the bad restorations, the sharp cusps, etc. can cause the corresponding mucosa to form ulcers or erosion surfaces. There may be only mild pain or swelling. After a long time, there is an inflammatory reaction around, the base of the ulcer is hard, and even the tissue hyperplasia occurs in the tongue of the elderly, often suspected of tongue cancer. The size, location, and depth of the ulcer vary, but it is compatible with the irritant. The severity of the condition is related to the time of the irritant and the physical condition of the patient. Secondary infections exacerbate pain, regional lymphadenopathy, tenderness, and dysfunction.
The sharp edge of the prosthesis or the overly long substrate compresses the mucosa of the vestibular sulcus to form an ulcer. The common margin of the denture base is not only ulcerated but also visible tissue hyperplasia, which is called decubital ulcer. When the fixed bridge presses the gums, an ulcer forms under the bridge. In the infant, the bilateral mucosa at the flap of the flap is sometimes artificially fed by a hard pacifier, often rubbed there, and is prone to ulceration, called Bednar ulcer. If the milking time is long after the eruption of the deciduous teeth, the tongue ligament, the tongue and the teeth will rub together, and only the local congestion will occur at the beginning. Then there will be small ulcers. The result of continuous stimulation will not only enlarge the ulcer, but also increase the pain. Visible tissue hyperplasia. Acute or accidental mechanical injuries are also common, such as trauma, bites, excessive toothbrush or improper use, improper use of sand or gravel, resulting in acute damage to the mucosa, ulcers, and even laceration.
(2) Chemical damage. Chemical damage of the oral mucosa is caused by improper local application or strong acid or strong alkali in the mouth. In oral therapy, there are often corrosive drugs that inadvertently damage the mucosa, such as arsenic trioxide inactivating agent, iodine phenol, silver nitrate solution, and the like. Arsenic trioxide can be seen in the temporary closure of the cement and into the interdental space, which not only damages the gray-brown tissue necrosis of the mucosa, but also causes the alveolar bone to be necrotic. Improper use of silver nitrate, trichloroacetic acid, etc., also causes mucosal necrosis. In addition, patients sometimes have painkillers such as aspirin due to toothache. Chemical damage occurs due to excessive exposure of the drug to the gums. Local congestion and erosion have a white pseudomembrane.
(C) mucosal blood blister. It is common in the clinic to eat overheated or hard foods. When chewing or swallowing, it can damage the soft palate, buccal mucosa, or parapharyngeal mucosa, and blood blisters can form immediately. The true cause of this is unclear. At this time, the patient feels a local abnormal feeling or tingling, and the mucosal blood blister can be seen here, which is purple-red, the blister wall is thin, the size is not limited, and the shape is different. After the rupture of the blisters, the herpes is necrotic and shedding, showing a bright red ulcer surface with a clear edge. There is a little secretion on it, and the surrounding mucosa is congested. The patient feels burning pain, and the pain is aggravated when talking and eating. If the damage range is too large, the healing is slow, and the granulation tissue grows gradually on the ulcer surface, and the fresh epithelium covers and heals.
Diagnosis
Differential diagnosis
Differential diagnosis of oral damage in foods that eat too much:
1. Identification with recurrent aphthous ulcers.
2. Cancer: The growth of the tongue, especially those with ulcers, should first think of the possibility of cancer. Traumatic ulcers caused by residual roots and crown stimulation are clinically very similar to cancer. In addition to identification from medical history and examination, the most important thing is to first remove local factors instead of biopsy. If local stimuli can be found in the local area, they should be removed, either severely or after removing the irritant. Quickly improved. If it does not heal after removal, a biopsy should be performed in time to confirm the diagnosis.
3. Glandular aphthous ulcer: First of all, we must carefully look for the irritant of the corresponding part of the lesion, and exclude the local factors, then consider the diagnosis from the medical history, oral examination and other aspects. Glandular aphthous ulcers have a longer ulcer period and should be observed.
4. Tuberculous ulcers: First of all, it is necessary to carefully check whether there is any irritant in the corresponding part of the lesion, and then from the history of the disease, the characteristics of the ulcer: the bottom is granulated, the edge is not uniform, etc., if necessary, for chest X-ray examination. A biopsy helps to confirm the diagnosis.
