DIAGNOSIS: MOUTH SORES

Submitted by: Kristine Danica E. Sugide

Introduction

Mouth sores, also referred to as oral ulcers or stomatitis, can cause discomfort and
pain, and they stem from various potential factors. Canker sores, characterized by small,
painful ulcers that may emerge inside the mouth, on the gums, cheeks, or tongue, are often
linked to triggers such as stress, specific foods, or hormonal changes. Cold sores, caused by
the herpes simplex virus type 1 (HSV-1), typically manifest as clusters of small blisters
around the lips or within the mouth, being contagious and prone to flare-ups triggered by
stress, sunlight exposure, or a weakened immune system. Trauma, resulting from accidental
bites, burns from hot food or drinks, or injury during dental procedures, can also lead to
mouth sores. Oral thrush, a fungal infection caused by Candida yeast, presents as white
patches on the tongue, inner cheeks, gums, or throat. Additionally, viral infections like hand,
foot, and mouth disease or herpes simplex virus type 2 (HSV-2) can contribute to mouth
sores, as can nutritional deficiencies in vitamins and minerals such as vitamin B12, iron, or
folic acid. Certain autoimmune diseases, such as Behçet's disease or lupus, may also trigger
recurrent mouth ulcers. Treatment for mouth sores depends on their underlying cause, with
many resolving on their own within a week or two. However, if mouth sores are particularly
painful or persistent, seeking evaluation and treatment from a healthcare professional, such as
a doctor or dentist, is advisable. Various options for treatment include over-the-counter and
prescription medications, mouth rinses, and topical treatments, all of which can help alleviate
symptoms and expedite the healing process.

Signs and Symptoms

● Difficulty in eating and swallowing
● Pain in the throat

Assessment:
Upon arrival at the Triage, the patient manifest:
● Weakness
● Pale
● Sunken eyeballs
● Poor capillary refill
● Pale nailbeds
● Pale lips
● Edematous on the left lower extremities
Health Teachings
- Educate the patient about the potential causes of mouth sores, including stress, viral
infections, nutritional deficiencies, and autoimmune diseases.
- Explain proper oral hygiene practices, emphasizing gentle brushing with a soft-bristled
toothbrush and regular flossing to prevent further irritation to the mouth sores.
- Discuss dietary modifications, advising the patient to avoid spicy, acidic, or rough-
textured foods that may exacerbate discomfort.
- Inform the patient about the importance of staying hydrated by drinking plenty of water to
keep the mouth moist and promote healing.
- Stress the significance of avoiding tobacco products and alcohol, as they can worsen
mouth sores and delay healing.

Management
- Recommend over-the-counter topical treatments containing benzocaine or lidocaine to
alleviate pain and discomfort. Advise the patient to apply these medications directly to the
affected area as needed.
- Suggest using mouthwashes or oral rinses with saline solution or baking soda to reduce
inflammation and promote healing. Instruct the patient to rinse their mouth several times a
day, especially after meals.
- Encourage the patient to maintain a balanced diet rich in vitamins and minerals to support
immune function and facilitate healing. Consider referring the patient to a dietitian if
nutritional deficiencies are suspected.
- Guide stress management techniques, such as relaxation exercises, deep breathing, or
mindfulness practices, to help reduce stress-related triggers for mouth sores.

Interventions
- Prescribe medications such as antiviral drugs (e.g., acyclovir), corticosteroids (e.g.,
hydrocortisone), or antibiotics (if bacterial infection is suspected) based on the underlying
cause of the mouth sores.
- Monitor the patient's progress and response to treatment, adjusting interventions as
necessary.
- Refer the patient to a specialist, such as a dermatologist or oral medicine specialist, for
further evaluation and management if mouth sores are severe, recurrent, or refractory to
initial treatment.
- Collaborate with other healthcare providers, including dentists, pharmacists, and
nutritionists, to ensure comprehensive care for the patient.