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Apthous ulcer in cheek. Habitual tobacco chewer. On medicines. Need biopsy to rule out other severeties?

I am suffering from Apthous ulcer in right side cheek. The lesion is about 7mm long. My dentist Rxed me BecosuleZ Cap 1 OD, Antoxid Cap 1 BD, and Tess mouthpaste t.i.d.for local application. No antibiotic was given. I have been taking the above dose for last ten days, and the lesion has still not disappeared. By the way, I was a habitual tobacco chewer=Pan masala addict. for last 25 years. For the last ten days my tobacco consumption has gone drastically down,limiting myself to 4 or 5 times in 24 hours. Without tobacco, my head & concentration wavers,and I feel irritated. My family says,taper off and leave tobacco gradually.I am trying to stop tobacco fully. From today a chemist friend advised me to take Rebagen [ Rebamipide 100mg] of Macleods Pharmaceutical, in doase 1 b.d. plus local application of paste of Laxanox [Amlexanox Oral Paste 5%] twice daily, for 5 days. I have added this regime also. Please advice if this is the correct therapy or I should go for a biopsy to rule out sub-cutaneous fibrosis or anything more severe. I shall be obliged for your response. I am a Indian male, aged 59. weight 98kg with normal health. Thank You. CSTewari. Uttar Pradesh.
Asked On : Tue, 12 Feb 2013
Answers:  4 Views:  128
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Dentist 's  Response
Thanks for sharing your concern with us.
The best thing to do before brushing or eating is to rinse with warm salt water. (1/2 tsp. salt with 10 oz warm water). Swish and SPIT the whole glass, wait five minutes and then brush or eat food.
avoid spicy foods, citric acids found in fruit and tooth pastes containing sodium dodecyl sulfate (sometimes called sodium lauryl sulfate, or with the acronyms SLS or SDS).
Vitamin B12 used orally may have some effect
You can contact me again directly through my profile.
Dr Neha Gupta
Answered: Tue, 19 Feb 2013
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Dentist Dr. Bindiya Bhaskar's  Response

Thanks for the query.

Regarding aphthous ulcers,corticosteroids are the treatment of choice.

Add plenty of nutitional food into your diet.

I would suggest you to stop the habit of pan chewing since it can lead into limited mouth opening,difficulty in eating/swallowing food resulting in oral submucous fibrosis.

Biopsy is mandatory to find out the cause of lesion.

vitamin.b supplements can be continued.



Answered: Wed, 13 Feb 2013
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Dentist Dr. Farah Hussain's  Response
Hello and welcome to HCM,
After reading your history i would add few possibilities , first of all Apthous ulcers are the most common ulcers seen with exact cause unknown they may be caused by physical trauma,chemical injuries like citrus, vitamin b deficiency , stress related , immunodeficiency disorders , food habits ,tobacco and alcohol addiction and so on..
they are painful with rupture of mucosa and if secondarily infected with herpes or bacteria needs antibiotic coverage to treat.
In your case ,since you are a tobacco user i would suggest you to get the lesion diagnosed by a oral surgeon before predicting it as apthous .
apthous ulcers take 15 to 30 days to resolve depending on your body immunity so u can wait for some time.
you can continue with antioxidants LYcopene2000mcg od, vitamin C lozenges and vitamin b supplements BID , tetracycline tablets BID for 7 days , use antiseptic mouth wash for oral rinsing .
get well soon ,
take care.
Answered: Wed, 13 Feb 2013
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Dentist Dr. Abid Pasha's  Response
U have not mentioned whether the size has increased or decreased since u started the treatment. Considering your history of tobacco chewing and the duration of the ulcer , i suggest not to add more drugs and get a biopsy done at a renowned medical center.
Answered: Tue, 19 Feb 2013
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