What are the causes of a chronic oral ulcer?

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Last updated: April 27, 2025 • View editorial policy

Differential Diagnosis for Chronic Oral Ulcer

Single Most Likely Diagnosis

  • Recurrent Aphthous Stomatitis: This is the most common cause of chronic oral ulcers, characterized by recurring, painful ulcers in the oral cavity. The condition is benign and often related to stress, trauma, or genetic predisposition.

Other Likely Diagnoses

  • Traumatic Ulcer: Caused by accidental biting of the cheek or tongue, sharp teeth, or dental appliances, these ulcers can become chronic if the cause is not addressed.
  • Oral Lichen Planus: An autoimmune condition that can cause chronic ulcers, along with white patches and redness in the mouth.
  • Dental or Periodontal Disease: Poor dental hygiene or gum disease can lead to chronic ulcers in the oral cavity.

Do Not Miss Diagnoses

  • Squamous Cell Carcinoma: Although less common, oral cancer can present as a chronic, non-healing ulcer. Early detection is crucial for effective treatment.
  • Tuberculosis: Oral tuberculosis can cause chronic ulcers, especially in immunocompromised individuals or those from endemic areas.
  • Syphilis: The secondary stage of syphilis can manifest with oral ulcers, among other symptoms.

Rare Diagnoses

  • Eosinophilic Ulcer: A rare condition characterized by an eosinophilic infiltration of the oral mucosa, leading to ulcers.
  • M MAGIC Syndrome ( Mouth And Genital ulcers with Inflamed Cartilage): A rare autoimmune disorder that can cause oral ulcers, along with genital ulcers and cartilage inflammation.
  • Behçet's Disease: A form of vasculitis that can cause oral ulcers, genital ulcers, and ocular inflammation, among other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.