188 Where There Is No Dentist 2012
2. Sores of the skin of the mouth (ulcers)
Open sores (ulcers) that
can appear anywhere in
the mouth. Usually the skin
around the sores is red. The
sores in this picture are on the
inside of the top lip.
Most people from time to time have had a small open sore (ulcer) in the
mouth caused by an infection that has destroyed the skin in that area. It is
usually painful and can make eating and speaking difficult for 1 or 2 weeks.
The ulcer heals if the mouth is kept clean. For people with HIV infection,
the healing process can be very slow and sometimes the sore area in the
mouth becomes very large. This is especially true if the person is taking
anti-retroviral medicines to weaken HIV, such as zidovudine (AZT).
Signs:
The skin lining the mouth or on the tongue is broken and will probably look
much redder than the skin that is not broken.
Treatment:
Keep the area clean to control the infection and to help the skin heal. Clean
the sores with a cotton swab dipped in 1% povidone iodine. Or use any of the
methods described in the “General Treatment” box on pages 184 and 185.
Also give antibiotics if:
• the skin around the ulcer is very swollen, AND
• you feel soft lumps (lymph glands) underneath the lower jaw bone.
Give 500 mg of amoxicillin by mouth, 3 times a day for 7 days. (Not safe
for people allergic to penicillin. Anyone who is allergic to penicillin will also
be allergic to amoxicillin and ampicillin).
OR 100 mg of doxycycline by mouth, 2 times a day for 7 days. (Not safe
for women who are pregnant or breastfeeding).
OR 500 mg of tetracycline by mouth, 4 times a day for 7 days. (Not safe
for women who are pregnant or breastfeeding).
OR 500 mg of erythromycin, 4 times a day for 7 days.