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Aphthous Ulcer Management — ORE Part 1 MCQ

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EasyOral MedicineAphthous Ulcer ManagementORE Part 1

A 20-year-old university student presents with a painful 3 mm round ulcer on the lower labial mucosa. It has a yellowish-grey base and an erythematous halo and appeared 3 days ago. She has had similar self-limiting episodes several times each year and is otherwise well. What is the most appropriate management?

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Correct answer: D — Give reassurance and recommend topical benzydamine for pain relief

**Answer: A.** The features are typical of a minor aphthous ulcer: a small painful recurrent ulcer on lining mucosa, with a yellow-grey base and erythematous halo, in an otherwise well young adult. It is self-limiting, so reassurance and topical analgesia/anti-inflammatory treatment such as benzydamine are appropriate. SDCEP recommends topical analgesia for oral ulceration and advises against antibiotics unless there is spreading or systemic infection. Aciclovir is for severe herpetic disease or zoster, not typical aphthae. Antibiotics are not indicated. Biopsy is inappropriate after only 3 days; unexplained ulcers persisting for 3 weeks require urgent assessment. Topical corticosteroids can be considered for more troublesome disease or early lesions, but are not the best first response to this straightforward, established minor ulcer.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Management of Acute Dental Problems: “Oral ulceration”, 2026. https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/oral-ulceration/