Read the text carefully. Pay attention to words in the bold print

Mouth ulcers are small painful sores that form in the mouth. The most common type are called aphthous or simple ulcers. There are three main types of aphthous ulcers.

• Minor ulcers are small, non-scarring and usually heal without any treatment within two weeks.

• Major ulcers are 1cm or larger, have a raised border and can last from two weeks to several months. Usually only one or two appear at a time. They can be very painful and cause difficulty eating, are slower to heal and can leave scars.

• Herpetiform ulcers are multiple tiny sores that can be very painful – particularly if they fuse together to form one larger sore. They can last from one week to two months.

Most people have at least one attack of mouth ulcers in their lifetime, but mouth ulcers are more common in women and those under the age of 40.

Minor mouth ulcers are usually caused by damage to the mouth from accidental biting of the inside of the cheek, vigorous tooth brushing and a sharp tooth or filling.

Although there may be no obvious reason why the ulcers keep returning, factorsthat can increase the risk include mouth trauma, stress, certain foods such as chocolate, coffee, nuts, strawberries and cheese. Many women also find they get more mouth ulcers during their period. Certain medical conditions such as vitamin B12 deficiency, viral infections, iron deficiency or HIV infection can make mouth ulcers more likely.

Occasionally, mouth ulcers can be caused by medication. Common examples include: painkillers, such as ibuprofen and aspirin and beta-blockers that are used in heart conditions.

Most mouth ulcers are easy to spot because they are round or oval in shape, whitish in colour, inflamed around the edge. They usually appear on the inside of the lips and cheeks or under the tongue.

They usually cause pain, especially when eating and drinking. Simple mouth ulcers do not usually require any formal diagnosis from a doctor. Patient should seek medical advice if mouth ulcer gets progressively more painful and inflamed, the ulcer lasts for more than three weeks and ulcers appear elsewhere on the body.

Fortunately, most mouth ulcers do not need specific treatment and heal naturally without medication.

A mouth ulcer will heal faster if a soft toothbrush is used and hard foods are avoided.

A dentist can advise the patient on the most suitable medication for an ulcer. Examples of treatment include corticosteroids or antimicrobial mouthwashes used twice a day.

If an ulcer is very painful, a dentist may prescribe the painkiller benzydamine as a mouthwash or a spray.

There is no sure prevention against mouth ulcers, but the following can help if they recur a lot. Patient should keep stress levels as low as possible, avoid any foods that seem to trigger mouth ulcers and make sure he/she has regular dental check-ups.

GLOSSARY
avoid – unikać 
border – brzeg, obwódka 
damage – uszkodzenie 
deficiency – niedobór, brak 
edge – brzeg 
factor – czynnik 
fuse – złączyć się 
heal – zagoić się, goić się 
occasionally – od czasu do czasu 
obvious – oczywisty 
oval – owalny 
particularly – szczególnie 
progressively – stopniowo
period – okres, miesiączka 
raised – uniesiony, podniesiony
recur – powracać, nawracać
require – wymagać
round – okrągły
scarring – blizny, bliznowacenie
seek – szukać
sore – rana, ranka, owrzodzenie
spot – zauważyć, zobaczyć
trigger – wywoływać
vigorous – energiczny

Substitute underlined words with their synonyms from a GLOSSARY section.

1. Different causes contribute to oral ulcers in different patients.
2. Some patients experience episodes of painful sores from time to time. 
3. Iron deficiency can cause mouth ulcers. 
4. Typical oral sore is painful and its edges are elevated. 
5. Oral ulcers tend to come back.
6. If you notice that sores are spreading all over your body you must consult with your GP or a dentist. 
7. Lack of vitamin B12 is a common reason of oral sores. 
8. Menstrual bleeding may bring the symptoms oral ulcers on.

Complete the short text about the importance of ulcer localization in proper diagnosis, and complete it with words from a table

Distribution of the ulcer can help in the diagnosis. If limited to the gums, 1)_____________ (NUG) may be the problem. 2)_______________ (ANUG) in medical term, is a condition that affects the gums which as its name implies; destroy gum 3) _____________, create sores and inflame the gums.4)___________distribution (presence on one side of the face) suggests shingles, caused by Varicella zostervirus which causes chickenpox as a primary infection and shingles as a 5)_________________. If the ulcer is found under a denture or other appliance, 6)__________ulceration may be the cause. Recurrent traumatic ulceration usually recurs at the same site, often close to a sharp tooth. 7)____________(RAS) almost exclusively affects mucosa. Erythema multiforme affects predominantly the 8)___________of lip, cheek mucosa and 9)___________mouth.

Rearrange the words to create questions or pieces of advice for an oral mouth sufferer

1. such as/ managed /make sure/, / IBS / underlying causes/ properly/ or/ diabetes mellitus/ are/ 
…………………………………………………………………………………
2. your /don’t brush/ teeth/ vigorously 
………………………………………………………………………………….
3.rinse / your/ salted water/regularly/ teeth/ with slightly/ …………………………………………………………………………………..
4. is / painful/ how/ the sore/ ?
………………………………………………………………………………….
5. of the ulcer/ are/ the borders/ raised/ ?
………………………………………………………………………………….
6. heal/ the ulcers /foods/ avoid/ until/ spicy and hot/
…………………………………………………………………………………..
7. by/ see / if/ you /of recurrent sores /frequent attacks/ , / are troubled/your dentist
…………………………………………………………………………………..
8. for/ lasted/ how long/ your ulcers/ have/ ?
………………………………………………………………………………….
9.you/ do/dentures/ use/ ?
…………………………………………………………………………………..
10.experienced/ to your mouth / major or minor/ have/ you/injury/ ?

Complete the instructions of proper use of oral corticosteroids with a proper form of words in brackets

How to use hydrocortisone buccal tablets
• Before you begin this 1)………….(to treat) read the manufacturer's printed information leaflet.
• Always follow your doctor's or dentist's instructions.
• Put one buccal tablet in your mouth, near or on the ulcer, and let it 2) …………… (solve) slowly. Do not suck the tablet.
• Use hydrocortisone buccal tablets four times 3) ………… (day) until the ulcer has healed.
• If your symptoms do not 4) …………. (improvement) within five days or if they get 5)…………. (bad), ask your pharmacist, doctor or dentist for 6)……….. (far) advice.
• Keep all medicines out of the reach and 7)………. (to see) of children.
• Store in a cool, dry place, away from 8)……………. (direction) heat and light.
• Hydrocortisone buccal tablets can occasionally cause oral thrush, which causes a sore mouth, often with white patches on the tongue and insides of the cheeks. If this becomes 9)……………. (trouble), ask your doctor, dentist or pharmacist for further 10)…………….. (to advise).


Lessons 31 answers