Linear White Ulcers: Causes and Connections to Oral Health - Otolaryngology

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Hello! Thank you for your question regarding your recent oral health issues, particularly the linear white ulcers and recurrent mouth sores. Let's break down your concerns and explore the potential causes and connections to your overall oral health.

1. Connection Between Medication and Oral Ulcers: You mentioned that you are currently taking a medication called "Ritalin" (利他能). While Ritalin is primarily used to treat attention deficit hyperactivity disorder (ADHD), it can have side effects that may indirectly contribute to oral health issues. One of the known side effects of Ritalin is dry mouth (xerostomia), which can lead to discomfort and increase the risk of developing oral ulcers. Saliva plays a crucial role in maintaining oral health by helping to wash away food particles and bacteria, and when saliva production is reduced, the mucosal tissues in the mouth can become more susceptible to irritation and ulceration.
Additionally, medications that affect the central nervous system can sometimes lead to changes in oral hygiene habits, such as reduced attention to oral care or changes in diet, which could also contribute to the development of ulcers. If you suspect that your medication is contributing to your oral issues, it would be wise to discuss this with your prescribing physician. They may consider adjusting your dosage or switching to an alternative medication.

2. Impact of Malocclusion on Oral Health: You also mentioned having a malocclusion (improper bite alignment). Malocclusion can indeed contribute to the development of oral ulcers. When your teeth do not align properly, certain areas of the oral mucosa may experience excessive friction or pressure from the teeth, leading to irritation and ulceration. This is particularly true if you have a habit of biting your cheeks or if your teeth are sharp or jagged, which can cause trauma to the soft tissues in your mouth.

The linear white ulcer you described, especially if it resembles a line or groove, could be a result of chronic irritation from your teeth. This condition is sometimes referred to as "linea alba," which is a benign condition characterized by a white line on the buccal mucosa due to frictional keratosis. However, if the ulcer is painful, swollen, or persists, it is essential to have it evaluated by a dental professional.

3. Recommendations for Management: To manage your symptoms, consider the following steps:
- Maintain Good Oral Hygiene: Regular brushing and flossing can help reduce the risk of infections and promote healing. Use a soft-bristled toothbrush to avoid further irritation.

- Stay Hydrated: Drink plenty of water to combat dry mouth and stimulate saliva production. You might also consider using saliva substitutes or mouthwashes designed for dry mouth.

- Avoid Irritants: Steer clear of spicy, acidic, or abrasive foods that can exacerbate irritation. Additionally, avoid tobacco and alcohol, as they can further dry out the mouth and irritate the mucosa.

- Consult a Dentist: Since you have a history of malocclusion, it would be beneficial to consult with a dentist or orthodontist. They can assess your bite and recommend treatments, such as orthodontic options or dental adjustments, to alleviate the pressure on your oral tissues.

In conclusion, your oral ulcers may be influenced by a combination of medication side effects and malocclusion. It is essential to address both factors to improve your oral health. If your symptoms persist or worsen, please seek professional dental care for a thorough examination and tailored treatment options. Take care, and I hope you find relief soon!