Non healing oral ulcers

A young female patient came in with a complaint of extremely painful oral ulcers. She had visited another physician who had prescribed her vitamin B12, analgesic for the pain and an antacid. She did not receive any relief and came into our dental clinic for a second opinion. She was also non responsive to topical lidocaine and topical steroids. The patient also complained of frequent burping. 

On clinical examination multiple ulcers were seen on the movable mucosa /parts of the mouth (tongue and lips). Marginal gingiva in the entire mouth was soft, puffy, extremely red and bled on slight touch.

Patient mentioned that ulcers started when she was stressed due to school studies. She described herself as one who needs consoling when stressed and likes to cling to a loved one for relief.

We postulated that her primary issue is indigestion which must have caused her acidity and thereby oral ulcers. All medicines were immediately asked to be discontinued. 

Treatment : Considering the burping homeopathic remedy lycopodium was given. Considering that the ulcers had central necrosis with burning, homeopathic remedy arsenic album was given.

After just 3 days, the patient reported that the ulcers almost healed and the issue of frequent burping also went away. Clinical examination after 7 days showed resolution of all the ulcers. 

Rationale : The ulcers were suspected to be stress ulcers since the patient was about to give her board exams and complained that stress was bad. Thus stress causing sympathetic excess triggered the ulcers. Lycopodium improved parasympathetic tone and arsenic album triggered rapid healing.