The mnemonic MINT will help the recall of the important causes of tongue ulcers.
· M—Malformation suggests malocclusion, which can cause repetitive trauma to the tongue. Also dental prostheses can promote ulceration.
· I—Inflammation provokes the recall of herpes simplex, Vincent stomatitis, herpes zoster, syphilis, and tuberculosis. This reminds one of chickenpox, smallpox, and pemphigus.
· N—Neoplasm suggests leukoplakia and carcinoma of the tongue.
· T—Trauma is probably the major cause of ulcerations. Repetitive trauma from a sharp, broken, or carious tooth produces painful ulceration.
Approach to the Diagnosis
Herpes simplex and herpes zoster can be diagnosed by the Tzanck tests, viral isolation, or serologic tests. A fluorescent treponemal antibody absorption (FTA–ABS) test will diagnose syphilis. A biopsy will be necessary to diagnose carcinoma. It is best to refer these patients to an oral surgeon if the ulcers do not clear up with observation and conventional treatment.