Oral ulcers of chronic duration could be the manifestation of systemic diseases like Behçet disease (a kind of rheumatologic disease that affects the joints as well as the mouth and eyes), inflammatory bowel disease (IBD, an autoimmune condition whereby the intestines are inflamed, in addition to skin and eye manifestations), or celiac disease (gluten sensitivity). If he has any of these illnesses, they need to be treated to get rid of the ulcers.
Otherwise, it's most likely what's known as recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU), a condition that starts during late childhood (as of 10 years of age) and that is characterized by recurrent oral ulcers (only in the mouth, of different sizes but usually round in shape, may leave scars upon healing, healing duration between 10 up to 40 days). This condition may not have a specific causative agent, but it could be due to deficiency in iron, vitamin B12, or folic acid, sensitivity to sodium lauryl sulfate containing toothpaste, certain viruses, tobacco, certain bacteria (helicobacter pylori, the bacteria that cause stomach ulcers), stress, and genetics.
The mainstay of treatment is topical steroids,vitaminB12, anti-inflammatory drugs, and mouth wash with chlorhexidine (an antiseptic).
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Annual Checkup
It is recommended that all individuals see a Family Doctor for a full medical examination annually. Adults should get their blood pressure checked (US Preventive Task Force), a flu vaccine (CDC) and more each year.
The American Dental Association recommends dental cleanings for adults at least twice annually. Some stains can only be removed by a professional cleaning.
It’s recommended by the American Academy of Ophthalmology that every adult between the ages of 18 and 80 does an eye examination at least once every two years.
It's recommended by the American Cancer Association that every adult between the age of 20 and 80 does an annual skin screening by a licensed dermatologist.
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