Mycobacterium tuberculosis can produce oral ulcers inoculated by sputum from the lungs. Syphilis can produce a primary chancre. Neisseria gonorrhea produces burning ulcerations of the gingiva and tongue as well as pharyngitis. Some are clinically significant, primarily in immunocompromised persons. Herpesvirus infections are discussed below.
Candidiasis generally looks like cheese curds, which when wiped off, leave a raw, bleeding surface.
Pellagra produces a smooth, fiery red tongue, painful mouth, and mucosal ulcerations. Unprovoked bleeding, decreased salivation, and an ammonia-like odor accompany uremic stomatitis. Cheek biting, mouth breathing, jagged teeth, orthodontic appliances, ill-fitting dentures, or nursing bottles with nipples that are hard or too long may cause local mucosal injury. Stomatitis may follow excessive use of alcohol, tobacco, hot foods, or spices as well as sensitization to ingredients in toothpaste, mouthwash, candy dyes, lipstick, or, rarely, acrylic dentures. Rarely, contact stomatitis may result from sensitivity to dental materials.