Condition	Clinical presentation	Treatment	Comments
Candidiasis4–9	Pseudomembranous: adherent white plaques that may be wiped off	Topical antifungals (e.g., nystatin [Mycostatin] suspension or troches, clotrimazole [Mycelex] troches, fluconazole [Diflucan] suspension, or systemic antifungals (e.g., fluconazole, ketoconazole [Nizoral], itraconazole [Sporanox])	Can confirm diagnosis with oral exfoliative cytology (stained with periodic acid-Schiff or potassium hydroxide), biopsy, or culture
	Erythematous: red macular lesions, often with a burning sensation
	Perlèche (angular cheilitis): erythematous, scaling fissures at the corners of the mouth
Recurrent herpes labialis10–14	Prodrome (itching, burning, tingling) lasts approximately 12 to 36 hours, followed by eruption of clustered vesicles along the vermilion border that subsequently rupture, ulcerate, and crust	Immunocompetent patients usually do not require treatment	Reactivation triggers: ultraviolet light, trauma, fatigue, stress, menstruation
		Topical agents include 1% penciclovir cream (Denavir)
		Systemic agents (e.g., acyclovir [Zovirax], valacyclovir [Valtrex], famciclovir [Famvir]) are most effective if initiated during prodrome or as prophylaxis
Recurrent aphthous stomatitis15–17	Ulcers surfaced by a yellowish-white pseudomembrane surrounded by erythematous halo	Mild cases do not require treatment	—
		Fluocinonide gel (Lidex) or triamcinolone acetonide (Kenalog in Orabase), amlexanox paste (Aphthasol), chlorhexidine gluconate (Peridex) mouthwash
Erythema migrans18	Migrating lesions with central erythema surrounded by white-to-yellow elevated borders; typically on tongue	Asymptomatic cases do not require treatment	—
		Symptomatic cases may be treated with topical corticosteroids, zinc supplements, or topical anesthetic rinses
Hairy tongue19–21	Elongated filiform papillae	Regular tongue brushing or scraping; avoidance of predisposing factors	Predisposing factors include smoking and poor oral hygiene as well as antibiotics and psychotropics
Lichen planus22	Reticular: white, lacy striae	Asymptomatic cases do not require treatment	Buccal lesions typical in reticular form; other sites (e.g., tongue, gingiva) may be involved
	Erosive: erythema and ulcers with peripheral radiating striae, erythematous and ulcerated gingiva	Symptomatic cases may be treated with a topical corticosteroid gel or mouth rinse