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BDS - Module 9 > 12. Oral Medicine > Flashcards

12. Oral Medicine Flashcards

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1
Q

Definition of a Sign:

A

A physical finding

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2
Q

Definition of a Symptom:

A

Evidence of a disease

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3
Q

What are the 8 signs of dry mouth?

A

Lack of saliva
Deep fissured tongue
Glossy palate
Dry mucosa
Evidence of candidiasis
Traumatic ulceration
Poor denture retention
Bacterial sialadenitis

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4
Q

What are the symptoms of dry mouth?

A

Difficulty functioning
Difficulty wearing dentures
Bad taste
Halitosis
Pain
Deteriorating dentition

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5
Q

List 7 possible causes of dry mouth:

A

Medications
Dehydration
Anxiety
Mouth breathing
Diabetes
Radiotherapy
Systemic disease

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6
Q

How would you assess dry mouth?

A

Challacombe scale

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7
Q

What investigation could you carry out to assess dry mouth?

A

Salivary flow rate

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8
Q

What are the 3 principles when managing dry mouth?

A

Prevention
Stimulation
Replacement

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9
Q

What is the challacombe scale?

A

A scale of 1-10 indicating serverity of oral dryness
1 = mild
10 = severe

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10
Q

What does challacombe score of 1-3 suggest and how would you manage this?

A

Mild Dryness
- monitor

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11
Q

What does a challacombe score of 4-6 suggest and how would you manage this?

A

Moderate Dryness
- investigate possible causes

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12
Q

What does a challacombe score of 7-10 indicate and how would you manage this?

A

Severe Dryness
- refer

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13
Q

How would you manage mild oral dryness?

A

Sugar free gym
Hydration

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14
Q

How would you manage moderate oral dryness?

A

Saliva stimulants (Sialogogues)
Saliva replacements
Topical fluoride

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15
Q

How would you manage severe oral dryness?

A

Saliva substitutes
Topical fluoride

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16
Q

List 5 conditions commonly associated with dry mouth:

A

Sjorgrens Syndrome
Bacterial Sialadenitis
Sialadenosis
Salivary Mucocoeles
Salivary gland tumours

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17
Q

What is sjorgresn syndrome?

A

A rare autoimmune chronic inflammatory condition that affects all exocrine glands in the body.

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18
Q

What are the 2 types of sjorgrens syndrome?

A

Primary - dry eyes and mouth only
Secondary - dry eyes, mouth and a connective tissue disorder

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19
Q

List 7 investigations used when sjorgrens is suspected:

A

Salivary flow rate
Lacrimal flow rate
Ocular staining score
Serology
Salivary gland biopsy
Ultrasound
Bloods

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20
Q

What is bacterial sialadenitis?

A

Inflammation of salivary glands caused by bacterial infections.

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21
Q

What are the signs of bacterial sialadenitis?

A

Salivary gland swelling
Pain
Redness of skin
Discharge from duct

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22
Q

What is salivary sialadenosis?

A

Salivary gland swelling

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23
Q

What are the signs of sialadenosis?

A

Bilateral swelling
Symmetrical

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24
Q

List 6 possible causes of sialadenosis:

A

Diabetes
Liver disease
Bulimia
Malnutrition
Pregnancy
Idiopathic

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25
What are salivary mucocoeles?
A cystic cavity filled with mucous that present as blue/transparent swellings.
26
What is a ranula?
A cystic cavity filled with mucous found on the FOM.
27
List the 3 main stages of management of salivary gland tumours:
1. Clinical exam 2. Radiographic exam 3. Tissue exam - fine needle aspiration, core biopsy, open biopsy, excisional biopsy
28
List 4 types of oral soft tissue lesion:
Commonly found lesions White patches Red patches Ulcers
29
List 4 commonly used found soft tissue lesions:
Geographic tongue Black hairy tongue Amalgam tattoo Vascular malformations
30
List 7 types of white patch commonly found in the oral cavity:
Genodermatoses Leukoemdema Frictional keratosis Licked planus Lichnoid reactions Hairy leukoplakia Psueodomembranous candida
31
List 5 types of red patch found in the oral cavity:
Geographic tongue Erythematous candidosis Angular chelitis Denture stomatitis Median rhomboid glossitis
32
List the 2 different types of ulcers:
Recurrent aphthous stomatitis Recurrent oral ulcerations
33
Genodermatoses
An asymptomatic rough white patch that occurs due to genetic factors
34
Leukoedema
An asymptomatic soft white patch that occurs due to low grade mucosal irritation causing oedema
35
Frictional Keratosis
An asymptomatic rough white patch that occurs secondary to physical, chemical or thermal irritation.
36
Licken Planus
A bilateral, symmetrical, painful, white patch that occurs due to medications, dental materials or due to unknown causes - note: this is a potentially malignant disorder
37
Hairy leukoplakia
A white patch found on the lateral border of the tongue caused by the Epstein Barr virus.
38
Pseudomembranous Candidiasis
A removable white patch cause by infection of candida albucans.
39
Geographic Tongue
An asymptomatic red patch with a cream border
40
Erythematous Candidosis
Red patches
41
List 3 red lesions associated with candidia infections:
Angular chelitis Denture stomatitis Median rhomboid glossitis
42
Angular chelitis
Bleeding, cracking, redness at the angles of the mouth
43
Denture stomatitis
Erythema (redness) of denture bearing area
44
Median rhomboid glossitis
Depapilliation and redness of the tongue in a rhomboid shape
45
List the 5 possible causes of oral ulceration:
Trauma Medications Idiopathic Infective Autoimmune
46
List the signs of oral ulcers:
Superficial lesion Yellow/cream colour Red border
47
List the 2 possible diagnosis’s of ulcers:
1. Recurrent aphthous stomatitis - recurrent ulcers in the absence of any systemic disease 2. Recurrent oral ulceration - recurrent ulcers associated with systemic disease
48
List 7 GI conditions commonly associated with with recurrent oral ulceration:
GIT disease Coeliac disease Inflammatory bowel disease Chrons Ulcerative colitis Carcinoma of the colon Haemorrhoids
49
How is recurrent oral ulceration managed?
Bloods Haematinics Immunology
50
How is recurrent aphthous stomatitis managed in primary care?
Referral and Symptom Management: - benzoate and cinnamon avoidance - SLS free toothpaste - topical analgesics - topical steroids
51
How is recurrent aphthous stomatitis managed in secondary care?
Topical steroids Triple mouthwash Systemic medications
52
How is licken planus managed in primary care?
1. Investigate any other site involvement 2. Smoking cessation and alcohol advice as potential cancer risk 3. Baseline Photos 4. Symptom Management: diet modifications, SLS free toothpaste, topical analgesics, topical steroids 5. Regular reviews
53
How is licken planus managed in secondary care?
Topical steroids Triple mouthwash Systemic medications
54
List the 6 groupings of orofacial pain according to ICOP:
1. Dental related 2. Myofascial 3. TMJ related 4. CN related 5. Headache related 6. Idiopathic
55
List 2 CN related orofacial pain conditions:
Neuralgia Neuropathy
56
List 2 types of headaches:
Migraines Tension headaches
57
List 3 types of idiopathic orofacial pain conditions:
Burning mouth syndrome Persistent idiopathic facial pain Persistent idiopathic dental pain
58
Trigeminal Neuralgia
A painful disorder of the Trigeminal nerve characterised by recurrent unilateral facial pain that lasts seconds to minutes.
59
List the 3 types of neuralgia pain:
Classical - caused by neuromuscular compression Secondary - caused by underlying disease Idiopathic - unknown cause
60
How is neauralgia diagnosed?
1. History 2. Examination: CN exam 3. Investigations: MRI scan 4. Diagnosis
61
How is neauralgia managed:
Pharmacologically: carbamazepine/oxycarbmazepine - first line lamotrigine/baclofen/gabapentin/pregabalin - second line Surgically: destruction of grasserion ganglion posterior cranial fossa surgery
62
Glossopharyngeal Neuralgia:
A painful disorder of the glossopharyngeal nerve characterised by unilateral brief stabbing pain.
63
Trigeminal Neuropathy
Constant facial pain in the distribution of the trigeminal nerve caused by another disorder.
64
Features of neuropathy:
Allodynia - pain to a normal stimulus Hyperalgesia - increased response to normal stimulus Hypoalgesia - reduced response to normal stimulus Hyperaesthesia - increased sensitivity to stimulus Dysesthesia - abnormal sensation
65
List 3 examples of Trigeminal neuropathies:
1. Painful Trigeminal neuropathy attributed to the herpesvirus zoster virus 2. Trigeminal post hermetic neuralgia 3. Painful post traumatic Trigeminal neuropathy
66
Idiopathic orofacial pain
Uni or bilateral intraoral or facial pain of unknown cause
67
List the features of Persistent Idiopathic Facial Pain:
Poorly localised Dull, ache pain Neurological examination results normal
68
How is persistent idiopathic facial and dentoalveolar pain investigated?
MRI CT CBCT
69
How is persistent idiopathic facial pain managed in secondary care?
1. Explain action of condition 2. Self management techniques 3. Topical Txs - lidocaine, capsaicin, levomenthol 4. Systemic tx’s - amitriptyline, duloxetine
70
Features of persistent idiopathic dentoalveolar pain:
Recurring daily dental pain of no known cause Localised Deep, dull, pressure pain No obvious cause
71
How is persistent idiopathic dentoalveolar pain maned in secondary care:
1. Explanation of condition 2. Self management techniques - relaxation, excercise, mindfulness, CBT 3. Topical Tx - lidocaine 4. Systemic Tx - amitriptyline, duloxetine
72
Burning mouth syndrome:
An intraoral burning sensation of unknown cause
73
List 4 possible local causes of burning mouth syndrome:
Parafunctijal habits Dry mouth GORD candidosis
74
List 5 possible systemic causes of burning mouth syndrome:
Anaemia Haematinic deficiency Diabetes Thyroid dysfunction Medications
75
What investigations need to be done before burning mouth syndrome can be diagnosed?
Bloods, haematinics, HbA1c, TSH, ZN, Sialometry
76
How is burning mouth syndrome managed?
1. Explain condition 2. Self management techniques 3. Topical Tx’s - benzydamine, capsaicin, clonazepam 4. Systemic Tx’s - amitriptyline, duloxetine

BDS - Module 9 (16 decks)

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