8 - OM problems in the elderly Flashcards
What is a haemangioma?
- malformation of venous vessels
- can rupture
- commonly found on FOM or inside of lip
- cryotherapy is curative
What is a fibroepithelial polyp?
- benign
- cause by trauma
- commonly found on tongue, inside of cheek
- should be removed before ulceration begins
What is black hairy tongue?
- variation of normal anatomy that has been stained by tannins
- common in smokers
- can smell
- difficult to get rid of
- ensure you clean forwards not backwards
What is geographic tongue?
- white patches with smooth patches
- common in 10% of people
- can cause sensitivity
- area of atrophy
What is atrophic glossitis?
- smooth tongue caused by low iron, folate or vit B12
- uncomfortable and can ulcerate
- should be referred to GP
What is frictional keratosis?
- white patch commonly found on tongue
- caused by trauma
- similar to a callous
- if not cause could be malignant
What is speckled leukoplakia?
- hyperplastic candidiasis
- speckled leukoplakia should ring alarm bells, as may be premalignant
- should be treated with antifungals, smoking cessation advice and biopsy
What is sublingual keratosis?
- white patch under tongue
- if ventral and crossing the midline this is a high risk site for malignancy
- should be referred to OM
What causes traumatic keratosis?
Ill fitting dentures
What causes denture-induced hyperplasia?
- ill fitting dentures
- more common in lower
How do you treat denture-induced hyperplasia?
- trim denture away to relieve soft tissue
- surgical removal
How do you prevent denture stomatitis?
- denture hygiene vital
- anti fungals if required
- new denture made as fungus may have infiltrated material
What are common causes for angular cheiltis?
- bacterial or fungal
- denture can harbour bacteria
- if patient overclosed
- haematinics low
- not drying or cleaning face properly
How do you manage xerostomia?
- change medication if possible
- salivary replacement
- salivary stimulants
Give examples of salivary replacements.
- saliva orthana
- glandosane (v acidic)
- biotene
- bioXtra
Give examples of salivary stimulants.
- sugar free chewing gum
- glycerine and lemon
What is lichen planus?
- autoimmune reaction
- presents with erosive ulcers in oral mucosa and tongue
What are bisphosphonates used for and how do they affect dentistry?
- used to improve bone density in treatment and prevention of osteoporosis, also used in the treatment of some cancers including breast and prostate
- can cause bone to become too dense that blood vessels cannot get through to heal extraction socket
- also inhibit bone turnover which prevents repair of microdamage
What are the risk factors of MRONJ?
- extremes of age
- concurrent use of corticosteroids
- systemic condition affecting bone turnover
- malignancy and treatment of malignancy including chemo and radiotherapy
- previous diagnosis of BRONJ
- invasive dental procedures
- poor OH and perio disease
- alcohol and tobacco use
Which jaw is MRONJ most common in?
Mandible
What is post herpetic neuralgia?
- constant burning sensation in dermatome of affected branch
- majority resolve within 2 months however can persist for more than 2 years
- suicide risk
- incidence reduced with antiviral therapy and/or steroids
What is the non-surgical treatment for post herpetic neuralgia?
- antidepressants
- gabapentin
- carbamazepine
- topical capsaicin
- transcutaneous electric nerve stimulation (TENS)
What are the surgical options for managing post herpetic neuralgia?
- cryotherapy
- injection of alcohol or glycerol to nerve, or balloon placed at ganglion
- neurectomy
- avulsion of nerve
What is burning mouth syndrome?
- signalling problem between mouth and brain
- no identifiable cause in 50% of patients
- can be caused by drugs, xerostomia, diabetes, hypothyroidism, allergy etc
