Aphthous Ulcers and Diseases of Teeth/Gums

Question 1

What are Aphthous Ulcers and when do they occur? (canker sore)

Answer 1

• recurrent oral ulcers
• common, begins in childhood/adolescence.
• incidence decreases midlife

Question 2

Where are aphthous ulcers found?

Answer 2

restricted to the oral cavity

lips, cheeks, tongue, floor/roof of mouth

Question 3

Clinical Features of Aphthous Ulcers?

Answer 3

• 2-4 mm shallow round/oval ulcer
• solitary lesion (maybe a few)
• ulcer floor= yellow–> as it heals= gray
• has punched out appearance
• surrounding erythema/edema
• minimally symptomatic

Question 4

Aphthous Ulcers

Painful stage____days?
Healing stage____days?

Answer 4

Painful stage=7-10 days
Healing Stage= 1-3 weeks
(so ulcer can remain for 3 weeks!)

Question 5

What is the TX/Rx for Aphthous Ulcers ?

Answer 5

Treatment is not necessary,

educate the patient….

 - they will likely occur (1-4 months)
 - avoid hard/rough food
 - avoid rough toothbrushing

• Topical Steroids (kenalog) orabase paste
• Refer if= manifestation of another disease

Question 6

Dental Caries, AKA ?

Answer 6

Cavities/tooth decay

Question 7

Dental Caries are caused by?

Answer 7

breakdown of tooth enamel from streptococcus mutants on the teeth.

food–>acids–> destruction of enamel

Question 8

What are the recommendations to prevent dental caries?

Answer 8

• brush 2x a day
• clean between teeth w floss/interdental cleaner
• eat nutritious/balanced meals
• avoid sugary goods/drinks
• no bottle in the crib

VISIT DENTIST REGULARLY

Question 9

When should tetracycline on TCN related abx NOT be used?

Answer 9

• Pregnancy

- less than 8 yo

Question 10

What color does TCN cause the teeth to turn? and Why?

Answer 10

yellow
gray
brown

TCN binds to Calcium ions in teeth before tooth erupts form gum=> TCN-calcium orthophosphate =YELLOW :(

Location of discoloration correlations w stage of tooth development.

Question 11

tx of discoloration of TCN staining? easy?

Answer 11

No! difficult!

• may lighten but will not resolve :)
• will need aggressive whitening or veneers.

Question 12

Trench mouth is another name for?

Answer 12

ANUG; Acute Necrotizing Ulcerative Gingivitis

Question 13

what is ANUG?

Answer 13

painful infection of the gums- excessive bacteria in mouth

Sudden onset

Question 14

Clinical Features of ANUG

Answer 14

• abrupt onset
• painful
• bleeding
• very very bad breath
• ulcerations on gingiva
• lymphadenopathy

Question 15

Tx for ANUG?

Answer 15

• Debridement (important to get rid of infection)
• Rinses
• education about oral hygiene
• Analgesics
• Oral ABX
  - Amoxicillin
  - erythromycin
  - tetracycline