BDS3 Oral Medicine

Question 1

What is primary herpetic gingivostomatitis and what is it caused by?

Answer 1

Acute infectious disease
Herpes simplex virus 1

Question 2

What are some signs and symptoms of primary herpetic gingivostomatitis?

Answer 2

Fluid filled vesicles - rupture to form painful ragged ulcers on gingivae, tongue, lips, buccal and palatal mucosa
Severe oedematous marginal gingivitis
Fever
Headache
General discomfort/ unwell
Swollen neck lymph nodes

Question 3

What is the most common complication of primary herpetic gingivostomatitis?

Answer 3

Dehydration

Question 4

What is the treatment for primary herpetic gingivostomatitis?

Answer 4

Bed rest
Soft diet/ hydration
Paracetamol
Antimicrobial gel/ mouthwash
Acyclover - anti-viral medication used for herpes simplex (only if child is immunosuppresed)

Question 5

What is the recurrent disease of primary herpetic gingivostomatitis?

Answer 5

Herpes labialis - cold sores
managed with topical acyclovir cream

Question 6

What diseases does the coxsackie A virus cause?

Answer 6

Herpangina
AND
Hand, foot and mouth disease

Question 7

What is the sign/ symptom for herpangina and how long does it last?

Answer 7

Vesicles in the tonsillar/ pharyngeal region

7-10 days

Question 8

What are the signs of hand, foot and mouth disease and how long does it last?

Answer 8

Ulceration on soft tissues of the mouth
Maculopapular rash on the hands and feet

7-10 days

Question 9

What are some causes of oral ulceration?

Answer 9

Infection
Immune mediated disorders - chron’s, coeliac
Vesiculobullous disorders
Trauma
Vitamin deficiencies
Immunodeficiency disorders

Question 10

What is the common cause of ulceration in children?

Answer 10

RAU - recurrent apthous ulceration (canker sores)

Question 11

How should you manage canker sores/ RAU?

Answer 11

Prevention of superinfection - corsodyl 0.2% mouthwash
Protect healing ulcers - hyaluronate gel/ mouthwash (hyaluronate)
Symptomatic relief - Difflam and local anaesthetic spray

Question 12

What are some clinical features of OFG?

Answer 12

Lip swelling - most common
cobblestone appearance of buccal mucosa
Full thickness gingival swelling
Linear oral ulceration
Angular cheilitis

Question 13

What does geographical tongue look like?

Answer 13

Shiny red areas on the tongue with loss of filiform papillae surrounded by white margins.

Question 14

What is the cause of geographical tongue?

Answer 14

Idiopathic

Question 15

How do you manage geographical tongue?

Answer 15

Bland food during flare-ups
(discomfort more likely with spicy food/ citrus food/ juice)

Question 16

What are epulides?

Answer 16

Common solid swellings of the oral mucosa
Benign hyperplastic lesions
3 main types:
Fibrous epulis
Pyogenic granuloma
Peripheral giant cell granuloma

Question 17

What is a congenital epulis and in what group is it most likely to occur?

Answer 17

Rare lesion
Granular cells covered in epithelium most commonly affecting anterior maxilla
Occurs in neonates
F>M
Excision is curative

Question 18

What is a mucocele?

Answer 18

A mucocele is a benign, mucus-containing cystic lesion of the MINOR salivary glands
Most are in lower lip

Question 19

What are the 2 types of mucocele and which is more common?

Answer 19

Mucous extravasation cyst - more common - secretions rupture into adjacent tissue
Mucous retention cyst - secretions retained in an expanded duct

Question 20

What is a ranula?

Answer 20

Mucocele in FOM
Can be from minor salivary glands or ducts of sublingual/ submandibular gland