BDS3 Paeds OM Flashcards
List examples of viral infections
HSV 1+2
- Primary herpetic gingivostomatitis
- Herpes labialis
EBV
- Hairy leukoplakia
Varicella Zoster
- Shingles
Coxsackie Virus
- Herpangina
- Hand foot and mouth disease
Measles/Mumps/Rubella
List examples of bacterial infections
Staph
Strep
Syphillis
TB
List an example of a fungal infection
Candida
Signs/symptoms of Primary Herpetic Gingivostomatitis
Fluid filled vesicles rupture to ulcers
Severe gingivitis
Fever
Malaise
Headache
Cervical lympadenopathy
Tx of Primary Herpetic Gingivostomatitis
Bed rest
Fluid - dehydration most common complication
Soft diet
OH - CHX
Painkillers
Immunocompromised: 200mg Aciclovir 5 tablets 5x daily
Name 2 types of coxsackie virus
Herpangina
Hand foot and mouth disease
Define Herpangina
Vesicles in tonsillar/pharyngeal region
Last 7-10 days
Define Hand food and mouth disease
Maculopapular rash on hands and feet
Ulceration on gingivae/tongue/cheek
Fever/runny nose/cough
Lasts 7-10 days
Define oral ulceration
Covering epithelium destroyed
Leaving exposed inflamed underlying connective tissue
Hx taking of oral ulceration (10)
Site
Size
Onset
Frequency
Number
Associated medical problems
Duration
Any lesions in other areas
Tx so far
Exacerbating diet factors
List causes of oral ulceration
Infection
Viral
- Coxsackie
- Herpes Zoster
- EBV
Immune mediated
- Crohns
- Coeliac
- Behects
VBD
- Pemphigus
- Pemphigoid
- Erythema Multiforme
RAU
Trauma
Vit Deficiencies
Different types of RAU
Minor <10mm
Major >10mm
Herpetiform 1-2mm
Aetiological factors contributing to RAU
Stress
Vit deficiency
GI disease
Trauma
Allergy
Hormones - period
Initial Investigations for RAU (3)
Diet diary
FBC + haematinics
Coeliac screen
Management of RAU
Diet analysis + exclusion
Avoid spicy food
SLS free toothpaste
Low ferritin - 3mths iron
Low folate/B12 - refer to pads
GDP management
CHX MW
Difflam spray (0.15% Benzydamine Hydrochloride LA spray)
What is a fibroepithelial polyp
Common firm pink lump (pedunculated or sessile)
Mainly in cheeks
Initiated by trauma
Tx for fibroepithelial polyp
Surgical excision
Name the 3 main types of Epulides
Fibrous Epulis
Pyogenic granuloma/Pregnancy pulls
Peripheral giant cell granuloma
What is an Epulis?
Swelling of oral mucosa
Features of a fibrous epulis
Frim
Pedunculated or sessile
Similar colour to gingivae
Inflammatory cell infiltrate and fibrous tissue
Features of a pregnancy epulis
Soft deep red/purple swelling
Haemorrhage spontaneously or with mild trauma
Reaction to calculus/plaque
What is congenital epulis?
Rare in nenates
Anterior maxilla
Grannula cells covered with epithelium
Benign
TX: Simple excision
Name examples of HPV associated swellings
Verruca vulgaris
HPV 2+4
Squamous cell papilloma
Benign
HPV 6+11
Surgical excision
Name examples of fluid swellings
Mucoceles
Ranula
Bohns nodules
Epstein pearls
VB lesions - primary herpetic/erythema multiforme
Features of a mucocele
Blue/translucent swelling
Can affect minor/major salivary glands
Most rupture
When would surgery for a mucocele be considered?
Fixed in size and may be affecting adjacent glands
What are the 2 types of mucocele
Mucous extravasation cyst
- Normal secretions rupture into adjacent tissue
Mucous retention cyst
- Secretions retained in an expanded duct
What is a ranula?
Mucocele in FOM
Can arise from minor salivary glands or ducts of sublingual/submandibular gland
What SI is needed with a ranula?
Ultrasound or MRI
Exclude plunging ranula into submental/submandibular space
Occasionally found to be lymphangioma - benign tumour of the lymphatics
What are Bohns Nodules
Gingival cysts
Remnants of dental lamina
Filled with keratin
Occur on the alveolar ridge
Found in neonates
Disappear in early months
What are Epstein Pearls?
Cysts along midline of palate
In neonates
Disappear in few weeks
