Care of Patient with Oral Cavity Problems

Question 1

Inflammation within the oral cavity
Painful single or multiple ulcerations that appear as redness/inflammation and ulcer/erosion of the protective lining of the mouth
Sores cause pain and open areas place the person at risk for bleeding and infection
Mild erythema (redness) may respond to topical treatments
Extensive stomatitis may require treatment with systemic analgesics or medications - comfort and treat underlying cause

Answer 1

Stomatitis

Question 2

Infection
Allergies
Vitamin deficiency
Systemic disease and immunosuppression
Irritants

Answer 2

Stomatitis causes

Question 3

Bacteria and viruses have a role in recurrent stomatitis and fungus

Answer 3

Infection - Stomatitis causes

Question 4

Certain foods, such as coffee, potatoes, cheese, nuts, citrus fruits, and gluten may trigger allergic responses that cause aphthous ulcers; irritate oral cavity

Answer 4

Allergies - Stomatitis causes

Question 5

B vitamins, folate, zinc, iron

Answer 5

Vitamin deficiency - Stomatitis causes

Question 6

Chemo, HIV/AIDS more likely get it

Answer 6

Systemic disease and immunosuppression - Stomatitis causes

Question 7

Tobacco and alcohol

Answer 7

Irritants - Stomatitis causes

Question 8

Most common type
Includes aphthous (noninfectious), herpes simplex and traumatic ulcers
Something happened to oral cavity that caused ulcer

Answer 8

Stomatitis types - Primary

Question 9

Results from infection by opportunistic viruses, fungi, or bacteria in patients who are immunocompromised
Can also result from drugs such as chemotherapy

Answer 9

Stomatitis types - Secondary

Question 10

Candida is a fungus sometimes present in small amounts in the mouth (thrush) - painful
Long-term antibiotic therapy destroys other normal flora and allows candida to overgrow causing a fungal infection that is very painful
Common in those undergoing immunosuppressive therapy, such as chemotherapy, radiation, and steroids

Answer 10

Stomatitis types - Ex. Candida albicans

Question 11

History of recent infections - long-course antibioitcs
Nutritional changes
Oral hygiene habits
Oral trauma
Stress
Drug history
Wear nonsterile gloves and ensure adequate lighting
If lesions are seen along the pharynx and the patient reports painful swallowing , the lesions might extend down the esophagus - report to HCP

Answer 11

Stomatitis assessment

Question 12

Remove dentures - further irritate
Encourage or provide oral hygiene after each meal and as often as needed - frequently, not aggressive when doing it
Increase mouth care to every 2 hours or more
Use a soft toothbrush or gauze
Encourage frequent rinsing of the mouth with warm saline or baking soda solution
Avoid commercial mouthwashes, specifically ones with alcohol and lemon/glycerin
Assist with food choices

Answer 12

Stomatitis interventions

Question 13

Soft, bland, and nonacidic foods can decrease irritation
Cool food can be soothing

Answer 13

Assist with food choices - Stomatitis interventions

Question 14

Antimicrobials for control of infection
Herpes simplex
Fungal infections/Yeast
Pain control

Answer 14

Stomatitis drug therapy

Question 15

Ex. Tetracycline, Minocycline, chlorhexidine mouthwashes (preventative)

Answer 15

Antimicrobials for control of infection - Stomatitis drug therapy

Question 16

IV Acyclovir (Zovirax) if severe or with immunocompromised patient
Can be given oral or topical, IV: more severe cases

Answer 16

Herpes simplex - Stomatitis drug therapy

Question 17

Nystatin (Mycostatin) swish/swallow - can swab in pat’s mouth; for candida often

Answer 17

Fungal infections/Yeast - Stomatitis drug therapy

Question 18

Anesthetics
Ex. Orabase, Anbesol, Campho-Phenique

Answer 18

Pain control - Stomatitis drug therapy

Question 19

Evidence shows that proper oral care is essential to prevent infections such as aspiration pneumonia and ventilator-associated pneumonia (VAP).

Answer 19

EBP