ENT - Mouth and Gum Conditions Flashcards
What is leukoplakia?
Characterised by white patches in the mouth, often on the tongue or insides of the cheeks. It is a precancerous condition
Increased risk of SSC
What are the characteristics of leukoplakia patches?
Asymptomatic
Irregular
Slightly raised
Fixed in place - unable to be scraped off
May need biopsy to exclude abnormal cells or cancer
What management options are available for leukoplakia?
Stopping smoking
Reducing alcohol intake
Close monitoring
Potentially laser removal
Surgical excision
What is erythroplakia?
Similar to leukoplakia, but the lesions are red and associated with a high risk of squamous cell carcinoma
Should have urgent referral to exclude cancer
What does erythroleukoplakia refer to?
Lesions that are a mixture of red and white
What are the three patterns of lichen planus in the mouth?
Reticular
Net-like web of white lines - Wickham’s striae
Erosive
Surface layer of mucosa eroded, leaving bright red and sore aeras of mucosa
Plaque
Large continuous areas of white mucosa
Stop smoking, give topical steroids
What is gingivitis?
Inflammation of the gums that can lead to periodontitis if not managed
What are common symptoms of gingivitis?
- Swollen gums
- Bleeding after brushing
- Painful gums
- Bad breath
What is periodontitis?
Severe and chronic inflammation of the gums and supporting tissues, often leading to tooth loss
What is acute necrotising ulcerative gingivitis?
A rapid onset of severe inflammation in the gums, usually caused by anaerobic bacteria
What are risk factors for gingivitis?
- Plaque build-up
- Smoking
- Diabetes
- Malnutrition
- Stress
What is tartar?
Bacteria live in plaque, damaging teeth and gums
Hardened plaque - tartar
What is the treatment for gingivitis?
Good oral hygiene
Stop smoking
Dental hygienist to remove plaque and tartar
Chlorhexidine mouth wash
Antibiotics for NUG (metronidazole)
Dental surgery if needed
What is gingival hyperplasia?
Abnormal growth of the gums, notably enlarged around the teeth
What are possible causes of gingival hyperplasia?
- Gingivitis
- Pregnancy
- Vitamin C deficiency
- Acute myeloid leukaemia
- Medications (e.g., calcium channel blockers)
- Cyclosporin
What are aphthous ulcers?
Common, small, painful ulcers of the mucosa in the mouth with a well-circumscribed, punched-out appearance
What factors can trigger aphthous ulcers?
- Emotional or physical stress
- Trauma to the mucosa
- Particular foods
What underlying conditions can aphthous ulcers indicate?
- Inflammatory bowel disease
- Coeliac disease
- Behçet disease
- Vitamin deficiency (iron, B12, folate and vitamin D)
- HIV
How long do aphthous ulcers usually take to heal?
Within 2 weeks
Manageable ulcers do not need intervention
What topical treatments can be used for aphthous ulcers?
- Choline salicylate (bonjela)
- Benzydamine
- Lidocaine
What topical corticosteroids can be used for severe aphthous ulcers?
- Hydrocortisone buccal tablets
- Betamethasone soluble tablets
- Beclomethasone inhaler
What do the NICE guidelines recommend for unexplained ulceration lasting over 3 weeks?
A two week wait referral
