Infections of the mouth Flashcards
Which organisms preferentially coloniza the following areas:
- Tongue and buccal mucosa
- Tooth surfaces
- Gingival crevice
Tongue and buccal mucosa
- Strep salivarius
- Veillonella species
Tooth surfaces:
- Strep sanguinis
- Strep mutans
- Actinomyces viscosus
Gingival crevice
- Fusobacterium
- Prevotella
- Anaerobic spirochetes
What is the definition of periodontal disease
It is a general term that refers to all diseases involving the supporting structures of the teeth (periodontium)
Explain the two categories of infections of the oral cavity
Odontogenic orofacial: Dental pulp, periodontium
Non-odontogenic orofacial: Oral mucosa
Explain the pathogenesis of infections of the mouth
Attachment to the mucosal and tooth surfaces - fimbrial protein
Protease, collagenase and hyaluronidase degrade the host proteins exposing for attachment
Biofilm formation - organised microorganisms encased in a polysaccharide matrix
Explain Vincents angina
Acute necrotising ulcerative gingivitis aka Trench mouth
Caused by Fusobacterium and Treponema
What are the risk factors for Vincents angina
Poor dental hygiene
Smoking
Malnutrition
Immunosuppresion
Gingiva that bleed easily
Interdental papillae have ulcerations
Halitosis
What is the treatment for Vincents angina
Irrigation and debridement
Penicillin
Metronidazole
Improve oral hygiene
Pain management
Explain Noma cancrum oris (Gangrenous stomatitis)
Caused by Borrelia, Fusobacterium, Prevotella species
Acute fulminating and gangrenous infection of oral and facial tissues
Commonly seen in severe debilitation and malnutrition
Children mostly affected
How is Noma cancrum oris treated
Penicillin
Cosmetic surgery
What is Ludwig’s angina and what is it caused by
Bilateral swelling of submandibular and sublingual spaces. It is a deep fascia space infection
Caused by:
- Infected tooth and or periodontal disease
- Rare: mandibular fracture
Polymicrobial: Strep, Anaerobes, Staph species
What is the treatment for Ludwigs angina
Protect the airway
Surgical drainage and removal of necrosis is essential
Antibiotic regimens:
- Penicillin G + Metronidazole
- Amoxicillin/clavulanate
What are the complications of odontogenic orofacial infections
Hematogenous: Endocarditis or metastatic foci
Direct extension:
- Mediatinal spread
- Intracranial
- Supportive jugular thrombophlebitis
- Carotid artery erosios
- Maxillary sinusitis
- Osteomyelitis
What are examples of and causes of non-odontogenic orofacial diseases
Mucositis, Aphthous ulcers, Oral candidiasis, Actinomycosis, Diphtheria
Causes:
- Chemical injury
- Thermal or radiation injury
- Traumatic injury
- Underlying disease
Explain Mucositis and the treatment thereof
Immunocompromised, breakdown in mucosal epithelium
Can lead to secondary fungal infections
Treatment: Saline rinse, topical antiseptics and steroids, milk of magnesium coating
Explain the three clinical variants and treatment of Aphthous ulcers
Variants:
- Minor: Multiple, buccal an dlabial mucosa, painful
- Major: Larger, affect all areas of the oral cavity
- Herpatiform: Painful, small, grey, multiple
Treatment:
- Oral hygiene - mouth washes
- Local anaesthetic gels for pain relief
- Topical steroids for extensive disease
