Intraoral Exams part 2 Flashcards
Most cases of xerostomia are chronic or acute?
chronic
What does xerostomia significantly increase the risk of?
caries, erosion, dentinal hypersensitivity, and candidiasis
What are the causes of xerostomia?
- over-the-counter/prescription meds
- systemic disorder/disease
- physical climate
- emotional response
- elderly
What types of diseases can contribute to xerostomia?
- diabetes
- hormone changes (menopause, pregancy)
- depression (anxiety-meds)
- radiation for head/neck cancers
- autoimmune diseases (sjogren’s)
What types of questions should you ask for xerostomia?
Do you have difficulty swallowing?
Does your mouth feel dry when eating?
Do you sip liquids to help swallowing?
Do you have any oral burning or soreness?
Do you often have bad breath?
Do you eat crushed ice or drink fluids to keep your mouth moist?
What are the clinical signs of xerostomia?
- reddened, pebbled surface of tongue
- dry and cracked corners of mouth
- red, glossy, parched mucosal tissues
What are the symptoms of xerostomia?
- candidiasis
- angular chelitis
- burning tongue
- root and cervical caries
- stomatitis
- dysphagia
What are the characteristics of candidiasis?
- white plaque
- creamy white lesions
- looks like hyperkeratosis (but wipes off)
- located on the buccal mucosa and lateral borders of the tongue
Where can candidiasis (thrush) spread to?
- tongue
- hard and soft palate
- tonsillary region
What are risk factors for developing candidiasis?
- immunocompromised
- pregnancy
- poor oral hygiene
- smoking
- stress
- depression
- birth control pills
- long term antibiotics
- diabetes
- ill fitting dentures
- xerostomia
- iron or B12 deficiency
What is atrophic candidiasis?
- forms under the dentures
- red on palate or tongue
- burn with spicy foods and alcohol
What is the treatment for candidiasis?
- good oral hygiene
- yogurt, acidophilus
- avoid alcohol and sugars
- medications (antifungal; nystatin or ketaconozole)
Primary herpes gingivostomatitis is seen mainly in _________
children
Severe primary infections of herpes gingivostomatitis have what symptoms?
oral lesions
high fever
malaise
cervical lymphadenopathy
dehydration
Where do herpes gingivostomatitis develop in the oral cavity?
pharynx
palate
buccal mucosa
lips
tongue
What do the vesicles of herpes gingivostomatitis break down into?
small ulcers that are covered with exudate
How long does it take for herpes gingivostomatitis to resolve without treatment?
two weeks
How long does HSV survive in the external environment?
Not long at all (most primary infections are from direct contact with infected person)
What percent of the population has herpes?
50-80%
What are the prodromal signs of herpes?
-tingling, itching, pain, burning. Arise 6-24 hours before lesions
develop.
What are the symptoms of herpes?
- multiple fluid-filled blisters
- merge and collapse
- yellowish crust
What can cause herpes simplex to recur?
immune weakness such as…
- stress
- fever
- illness
- injury
- sunburn
What is herpetic whitlow?
INFECTIONS OF THE THUMBS OR FINGERS. GROUPED, FLUID OR PUS FILLED. USUALLY, ITCH AND /OR PAINFUL
What are the treatments for primary herpetic gingivostomatitis?
- antiviral medications
- acyclovir suspension
What are the treatments for herpes labialis?
- acyclovir ointment
- systemtic acyclovir, valacyclovir, famciclovir
What percent of the US population has aphthous ulcers?
60%
What are the prodromal symptoms of aphthous ulcers?
tingling or burning sensation (1-2 days before the ulcer appears)
How many days of pain and days until healed for aphthous ulcers?
3 days pain
7 days healed
When do aphthous ulcers usually start (age)?
10-20 years old
What appears to be the mechanism for aphthous lesions?
mucosal destruction appears to represent a T-cell mediated immunologic reaction
What are the 3 clinical variations of aphthous lesions?
minor
major
herpetiform
Are aphthous lesions usually inherited or is it not related to family?
- tends to occur along family lines
How large are the minor aphthous ulcerations?
3-10 mm in diameter
How long does it take for minor aphthous ulcerations to heal without scatting?
7-14 days
What type of mucosa do minor aphthous ulcerations arise on?
nonkeratinized mucosa
What are the prodromal symptoms of minor aphthous ulcerations?
burning, itching, or stinging
What areas of the oral cavity are most likely to experience minor aphthous ulcerations?
buccal/labial mucosa
ventral surface of tongue
How many lesions occur with minor aphthous ulcerations??
1-5 lesions
What type of ulcerations of the oral cavity have the longest duration per episode?
major aphthous ulcerations
How long does major aphthous ulcerations take to heal?
2-6 weeks
How many lesions involved in major aphthous ulcerations?
1-10 lesions
What type of ulcerations in the oral cavity have the greatest number of lesions and most frequent recurrence?
herpetiform aphthous ulcerations
How many ulcers are present with herpetiform aphthous ulcerations?
as many as 100 in a single recurrence
How long do the lesions of herpetiform aphthous ulcerations take to heal?
7-10 days (recurrences tend to be closely spaced)
Does herpetiform aphthous ulcerations affect males or females more?
females
What are the treatments for aphthous ulcers?
symptomatic
- visocus benzocaine
- orajel
- anbesol
local anti-inflammatory
- kenalog in orabase paste
sealing agent
- ameseal
FDA approved
- aphthasol
What is the only FDA approved treatment for canker sores (aphthous ulcers)?
aphthasol
