Intro to Oral Med Flashcards
what is oral med
Speciality of dentistry with core interest in managing:
* Soft tissue diseases in the mouth including cancer risk
* Oral changes as a result of other medical system disease
* Non-odontogenic facial pain (Pain in the face/mouth/teeth but not caused by teeth)
soft tissues in mouth
gingiva
palate
buccal mucosas
tongue
FOM
amalgam tattoo
filling material gets into soft tissue
blue colour
taken up by phagocytic cells
what is this
geographic tongue
benign
normal for some
what is this
fibroepithelial polyp
what is this
recurrent HSV
cold if on lip, but presented on palate caused viral vesibles than ulcers
what are these
Many reasons, types and locations
* Apthaous ulcer
* Medicine induced oral ulceration
lower is angina med induced, painful on side of tongue – need to remove medicine for it to resolve
what is this
Lichen planus
* immunological damage to oral mucosa caused by lymphocytes in connective tissue
variety of presentations
* thicken (white appearance) or thinning (red appearance) oral tissue
* ulcerated
oral mucosa dervived from same embrylolgical origin as skin, many skin conditions seen in dermatology can manifest in mouth, vice versa
lichen planus – itchiness, hair loss, changes to nails
lichen planus on gingiva
appear red – as if they are inflammed, but it is due to reddness because of the thinning of the surface of the oral mucosa due to lichen planus
what caused this
angio-oedema
* within 1 hour, type 1 hypersensitivty reaction
* lasts approx 1 hour
allergy - usually to food stuff
what is this
Orofacial granulomatosis
* Swelling to angio-oedema, but aetiology different
Blockage of lymphatics due to unknown pathogen (as yet), fluid cannot drain
Go on for weeks/months
other changes seen in OFG are similar to what happens in gut with Crohn’s disease – can go onto develop, or vice versa (have multi-system disease affecting gut and mouth)
allergy testing in oral disease
Dietary allergens (mainly)
- Benzoate and sorbate (preservatives) - E210-219
- Cinnamon aldehyde
- Chocolate
- Citrus fruit
- Cheese
- Nickel
May advise to avoid them to prevent/settle oral condition
what is this
Vesiculobullous – forms large blisters in mouth and on skin
* E.g. Pemphigoid
Filled with fluid and can rupture, ulcer – painful
Need tx with systemic medicines – cannot be managed locally
oral med specialists assess
when meds needed to tx oral disease as well as whole body – when appropriate to tx systemically
overlapping oral med and systemic problems
vesiculobullous (pemphigoid)
rheumatology
immune deficiency
neurological problems
facial pain assessment (non dental)
oral cancer
rheumatology problems in oral med
Rheumatoid arthritis
SLE systemic lupus erythematous
Systemic Sclerosis
* Elastic tissue in body gradually lost
* Difficulty – swallowing (oesophagus), opening mouth
example immune deficiency issue appearance in mouth
Oral candidiasis
* Happens when immune system reduced – bone marrow transplant, chemotherapy, HIV viral infections
example neurological problem in oral med
Acoustic neuroma
* Large white mass inside base of brain
* Cancer that forms on CN8
Due to position of nerves at brainstem, may not show to pt bar changes to trigeminal facial nerve
* Presents with numbess/weakness of face
Imp dx
facial pain assessment (non dental)
different modes of assessment depending on pt age and communication
commonly seen in oral med
non dental facial pain can inc
3
inflammatory conditions
severe and acute nerve problems
neuropathic pain
e.g. non dental facial pain caused by inflammatory conditions
temporal arteritis
inflammation in arteries which leads to limitation to blood flow to facial tissues
e.g. nerve probelm causing severe/acute non dental pain
trigeminal neuralgia and cluster headache
autonomic mediated headache (changes to trigeminal autonomic nerves in face. severe short lasting pain)
combo tx neurological/neurosurgical
neuropathic pain is
pain through nerve damage or nerve
common high risk sites for oral cancer
6
floor of mouth
lateral border of togue
retromolar regions
soft and hard palate
gingivae
buccal mucosa
dentist role in oral cancer detection
mainly concerned within oral cavity itself
dentist needs to be aware of changes indicative of cancer
educate pt on risks (health education)
* more alcohol – greater risk
opportunistic health intervention, better able at dentist than doctor
