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LO 15 Flashcards

1
Q

Depending on the diagnosis, a lesion may require:

A
  1. only reassurance
  2. palliative treatment
  3. specific treatment
  4. surgical intervention
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2
Q

Describe the possible treatments for NUG/NG

A

Local treatments:
1. Scale & root plane
2. Rinses - Saline or chlorhexidine

Food Supplement

If systemic involvement:
1. Fever - ibuprofen
2. Antibiotics - metronidazole

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3
Q

Describe the possible treatments for HSV-1

A

Topical pain relief:
1. Lidocaine rinse
2. DPHA rinse - AKA Benadryl
3. Orabase cover - allows healing

Fever:
1. ibuprofen, acetaminophen

Food supplement

Antivirals (severe reaction)
1. Abreva
2. Acyclovir

  • Important note: Keep child hydrated.
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4
Q

What are the predisposing risk factors for candidiasis?

A
  1. chronic AB
  2. appliances
  3. immune compromised
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5
Q

What is the typical treatment for candidiasis?

A
  1. 2 week TX course
  2. Topical AF Nystatin rinse
  3. Systemic AF Ketoconazole tabs
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6
Q

Describe the possible treatments for Angular Cheilitis

A

Depends on cause
1. Antifungals if C. Albicans - Nystatin cream
2. Antibiotics if Gram positive bacteria - Penicillin
3. Topical steroids - Kenalog - not very common
4. Vitamin B supplement if caused by vitamin deficiency

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7
Q

What are the predisposing factors for Alveolar Osteitis (AKA dry socket)?

A
  1. Noncompliance with post op instructions
  2. Smoking
  3. Oral contraceptives
  4. Complicated surgery
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8
Q

What are the treatment options for Alveolar Osteitis (AKA dry socket)?

A
  1. Saline rinse
  2. Analgesics : ibuprofen
  3. pack: alveogyl
  4. AB: penicillin - only if accompanied by fever/systemic symptoms
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9
Q

Antibiotics should be considered only if the patient is immunosuppressed or if ____________

A

evidence of systemic involvement exists (fever, lymphadenopathy…etc)

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10
Q

What are the influencing factors for Aphthous Ulcers?

A
  1. stress
  2. malnutrition
  3. hormonal changes
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11
Q

What are the 3 types of Aphthous Ulcers?

A
  1. minor
  2. major
  3. herpetiform - despite name, nothing to do with herpes
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12
Q

What are the treatment options for Aphthous Ulcers?

A
  1. Topical steroids: “aphthasol”
  2. DPHA rinse
  3. Immunosuppressants? Refer to own MD
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13
Q

What are the treatment options for Lichen Planus?

A
  1. If asymptomatic - no Tx necessary
  2. Topical steroids - Orabase w/ Kenalog
  3. Saline rinses
  4. Systemic steroids - send to MD
  5. “Common sense lifestyle changes” - no alcohol, no spicy food, good oral hygiene, no smoking
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14
Q

What are the treatment options for lupus?

A
  1. local corticosteroids - Kenalog
  2. Systemic corticosteroids - refer to MD
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15
Q

What is geographic tongue associated with?

A
  1. Spicy food
  2. Alcohol
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16
Q

What are the treatment options for geographic tongue?

A
  1. Reassurance
  2. Avoidance of irritating food and alcohol
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17
Q

What are the possible etiologies for burning mouth sensation?

A
  1. candidiasis
  2. diabetes
  3. blood disorders
  4. xerostomia
  5. B12, Fe deficiency
  6. idiopathic
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18
Q

Define Glossodynia

A

A painful tongue and is divided into two types: with and without observable alterations on the tongue

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19
Q

What are the treatment options for Glossodynia/Burning Mouth Sensation

A
  1. Tx of cause! (Differential diagnosis)
  2. For topical relief : DPHA or lidocaine rinse
  3. Palliative therapy involves topical DPHA to relieve symptoms
  4. Tricyclic antidepressants can be used on a trial basis - these can be good for neurologic chronic pain
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20
Q

What are the symptoms of Post Irradiation Caries?

A
  1. xerostomia
  2. caries (Cl V) - around CEJ
21
Q

What are the treatment options for Post Irradiation Caries?

A
  1. biotene
  2. refer to DDS (caries)
  3. sugarless gum
  4. drink water
  5. self-application of sodium fluoride gel four times daily
22
Q

List the causes of root sensitivity

A
  1. heat
  2. cold
  3. sweet
  4. sour foods
  5. after perio surgery
23
Q

What are the treatment options for root sensitivity?

A
  1. fluoride varnish and gel trays
  2. Desensitizing toothpaste: Sensodyne, Colgate Pro-Relief**
  3. Home brushing with concentrated sodium chloride and 0.4% stannous fluoride
  4. Sodium fluoride gel may be self-applied in a bite guard
24
Q

Current research indicates that root sensitivity caused by: ___________

A

recession, bleaching, or abrasion may be successfully treated with amorphous calcium phosphate

25
Q

Describe Actinic Cheilitis

A
  1. Long-term exposure of the lip to the sun can cause irreversible tissue change => Loss of vermillion border (could turn into squamous cell carcinoma)
  2. Prevention: SPF lip balm - min SPF 50
  3. Treatment - topical anti-neoplastic (Fluorouracil); topical steroids: Kenalog
26
Q

Describe Stomatitis

A
  1. An inflammation of the mucus lining the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth
  2. Treatment is based on its cause and usually includes good oral hygiene
27
Q

List the possible causes of Stomatitis

A
  1. poor oral hygiene
  2. poorly fitting dentures
  3. mouth burns ( hot food or drinks)
  4. systemic conditions
  5. medications
  6. allergic reactions
  7. radiation therapy
  8. infections
28
Q

Describe Pericoronitis

A

Associated w partially erupted third molars - operculum

29
Q

What are the treatment options for Pericoronitis?

A
  1. irrigation w/ saline
  2. area debridement
  3. analgesics (ibuprofen)
  4. AB: penicillin G+ bacteria
  5. book w/ oral surgeon for ext 8’s if no room for full eruption
30
Q

Describe Drug-Induced Oral Side Effects

A
  1. Different kinds of lesions can be produced with the same drug
  2. The same kind of lesion can be produced by different agents
  3. Common oral side effects include xerostomia, drug-induced lichenoid-like reaction, and hypersensitivity reactions
31
Q

Describe Xerostomia

A
  1. People with this condition are high risk for class 5 caries
  2. Caused by age, radiation, and medications
32
Q

List the medications that can cause Xerostomia

A
  1. anti-depressants (Amitriptyline)
  2. anti-anxiety (Valium)
  3. anti-psychotics (phenothiazine)
  4. anti-hypertensives (hydrochlorothiazide & b-blockers) (olol)
  5. anticholinergic meds (Atropine) (anti SLUD)
33
Q

What are the treatment options for xerostomia?

A
  1. caries prevention
  2. artificial saliva (biotene)
  3. Home care - OHI, fluoride trays, sugarless gum, reduce alcohol, reduce sugar/candy
  4. alter meds (as per MD) - if possible, unlikely doctor will agree
  5. Drugs - Pilocarpine (cholinergic - SLUD), Cevimeline hydrochloride
34
Q

Describe sialorrhea

A
  1. Increased salivation -spit talking, drooling, etc.
  2. Can be drug induced - Li (lithium) or Pilocarpine
35
Q

What is the only drug that can cause both sialorrhea or xerostomia depending on the patient?

36
Q

List possible allergic reactions in an oral/dental context

A
  1. Intraoral contact stomatitis= stomatitis venenata

Possible causes
1. new toothpaste, new mouth rinse
2. new foods, new gum
3. new cream, new makeup
4. oral piercing
5. latex/rubber dam
6. topical creams
7. prophy paste (cinnamon aldehyde)
8. restoration material

37
Q

Describe the 3 types of oral allergic reactions and their causes

A
  1. Lichenoid RXN - hydrochlorothiazide, amalgam, Beta-blockers
  2. Lupus-like rxn - anticonvulsants
  3. Erythema multiforme-like reaction - anticonvulsants
38
Q

What are the treatment options for oral allergic reactions?

A
  1. Lidocaine rinse
  2. Benadryl rinse
  3. remove amalgam
39
Q

What are the types and treatments of INTRINSIC stains?

A

Types
1. AB: Tetracycline
2. endo
3. resto especially amalgam
4. trauma (internal bleeding)

Treatments
1. bleaching
2. veneers

40
Q

What are the types and treatments of EXTRINSIC stains?

A

Types
1. habits: smoking, red wine, coffee, tea
2. foods : berries, beats,
3. iron rich foods and iron supplement especially liquid
4. chlorhexidine

Treatment
1. polish
2. OHI
3. patient ed

41
Q

What 3 types of drugs can cause Gingival hyperplasia?

A
  1. cyclosporin (Immune suppressant)
  2. verapamil, nifedipine (CCB)
  3. Dilantin (anti-convulsant)
42
Q

List the possible treatments for Gingival hyperplasia

A
  1. OHI
  2. frequent visits
  3. lower drug dose/ or change drug (as per MD)
  4. gingivectomy
43
Q

Describe Palliative treatments

A
  1. Treatment designed to make the patient more comfortable
  2. Agents that reduce the pain of the oral cavity can be topical and systemic
  3. Topical agents are applied by swishing the liquid around in the mouth
  4. Systemic analgesics can often provide relief from a painful oral lesion
44
Q

List drugs that are commonly used for palliative treatments

A
  1. Benzocaine liquid Brand Names: KANK-A
  2. Lidocaine
  3. DPHA
  4. Orabase
  5. topical anesth
  6. analgesics
45
Q

Describe Topical Corticosteroids

A
  1. Topical corticosteroids selected based on their potency
  2. Topical and systemic agents may be used together for an additive effect

Levels:
1. weak: hydrocortisone
2. intermediate: TAC
3. potent: Clobetasol

46
Q

Describe Systemic Corticosteroids

A
  1. If topical corticosteroid therapy is ineffective, or if the condition is severe, then systemic corticosteroids may be indicated
  2. Drug: Prednisone (rule of 2s)
47
Q

What are the adverse reactions of Prednisone?

A
  1. adrenal suppression (rule of 2s)
  2. candidiasis
  3. poor healing
  4. osteoporosis
  5. fluid retention
  6. weight gain
  7. moon face
48
Q

Describe the rule of 2s

A

If the client has taken more than 20mg of prednisone for a continuous 2 weeks or more within the last 2 years, they are considered suppressed (adrenals) - If suppressed, need to consider steroid supplementation - call MD

Pharmacology (15 decks)

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