LO 4 Part 2

Question 1

Describe herpes virus type 1 (simplex)

Answer 1

1. Infection of mouth, skin, eyes, genitals
2. Vesicles at any site of the body may contain the virus and can be spread by direct contact
3. Do not treat a client with active herpes lesion
4. May also be present in saliva
5. Viral breakout in skin of extremities called herpetic whitlow

Question 2

Describe human herpes virus type 2

Answer 2

1. Is 90% of genitals herpes infections
2. Treatment with acylclovir will reduce severity and duration, but will not prevent recurrence

Question 3

What are the most common types of herpes?

Answer 3

Type one and two - about 90% of adults have been infected with human herpes virus type 1

Question 4

Describe oral candidiasis

Answer 4

1. Candida albicans is yeast that occurs in the mouth asymptomatically in 1/3 of adults
2. The yeast is an opportunistic pathogen that usually causes a harmful infection only under special circumstances
3. Whitish lesions (thrush), reddish areas (stomatitis)
4. Treatment with antifungal agents: Nystatin, Ketoconazole, Clotrimazole

Question 5

Describe oral syphilis

Answer 5

1. Treponema pallidum - spirochete, cause of syphilis
2. 5 to 10% of cases first occur in mouth in form of canker (open ulcer on the tongue)

Question 6

Describe oral gonorrhea

Answer 6

1. Neisseria gonorrhoeae
2. Graham negative bacteria, cause of gonorrhea
3. Spreads to mouth from sex practices with an infected person

Question 7

_______ and _______ are oral diseases that have some potential for spread to the dental team

Answer 7

1. Oral syphilis
2. Gonorrhea

Question 8

Describe herpangia and hand foot and mouth disease

Answer 8

1. Herpangia when only present in the mouth - hand foot and mouth when also on palms and soles of feet
2. Vesicles on soft palate breakdown to ulcers that last for a week
3. Rarely appear on gingiva, buckle mucosa, or tongue - this differentiates it from herpes
4. Caused by Coxsackie virus

Question 9

What are three systemic diseases with oral lesions?

Answer 9

1. Secondary syphilis
2. Chicken pox
3. Mononucleosis

Question 10

Describe secondary syphilis

Answer 10

1. Occurs when primary syphilis goes untreated
2. Secondary phase occurs 2 to 10 weeks after initial lesion
3. Mucus patches in the mouth
4. Contain live spirochetes and spread by direct contact
5. Treatment with Penicillin

Question 11

Describe chicken pox

Answer 11

1. Human herpes virus type 3 (varicella zoster virus) causes chickenpox
2. Primary disease in young children
3. Reoccurrent disease is shingles - commonly occurs in those 50 years or older
4. Although chicken pox commonly produces skin lesions, the disease is classified as a respiratory disease
5. Can have oral lesions
6. The virus is spread through a saliva and nasal secretions in addition to contact with skin lesions

Question 12

Describe infectious mononucleosis

Answer 12

1. Caused by human herpes virus type 4 (Epstein-Barr virus)
2. Hhv4 usually causes mild symptoms, if any, in young children, but causes infectious mononucleosis and adolescents and young adults
3. Spreads direct contact person to person
4. Symptoms are fever, malaise, anorexia, fatigue, sore throat, oral ulcers, enlarged cervical lymph nodes, palatal petechiae, erythema of oral mucosa, swelling of uvula
5. Causes hair leukoplakia

Question 13

What three diseases streptococcus pyogenes cause?

Answer 13

1. Streptococcal pharyngitis also known as strep throat
2. Scarlet fever, which is strep throat with a skin rash
3. Necrotizing fasciitis spreading damage to muscle tissue (flesh eating disease) - response well to penicillin therapy

Question 14

Describe the tuberculosis disease process

Answer 14

1. If enough M tuberculosis reach the lung alveoli and begin to multiply, one is infected
2. Only evidence of infection through tuberculin skin test
3. Begins with pneumonia like symptoms leading to formation of tubercles (consolidation of tissue around lung infected site); may enlarge, become necrotic and produce open spaces in the lung tissue

Question 15

Describe the tuberculin skin test

Answer 15

1. Called the Mantoux test or purified protein derivative (PPD) test
2. Injection of PPD under skin in forearm
3. Observed for 48 to 72 hours for reaction
4. Positive reaction causes induration (hardening) of injection site and diameter is measured

Question 16

Describe streptococcus pneumoniae

Answer 16

1. Estimate normally exists in the nose and throat and is carried asymptomatically in preschoolers and adults
2. Leading cause of middle ear infections in children
3. Can cause bacterial meningitis

Question 17

Describe human herpes virus type 5

Answer 17

1. Cytomegalovirus
2. Causes congenital disease called cytomegalic inclusion disease
3. Causes mental impairment, neurologic problems, deafness, possible damage to internal organs

Question 18

Describe human herpes virus type 6, 7, and 8

Answer 18

1. Type 6: isolated from saliva; causes high fever and skin rashes and infants
2. Type 7: isolated from saliva; not associated with any particular disease state
3. Type 8: associated with Kaposi’s sarcoma in AIDS patients

Question 19

Describe influenza

Answer 19

1. Type A and type B typically infect humans
2. Transmitted through droplet exposure of mucosal surfaces (coughing/sneezing), direct contact, contact contact with fomite, self-inoculation

Question 20

The water inside dental units and hoses for water spray and pieces and the air/water syringes are ________

Answer 20

Contaminated heavily with bacteria

Question 21

Describe waterborne disease and name the two most common types

Answer 21

1. Transmitted through contaminated water
2. Water inside dental units and hoses for air water syringes are contaminated heavily with bacteria
3. Bacteria will form a biofilm on the inside of water lines - typically 30 to 40 types of bacteria present
4. Two most prevalent are Legionella pneumophilia and pseudomonas aeruginosa

Question 22

How can you combat waterborne diseases in the dental office?

Answer 22

1. Flushing water lines between patients
2. Flushing water lines at the start and end of day
3. Do not use dental unit water line to irrigate surgical sites in which bone is exposed
4. Never ask the client to close their mouth on the suction

Question 23

Describe legionaries disease

Answer 23

1. Caused by L. Pneumophilia
2. Graham negative Rod bacteria
3. Pneumonia like disease
4. Treated with erythromycin
5. Spread of disease from person to person has not been documented

Question 24

Describe a pseudomonas infection

Answer 24

An opportunistic pathogen that occurs widely in nature but low in numbers in water used in a dental unit

Question 25

Describe methicillin-resistant staphylococcus aureus (MRSA)

Answer 25

1. A bacterium that is resistant to certain antibiotics called beta lactams (skin infections)
2. More severe or potentially life-threatening MRSA infections occur most frequently among patients in healthcare settings
3. Fortunately, not prevalent in dentistry yet