Mouth Disorders Flashcards
Mouth Ulcer Outline
Superficial lesions in oral cavity. On lips, tongue and cheeks. Causes pain. 2 Types: small and big
Small Mouth Ulcers Outline
80% of ulcers. <1cm size, round, grey-white, raised (superficial). Self-limiting, heals after 7-14 days. Reoccuring
Major Mouth Ulcers Outline
> 1cm in size. Needs referral from a doctor (not self-limiting)
Treatment Options Outline
Small ulcers need no treatment but at patients request may need pain treatment. Large ulcers need treatment to prevent infection
4 over the counter treatments for mouth ulcers (not too strong)
Topical antimicrobials, topical anesthetics, topical analgesics (anti-inflammatory) and protectants
Treatment that requires prescription for mouth ulcers (stronger)
Topical corticosteroids
Topical Antimicrobials Outline
Used to prevent (not treat) infections. eg chlorohexidine mouthwash, hexetidine
Topical Anesthetics Outline
Act locally, numbs pain. Problems with retention on site of action (can accidentally be swallowed) eg lidocaine
Topical Analgesics Outlines
Act locally, anti-inflammatory. Eg NSAIDs and salzoic acid (aspirin)
Protectants Outline
Creates a protective layer (eg biofilm), can also increase mucus production. Prevents irritation to the ulcer. Can be a spray, mouthwash or gel
Topical Corticosteroid Outline
Can act locally or systemically. Has to be prescribed over the counter (strong, a lot of interactions). Hydrocortisone = a mucoadhesive tablet that acts locally. Beclomethasone = inhaler, soluble tablet and mouth wash. Side effects: sleep disturbances, oral thrush
Oropharyngeal Candidiasis (oral fungal infections) Outline
Opportunistic fungal infections in immunocompromised individuals (young, old, immunosuppressant). A risk factor is dry mouth which can be a result of hyoscine (cramps treatment medication)
Thrush Outline
Pseudomembranous candidiasis. An acute infection that can turn chronic. Creamy white membrane on mouth and tongue
Acute erythematous candidas outline
Burning sensations on mouth and tongues. Red = highly inflammed. Needs immediate treatment as can turn from acute to chronic and causes intense pain
Chronic atrophic candidiasis Outline
Misfitting dentures cause dry and different shaping of mouths. This causes chronic candidiasis
Chronic hyperplastic candidiasis Outline
Plaque like chronic fungal infections
Oropharyngeal candidiasis Symptoms
cream/white soft elevated, removable patches. Red mucosa. Pain, burning, soreness and lesions in mouth
Oropharyngeal Candidiasis Treatment
Miconazole (topical gel. held in mouth for as long as possible before entering GIT ( interactions in wrafin thins blood too much)), nystatin (oral suspension. local drug delivery), flucanzole capsules (systemic, step up from other 2 as higher chance of interactions with drugs and other tissues)
Gingivitis Outline
Gum disease/inflammation due to plaque. Preventable, treatable and common
Gingivitis Symptoms
Mild and painless often diagnosed in dental appointments. Halitosis and bleeding gums mat occur (these may be symptoms of other things eg medication, NSAID). Plaque may be visible
Causes of bleeding other then gingivitis
Medication (eg warfarin and NSAIDs) and gum hypertrophy (overgrowth) due to drugs such as ciclosporin
Gingivitis Outline
chlorohexidine, hexedine and hydrogen peroxide (same treatment as antimicrobial mouth ulcers). Prevention teeth brushing, flossing and mouth washing
xerostomia Outline
Dry mouth due to insufficent saliva production due to lifestyle factors, medication and aging. Increases risk of fungal infection
Xerostomia Treatment
Lifestyle changes, clinical sugarless gum, breathing through nose and strict dental care
Angular Cheilitis Outline
Fissuring and cracking of skin at sides of mouth. Soreness, erythema (redness of skin) associated with denture stomatitis (misshapen mouth), nutritional deficiency and immunosuppression (opportunistic bacterial infection). Self limiting
Angular Cheilitis Outline
Identify bacterial and/or fungal infection. Miconazole cream (different from gel, not taken into GIT, fungal treatment), fusicic acid cream (bacterial treatment) and hydrocortisone cream(step up)
