Mouth lesions Flashcards
Gingivitis
red, swollen, bleeding gingiva, reversible if treated
Periodontal disease
bone loss, periodontal pocket formation, tooth mobility may be present, halitosis (bad breath)
Herpes simplex virus
general
HSV-1
general
reccurant oral herpes labialis
Cold sore (describe them)
Reccurant intraoral herpes
general
recurrent intraoral herpes
Acute primary herpetic gingivostomatitis
general, Sx, Tx
acute herpetic gingivostomatitis
acute herpetic gingivostomatitis
Tx
Tx for more generalized oral lesions of primary infection is mostly palliative, using soothing mouth rinses and analgesics
Magic mouthwash:
Viscous lidocaine
Benadryl
Mylanta
Nystatin
Prednisone
acute herpetic gingivostomatitis
Treatment (non-palliative)
Oral antivirals:
Acyclovir
Valacyclovir
Famcyclovir
Topical antivirals:
Acyclovir
Penciclovir
Necrotizing Ulcerative Gingivitis
general
Offending pathogens
Infection with spirochetes AND fusiform bacilli
Common in young adults under stress (sound familiar?!); also seen in poor oral hygiene, patients with HIV/ immunocompromised
Smoking increases risk
Painful gingival inflammation and tissue death (necrosis)
Bleeding, halitosis, fever, cervical lymphadenopathy
Necrotizing Ulcerative Gingivitis
Dx and Tx 4
Diagnosis is usually clinical; usually refer out for full diagnosis and treatment (periodontal specialist if possible)
Tx: warm chlorhexidine or diluted peroxide rinses PLUS antibiotics (metronidazole and PCN); will need to debride dead tissue if severe
Oral candidiasis
General
opportunistic fungal infection
most common form in Candida albicans
mostly in immunocompromised ots, elderly and infants
30-50% of humans have C. albicans
also called Thrush, angular chilitis, median rhomboid glossitis, denture sore mouth, yeast infection.
can be acute, chronic, or mucocutaneous
Candidiasis
Predisposing factors
Candidiasis
classifications
candidiasis
S/Sx
Small soft plaques
wiping away the plaques leaves a painful erythametous, eroded, or ulcerated surface.
if the plaques have not been disturbed, the associated sx are minimal.
found in buccal mucosa, mucobuccal folds, the oropharynx, and lateral aspects of the tongue.
Severe cases: pts may complain of tenderness, burning, and dysphagia.
Acute erythametous candidiasis
general
generalized red lesion
caused by ABx Tx
Painful
ABx withdrawal will improve Sx
Chronic erythametous candidiasis
(Denture stomatitis)
Chronic erythametous candidiasis/ Denture stomatitis
Tx
remove dentures at night
clean dentures with strong antiseptic solution
good oral hygiene
peridex mouthwash
Aphthous Stomatitis
causes
Apthous Ulcers
Types
Minor apthous ulcer
general
Minor apthous ulcer
Tx Meds and diet(4)
topical steroid gel is most successful
systemic steroid for 1 week
oral rinse: Chlorohexidine
dietary changes: folic acid, B12, iron, remove gluten
reduction of oral lesion coincides with improvements in GI tract
Leukoplakia
General
leukoplakia
general
appearance, location, causes
leukoplakia
Dx and Tx
Hairy leukoplakia
general and Tx
Lateral border of tongue
Common early finding in HIV but can also occur in organ transplant patients, EBV, long term corticosteroid use
Like regular leukoplakia BUT a little thicker and appears hairy
Treat with antivirals (acyclovir, famciclovir, valacyclovir) but only get temporary relief
Erythroplakia
general
Similar to leukoplakia but it is erythematous in appearance
90% are dysplasia or carcinoma (“precancer” or cancer)
DDx is basically anything that causes a change to the tongue (such as candidiasis, oral lichen planus, glossitis, etc)
Biopsy
Oral Lichen Planus
general and dx
“lacy” leukoplakia
Erosive
Chronic inflammatory autoimmune disease
Must biopsy to diagnose and to be sure it isn’t squamous cell carcinoma
Oral Lichen Planus
Tx
Treatment: manage pain- no cure and can’t really shorten length of episodes
Medications: daily topical corticosteroids are 1st line, can try cyclosporine, retinoids and tacrolimus
Squamous Cell Carcinoma
general
Squamous Cell carcinoma
Tx
Surgical excision
radiation/chemo
successful Tx depends on the size, site, and stage of the lesion
early detection is KEY!
Taste
Salt
Saltreceptors use a Na+channel to sense the [Na+] in the mouth.
Tatse
Sour
Sournessreceptors respond toacidity (H+).
Taste
Sweetness
Sweetnessreceptors use intracellular second messengers. (For example, binding of a sugar may stimulate formation of cyclic adenosine monophosphate (cAMP), which inhibits a K+channel and depolarizes the receptor cell membrane.)
Taste
bitterness
Bitternessreceptors use more than one transduction mechanism, depending on the chemical. Mechanisms include direct binding to K+channels and changes in second messengers.
taste
Umami
Umami(Japanese word meaning “delicious”) receptors respond to amino acids, particularly glutamate.
