Oral Cavity Flashcards
What is the leading cause of tooth loss in children?
Dental caries
What are the etiologies of dental caries?
Streptococcus mutans, and S. Sobrinus Lactobacillus casei Actinomyces species Bifidobacterium species Low pH tolerant Streptococcus species
What is the pathogenesis of dental caries?
Dental caries cause damage to the surface of the tooth enamel and/or dentin by action of bacteria breaking down sucrose into lactic acid
A drop in pH below 5.5 results in demineralization of enamel
What are the virulence factors that cause dental caries/
Adhesins bind to tooth Acidogenicity makes acid Acidurity helps survive low pH Extracellular polysaccharides Intracellular polysaccharides
What are the periodontal diseases?
Gingivitis
Acute necrotizing ulcerative gingivitis (trench mouth)
Vincent’s angina
Periodontitis (chronic or agressive)
What is a periodontal disease?
Infection and inflammation of the structures surrounding the teeth
Structures include: gingiva, periodontal ligament and alveolar bone
What is the leading cause of tooth loss in adults?
Periodontal disease
What are the etiologies of the periodontal disease?
High number of gram negative anaerobes and spirochetes residing in plaque
What are the different risks of periodontal disease?
High risk or red complex
Moderate risk or orange complex
Low risk or yellow complex
What are the etiologies of aggressive periodontitis?
AGGregatibacter actinomycetemcomitans
Eikenella corroden
With fusobacterium nucleatum
What is the pathogenesis of gingivitis?
Bacteria in plaque produce hemolysins and proteases causing inflammation
Inflammation results in redness, swelling, bleeding with trauma but no pain
What are the characteristics of Trench mouth?
Also called acute necrotizing ulcerative gingivitis is a form of severe gingivitis due to poor oral hygiene and rare in the USA
Its symptoms include fever, malaise, halitosis, painful and inflamed gingiva with necrotic gray to black ulceration of interdental papillae
Has a gray pseudomembrane that covers lesions and is easy to remove
What are the characteristics of Vincent’s Angina?
It is an extension of Trench mouth to the oropharynx
Symptoms include fever, swelling of lower face and neck, difficulty with speech and swallowing, membranous pharyngitis
What are the virulence factors of Trench mmouth and Vincent’s Angina?
Excessive growth of organisms in the mouth due to:
Poor hygiene
Immunosuppression
Stress
What is the pathogenesis of periodontal disease?
Plaque spreads down the root surface
Inflammation causes detachment of the gingiva leading to pocket formation and alveolar bone resorption
Collagenases destroy the periodontal ligament
What is the difference between dentoalveolar abscess and periodontal abcess?
Dentoalveolar abscess is due to extension of dental caries and forms at the end of the tooth root and is caused by polymicrobial especially anaerobes
Periodontal abscess forms along tooth root after development of periodontal disease
Both cause pain in and around affected tooth and swelling of the face over the abscess site.
What is Ludwig’s angina?
Cellulitis of the sublingual and submylohyoid spaces
Rapidly fatal without treatment
In adults due to predisposing factors
In children can occur without precipitating cause
Wha are the predisposing factors of Ludwig’s angina in adults?
Dental caries Recent dental treatment Sickle cell disease Compromised immune system Trauma Tongue piercing
What are the etiologies of Ludwig’s angina?
Streptococcus bacrteroides
Fusobacterium
Staphylococcus aureus
If foul breath odor present more likely anaerobes
What are the symptoms associated to Ludwig’s angina?
Fever Severe dysphagia Drooling and dysphonia Trismus Swelling ad erythema of neck under chin Pain on movement of tongue Acute airway closure can occur
What is stomatitis?
Inflammation of the mucosal surfaces of the mouth and tongue
Most common infectious causes are Candida albicans , HSV 1 and 2
Gingiostomatitis common with HSV
What are the manifestations of oral herpes?
Primarily fever, malaise, irritability, itching at infection site, blister breakdown form small shallow gray of ulcers on a red base
Painful sores around lips, gums, front of tongue
Recurrence during times of stress
Diagnosis made thru positive Tzanck test
What are the 3 types of candidiasis?
Pseudomembranous, thrush- acute
Erythematous, red- acute and chronic
Hyperplastic, leukoplakia- Chronic
All caused by candida albicans
What are the characteristics of acute pseudomembranous or thrush?
Creamy white , curd like plaques of mucosal cells, neutrophils and yeast cells
Hard to remove
When removed leave behind inflamed base that may be painful an bleed
Pseudomembrane formation due to accumjulation of keratin, bacteria , yeast and necrotic tissue
In infants presence of diaper rash
What are the characteristics of erythematous candidiasis?
Red areas of varying sizes in any part of the oral mucosa
Fiery red and shiny with depapillation on tongue
Can be acute or chronic
No pseudomembrane
Common for denture wearers
What are the characteristics of hyperplastic or leukoplakia?
Individual lesion of cheek near commissure, angles of mouth or on the tongue
Homogenous or speckled areas
Does not rub off
Chronic and can become malignant
Marked hyperplasia of parakeratinized layer with candidal hyphae invading at right angles to the layer
What are the predisposing factors in candidiasis?
Common in neonates Taking antibiotics or steroids Polyendocrine disorders (diabetes) Smokers Denture wearers Drugs that cause dry mouth Compromised immune system
What is oral hairy leukoplakia?
Disease of lateral borders of tongue found usually in I/C patients, patients with malignant tumors and organ transplant recipients
Caused by EBV
Common in HIV infected homosexual males
Diagnosis thru Cowdry type A inclusions
What is Angular cheilitis?
Also called angular stomatitis or perleche
Inflammation of the angles of the mouth usually cause by candida albicans or staphylococcus aureus if yellow crusting is present
What is the pathogenesis of angular cheilitis?
Common in elderly, children who suck their digits and in people with riboflavin or iron deficiency
Cause maceration of the skin resulting in inflammation
In elderly cause sagging of facial muscles and ill fitting dentures
Can be a sign of anemia or vitamin deficiency
What are the characteristics of mumps?
Benign viral parotitis cause by Mumps virus (RNA)
Once a common childhood disease
Disease of the salivary glands
Occasional serious complications such as aseptic meningitis, oophoritis and epididymoorchitis
Usually asymptomatic
If symptomatic prodrome phase marked with low grade fever and myalgia followed by unilateral or bilateral parotitis
During pregnancy can lead to death during 1st trimester
Infectious 3 days before to 9 days after symptoms
Jelly like feel not warm
What is the etiology and manifestations of acute bacterial parotitis?
Staphylococcus aureus Manifested as : Swelling of salivary glands chewing increases pain Skin is erythemous and warm Purulent saliva upon massage of glands
What are the predisposing factors of acute bacterial parotitis?
In elderly taking medications that affect the flow of saliva Dehydration Chronically ill Postoperative patients Patients with dry mouth
