Oral Cavity and Salivary Gland Diseases Flashcards
Disorders of the Lip
- Exfoliative cheilitis
- Angular cheilitis
- Actinic cheilitis
Exfoliative Cheilitis
aka “factitious cheilitis”
– Chronic superficial inflammation of vermilion borders of the lips
– Characterized by persistent scaling
– Attributed to repeated lip sucking, chewing or other manipulation of lips
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Angular Cheilitis
– Environmental
– B2 (Riboflavin) deficiency
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Actinic Cheilitis
– Premalignant condition due to chronic UVR exposure
– Affects lower lip, initially edematous & erythematous, later atrophic, white, scaly plaque, may obliterate vermillion border
– Ulceration or induration
- biopsy to rule out malignant transformation
Geographic Tongue
-•benign inflammatory condition, due to Loss of filiform papillae
- Erythematous plaques with an annular or serpiginous well demarcated white border
- Etiology- psoriasis, Reiter syndrome, atopic dermatitis, diabetes mellitus, anemia, hormonal disturbances, Down syndrome, lithium therapy
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Hairy Tongue
(white or black hairy tongue)
- hypertrophy of filiform papillae resembling hair-like projections
• Associated with
- heavy tobacco use, mouth breathing, antibiotic therapy, poor oral hygiene, general debilitation, radiation therapy, chronic use of bismuth containing antacids, lack of dietary roughage
• White, yellow green, brown, or black color is due to chromogenic bacteria or staining from exogenous sources
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Oral Chancre - Trepenoma pallidum
- Painless ulceration in primary syphilis
- Highly Contagious
- Represents the site of infection
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Disorders of the Tongue
- Geographic Tongue
- Hairy Tongue
- Oral Chancre - Trepenoma pallidum
Oral Ulcers
- Aphthous Ulcers
- Herpes Simplex Virus
Aphthous Ulcers
Etiology Unknown
- runs in the family, starts in childhood/adolescence
- typically resolves in the third decade of life.
- up to 40% affected
Exclude Systemic Conditions
- may be associated with immunological disorders – Crohn’s; ulcerative colitis]
- exclude cause due HIV/AIDS, vitamin deficiency states, or drugs [e.g. NSAIDS]
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Herpes Simplex Virus
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Primary infection:
- usually caused by HSV-1
- widespread gingivostomatitis
- entire oral mucos red/ blistering
- Concomitant systemic viral symptoms
Recurrent infection after latency period
- Localized cold sore
- Localized herpetic stomatitis
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Oral Manifestations of fungal Infections
- Oral candidiasis
- Many clinical appearances
- Acute pseudomembranous, Erythematous , Chronic hyperplastic
- Predisposing factors- dry mouth, antimicrobials, corticosteroids, leukemia, HIV inf, tobacco smoking, denture wearing, endocrinopathy
Oral Candidiasis
- Most common oral fungal infection
- Caused by Candida albicans
- •*3 Manifestations:
- Pseudomembranous candidiasis
- Erythematous candidiasis
- Hyperplastic candidiasis
Pseudomembranous candidiasis
Most common of the 3 forms
- Also called thrush
- Superficial gray– to – white inflammatory membrane
- Scrape off exudate
- underlying erythematous inflammatory base
- HIV/AIDS patients present with pseudomembranous candidiasis. White or yellow plaques on mucosa leave raw, bleeding surfaces after being wiped away.
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Erythematous candidiasis
- Also known as atrophic form
- Red raw-looking lesion
- Associated with inhaled steroids
- Appears on palate or dorsum of tongue
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Hyperplastic candidiasis
- Nodular or plaque-like
- White plaque persistent
- Generally involves buccal mucosa on both sides of mouth
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Treatment of Oral Candidasis
•Nystatin
-Topical use only
•Fluconazole
- Azole drug family
- decrease sterol synthesis – inhibit cytochrome P-450 [lanosterol –> ergosterol]
- Adverse effect – liver dysfunction
•Caspofungin
- Echinocandin drugs
- decrease cell wall synthesis – block formation of beta-glycan
- Adverse effect – GI upset; flushing due to histamine release
Gingivitis and Periodontal Disease
- inflammationof the gums
- manifestations
- redness
- swelling
- bleeding
•results from bacterial colonization at gum margin
Gingivitis and Periodontal Disease Risk Factors
– Smoking
– Diabetes
– Medications
– Poor nutrition
– Stress
– Illness
– Genetic susceptibility