Oral Cavity/Salivary Gland Diseases Flashcards
Oral Cavity
- Disorders of the Lip
- Disorders of the Tongue
- Disorders of Buccal and Tongue
Oral Cavity - Disorders of the Lip
- Exfloiatice Cheilitis
- Angular Chelitis
- Actinic Cheilitis
Exfoliative Cheilitis
•facititious 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
Angular Cheilitis
– Environmental
– B2 (Riboflavin) deficiency
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
Disorders of the Tongue
- Geographic Tingue
- Hairy Tongue
- Oral Chancre (Syphilis)
Geographic Tongue
- 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
Hairy Tongue
- 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
Oral Chancre: Trepenoma pallidum
- Painless ulceration in primary syphilis
- Highly Contagious
- Represents the site of infection
Disorders of Buccal Tisue and Tongue
- Aphthous Ulcers
- Herpes Simplex Virus
- Oral Candidiasis
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]
Herpes Simplex Virus
•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
Oral Candidiasis
- most common oral fungal infection
- Predisposing factors- dry mouth, antimicrobials, corticosteroids, leukemia, HIV inf, tobacco smoking, denture wearing, endocrinopathy
- caused by Candida albicans
- acute pseudomembranous, erythematous, chronic hyperplastic
Oral Candidiasis - Pseudomembranous
- Most common of the 3 forms
- Also called thrush
- Superficial gray – to – white inflammatory membrane
- Scrape off exudate
- underlying erythematous inflammatory base
Oral Candidiasis - Erythematous
- Also known as atrophic form
- Red raw-looking lesion
- Associated with inhaled steroids
- Appears on palate or dorsum of tongue
Oral Candidiasis - Hyperplastic
- Nodular or plaque-like
- White plaque persistent
- Generally involves buccal mucosa on both sides of mouth
Oral Candidiasis Treatment
•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
- Inflammation of the gums
- Manifestations – Redness – Swelling – Bleeding
- Results from bacterial colonization at gum margin
- necrotizing ulcerative gingivitis
- coxsackievirus infections
- herpangina
- hand foot and mouth disease
- acute lymphonodular pharyngitis
Risk Factors for Gingivitis and Periodontal Disease
– Smoking
– Diabetes
– Medications
– Poor nutrition
– Stress
– Illness
– Genetic susceptibility
Necrotizing Ulcerative Gingivitis
• A painful, erythematous gingivitis with necrosis of interdental papillae
– Most likely caused by both a fusiform bacillus and a spirochete (Borrelia vincentii)
– Associated with decreased resistance to infection
• Diagnosis
– Necrosis results in cratering of the interdental papillae.
– Sloughing of necrotic tissue causes a pseudomembrane over the tissue.
• Treatment
– Gentle debridement
– Antibiotics if fever is present
Coxsackievirus Infections
• Causes several different infectious diseases
– May be transmitted by fecal-oral contamination, saliva, and respiratory droplets
• Three have distinctive oral lesions
– Herpangina
– Hand-foot-and-mouth disease
– Acute lymphonodular pharyngitis
Coxsackievirus Infections - Herpangina
• Characterized by fever, malaise, sore throat (odynophagia), and difficult swallowing (dysphagia)
– Includes vesicles on the soft palate
– Erythematous pharyngitis
• Resolves in less than 1 week without treatment
Coxsackievirus Infections - Hand Foot and Mouth Disease
• Usually occurs in epidemics in children less than 5 years old
– Multiple macules or papules occur on the skin, typically on feet, toes, hands, and fingers.
– Oral lesions are painful vesicles that can occur anywhere in the mouth.
• Resolves within 2 weeks
Oral Cancer
- Occurs most often in people over age 45
- Symptoms
– Sore that does not heal
– Lump on lip or mouth
– White or red patch on gum, tongue, or buccal mucosa
– Unusual bleeding, numbness, or pain
•pre-malignant epithelial lesions
- leukoplakia
- erythroplakia
- oral hairy leukoplakia
•SCC
- traditiona;
- HPV
