Oral Disease Flashcards
What symptom is a big risk factor for periodontal disease and dental caries?
dry mouth
subjective complaint of dry mouth
Xerostomia
objective reduction in salivation
Hyposalivation
Why is dry mouth is very common in the elderly?
> 30% of people over 65
Salivation does not decrease with age – medical conditions and treatments are the cause
Elderly patients with new onset dry mouth - what should you rule out/think of first?
worry about diabetes
What are the mainstay of good oral hygiene and can prevent endocarditis?
Brushing and flossing
Frequency of bacteremia is correlated to what?
poor dental and periodontal health
List some drug causes of dry mouth
Calcium channel blockers
Anticonvulsants
Immunomodulatory agents
Anticholinergics
Sedatives
Antihistamines
diuretics
List some causes of dry mouth
Sjogren’s disease
Dehydration
DM
Drugs
Ductal obstruction
Infections
Tumors
Radiation therapy
What are some complications of dry mouth?
Reduces compliance with medications
Restricts dietary choices
Chronic esophagitis
GERD
Dental caries
Periodontal disease (Increases frequency and severity)
Dentures are not comfortable
What are most common and are often secondary to medication-induced dry mouth?
Root caries
In infants, how can you distinguish thrush from milk?
Cannot scrape off thrush – how to distinguish from milk
How do infants typically present with thrush?
Mom may complain of fussy infant who is eating more than normal
Thrush is painful and the milk is soothing, so will ingest more
Creamy-white, curd-like removable patches overlying erythematous
mucosa
Thrush
What is the organism responsible for thrush?
Candida albicans
What testing is used for the diagnosis of candidiasis of the mouth?
Wet prep KOH
White, non-removable lesion – cannot be removed by rubbing the mucosal surface
Whitish, lacey appearance – patches or plaques of the oral mucosa
Chronic inflammatory disease
May be erosive
Leukoplakia
Why is leukoplakia concerning?
2-6% represent SCC
1-20% will progress to carcinoma within 10 years
Usually on tongue – affects lateral portions
One of the first manifestations of HIV
Not considered a pre-malignant lesion
White corrugated painless plaque
Oral Hairy Leukoplakia
Epstein-Barr virus-mediated mucocutaneous disease – relatively specific for HIV infection
Oral Hairy Leukoplakia
What is the responsible pathogen for oral hairy leukoplakia?
Epstein-Barr virus-mediated
Red mucosal plaques
Compared to leukoplakia, these lesions are more likely to represent malignancy
90% dysplasia or CA
See in EtOH or tobacco use
Erythroplakia
90% of oral cancers are what type?
SCC
AKA Trench Mouth and Vincent’s Infection
Spirocetes and fusiform bacilli
Common in young adults under stress
Necrotizing Ulcerative Gingivitis
AKA Canker sore and ulcerative stomatitis
Painful, small round ulcerations with yellow-gray fibrinoid centers with
surrounding red halo
May be single or multiple, often recurrent
Etiology is not certain
Aphthous Ulcer
Aphthous ulcers are associated with what chronic disease?
Can be associated with bowel disease
Can be the earliest manifestation of Crohns disease
Although the etiology is not certain for aphthous ulcers, it is believed to be associated with what virus?
Associated with Herpesvirus 6
Self limiting in most cases
Vesicles on an erythematous base
Treat with acyclovir, valacyclovir
Herpetic Stomatitis
Inflammatory disorder of the tongue
Tongue has a smooth, glossy appearance with a red or pink background – caused by atrophy of filiform papillae
Atrophic Glossitis
What are some causes of atrophic glossitis?
Nutritional deficiencies
Protein-calorie malnutrition
Infection (Syphilis, Oral candida infection)
Sjorgren syndrome
Celiac disease
Which nutritional deficiencies are associated with atrophic glossitis?
Iron
Vitamin B12
folic acid
Niacin
Unknown etiology
Possible similar etiologies as atrophic glossitis
Loss of filiform papillae leads to ulcer-like lesions
Geographic Tongue
What is the most common form of periodontal (gum) disease?
Gingivitis
What is a precursor to periodontitis?
Gingivitis
Inflammatory process – manifests as gingival redness and swelling
Bleeding may develop when brushing or flossing the affected area
Can be reversed with good, regular oral hygiene (brushing teeth,
flossing, tartar removed by dentist, etc)
Gingivitis
Characterized by gingival inflammation accompanied by loss of
supportive connective tissues, including alveolar bone
Periodontitis
What are some complications of untreated periodontitis?
If left unchecked, can lead to destruction of the periodontium and tooth loss
Suppurative odontogenic infections may extend to facial spaces in the
orofacial region (e.g. Ludwig’s angina – bilateral infection of the
submandibular space) or deep in the head and neck
What is the etiology of dental caries?
Caused mainly by microorganisms that generate acids on the tooth surface from disaccharides and monosaccharides
