oral disease Flashcards

1
Q

teething myth/ misconception

A

cause fever, cold, ear infection (serious symptoms)
gum irritation, drooling, fever, diarrhoea, sleep disorder/restlessness

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2
Q

teething truth

A

pain
mild increase temp
irritability
increase drooling
loss appetite
restlessness

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3
Q

teething important facts

A

start 6-8 months
developmental change also change sleep pattern separation anxiety, irritability, change eating habit

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4
Q

teething science

A

teething release inflammatory cytokines (pain, slight temp up) - rectal temp most accurate
diarrhoea - put everything in mouth, changing eating patterns

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5
Q

teething treatment

A

chilled teething ring/fruit veg
sugar free teething rusk
massage gum cold spoon (parent already try)
NO NECKLACE/BEADS
protect skin - drool rash (bibs & creams) butt cream
brush teeth no toothpaste - dog brush

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6
Q

teething - drugs

A

no teething gels or oral analgesic
no aspirin

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7
Q

teething gel bad

A

contain choline salicylate or sodium salicylate or lignocaine/lidocaine
impractical - contact time, swallowed, dosing
risk outweigh benefit
salicylate intoxication
VERY CLEAR DOSAGE
careful homeopathic - no study, deadly nightshade

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8
Q

oral analgesic - paracetamol

A

calculate weight in pharmacy
**15mg x kg, 4-6hrs pro nata
**60mg x kg - daily
<1000mg max dose
create chart

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9
Q

oral analgesic - ibuprofen

A

10mg x kg tid - max 400mg
max 30mgxkg - max 2.4g
careful contraindication - diarrhoea/ dehydration
lots fluid intake
dont cycle both
no aspirin

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10
Q

teething red flags

A

general mouth pain
severe inflammation/ bleeding
sign infections - pus
high fever
behavioural change
excessive symptoms

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11
Q

dental plaque

A

sticky bacterial biofilm,
–> tartar 3-4 days
bacteria generate acid demineralise tooth enamel
–> gingivitis - gum inflammation

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12
Q

fluoride

A

reduce demineralisation
promote remineralisation
inhibit bacterial acid production
fluoride free products

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13
Q

high conc fluoride toothpaste S3

A

CONFIRM PRESCRIPTION
pea sized amount
spit out no rinse
avoid drink 30 min eat drink
limited duration
effect - fluorosis
check <13, pregnant
should be part prevention plan

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14
Q

mouthwash use & council

A

occasional - not replace brush
short periods only
diff mouthwash diff purpose
share safety warnings

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15
Q

mouthwash adverse effect

A

stain teeth & tissue
taste change
CHX build up
worse dry mouth
change oral microbiome
mouth cancer

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16
Q

appropriate use mouthwash

A

pre/ post surgical prep
treat infection
reduce inflammation
orthodontic care - braces
high caries risk
limited manual dexterity
chemotherapy - alcohol free

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17
Q

mouthwash directions

A

after brush/ floss
swish 30-60second
15-20mL
dont eat/drink 30 min after
chlorhexidine - 2 weeks
0.5-2hhrs after brush

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18
Q

gingivitis

A

inflammation
excess plaque tartar buildup
bacteria release enzymes
erode bone holding tooth - create pocket
- mild/painless
- redness/ bleeding
- receding gum

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19
Q

med induced gingivitis

A

gum overgrowth?
- phenytoin, nifedipine, cyclosporin
worse condition
- oil contraceptive, antidepressant, antihistamine, beta blocker, chemo
medicine induced
- blood thinners

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20
Q

gingivitis red flag

A

spontaneous bleeding
fatigue, weakness
timing med induced
loose/ lost teeth

21
Q

gingivitis treatment

A

topical analgesic
- nyal toothache drop (phenol!)
- oral-eze toothache med
(1-2drop cotton pellet, hold 1 min)
paracetamol, ibuprofen, diclofenac - if no other drug

22
Q

dentures care

A

brush daily - remove food plaque
soak overnight
adhesive & comfort product - ill fitting dentures CAREFUL

23
Q

xerostomia pathology

A

reduce saliva flow/ chronic dry mouth
increase risk mouth problem - gingivitis, oral thrush
cause - old age, radiotherapy, certain meds
symptom - sore throat, burning mouth, problem speaking & swallowing, hoarse, dry nose & lips

24
Q

xerostomia treat

A

regular dental cleaning, fluoride varnish
management treatment
- review meds
fluoride toothpaste sugar free gum/lozenge
OTC - saliva substitute, saliva stimulant (some function saliva glands)

25
xerostomia self care
drink not sip water - not just tea chewy foods - stim saliva celery, sugarless gum/ sweets limit alcohol, caffeine cigarettes
26
halitosis - bad breath
poor oral hygiene diseases, infections, meds
27
halitosis treatment
mechanical clean chewing gum deodorising agent topical agent toothpaste mouthwash tablet no clear thing - not enough study
28
halitosis management
promote orla hygeine & care microbiome avoid self limiting cause med review if needed underlying pathology OTC product
29
ulcer cause
stress infection trauma nutritional deficiency meds food hypersensitivities
30
ulcer types
aphthous ulcer major and minor herpetiform ulcer - clusters, not herpes
31
minor aphthous ulcer
round small shallow greys white painful 1-5 tongue margin, inside lips & cheek heal 7-14 days
32
ulcer treatment
local analgesic salicylic acid, lignocaine, benztdamine, choline salicylate - antiinflam water based gels (problem contact time) mouth numbing mouthwash - meh corticosteroids - triamcinolone - promotes healing (kenalog)
33
ulcer referral
children - first time, no cause persist 14 days< painless larger than 1cm 10+ simultaneously if ill fitting dentures
34
mouth ulcer self care
avoid food drink irritate suck on ice nutrition rich diet - v b12, folate quit smoking relax/address stress prevent oral trauma
35
cold sore
labial herpes simplex HSV1 - cold sores HSV2 - genital herpes infection result from direct/indirect contact highly contagious
36
cold sore pathology
initial infection - usually unnoticed, childhood virus lie dormant in nerve root reactive later life - stress
37
cold sore factor
stress fatigue sunlight menstruation wind local trauma being run down illness/fever
38
cold sore sypmtom
1 discomfort, tingle, burn before appearance 2 lesion/blister 3 crusting - blister burst 1-2 weeks
39
cold sore differential diagnosis
oral cancer - painless, last longer impetigo (crusty golden) - not always near mouth/more widespread, common in school children
40
cold sore treatment 1
aciclovir - antiviral, reduce healing time 24hrs, reduce pain experienced start as soon as symptom felt (before lesion) 5 times a day for 5 days safe >2yr stinging when apply, disappears safe pregnant, breastfeeing careful combo drugs
41
cold sore treatment 2
virasolve cold sore cream - idoxuridine (mid antiviral) - lignocaine (local anaesthetic) - benzalkonium chloride (antiseptic, prevent 2nd infect) every hr day1, qid until heal avoid pregnant, lactation, <12
42
cold sore treatment 3
povidone iodine cold sore paint & ointment qid, avoid pregnant <6m reduce 2nd bac infect
43
cold sore treatment
cold sore patch/ hydrocolloid dressing - cover & promote healing oral famciclovir - 500mg RECURRENT INFECTION ONLY 3 tab in adult use before lesion/ prodromal phase CI - pregnant, breastfeed, immunocompromised ADR - headache, fatigue, nausea, diarrhoea
44
cold sore self care
wash hand before/ after dont touch/pick dont touch eyes reduce mouth directi/ indirect contact w others avoid sun&wind exposure lysine 1000mg ads reduce outbreak
45
cold sore referral
babies, young children <18 & topical therapy not suitable for sign bacterial infection systemic infection immunocompromised OTC treatment not work Ocular signs/ symptoms lesions - present >14 days, >7d w treatment - severe/widespread/ not on lips - occur 3< yr
46
oral thrush pathology
candida infection affect surface tongue, inside cheek most likely affect v v young/old or underlying pathology- diabetes, IC, Xero or meds - recent AB, inhaled corticosteroid creamy white, painful, sore, can be wiped off
47
oral thrush treatment
nystatin oral drops 1ml qid pc safe pregnancy, lactation, baby baby - apply slowly prevent choking adult - swish in mouth high sucrose content
48
oral thrush referral
>3 weeks diabetes pregnant immune compromised recurrent infection white painless patches - prob not thrush
49
oral thrush self care
clean dentures replace toothbrush sterilise stuff go baby mouth - dummies, mouth toys, in baby - check nappy rash treat b m&b if breastfeeding - antifungal on nipples