Oral Diseases Flashcards
What are clinical patterns of oral pathology?
Ulcers Keratosis Swelling Vesicles Pigmentation changes
Primary Risk Factors for Oral Disease
Tobacco Alcohol Medications Stress/hormonal changes Genetics Infections Immunosurpressed Anemia Bowel disease Autoimmune disease
Define Hyperkeratinisation
Excessive growth of stubbornly attached keratin
Reasons for Hyperkeratinisation
Genetic
Physiological
Pre-cancerous
CA
Types of Local Oral Infections
Dental caries/acute pulpits Gingivitis/periodontitis Dental abscess Necrotizing periodontal disease Ludwig's angina Cold sores Herpangina Thrush Hairy tongue
Cause of Dental Caries/Acute Pulpitis
Stretococcus mutans
Other bacteria
Pathophysiology of Dental Caries/Acute Pulpitis
Destruction of the enamel
Progresses into dental pulp
Symptoms of Dental Caries/Acute Pulpitis
Hot/cold sensitivity
Continuous throbbing pain
Prevention of Dental Caries/Acute Pulpitis
Fluoride Brushing Flossing Mouthwashes Routine cleanings
Treatment of Dental Caries/Acute Pulpitis
Simple caries: restoration
Pulpitis: antibiotics and NSAIDs
High Risk Populations for Dental Caries/Acute Pulpitis
Chemotherapy
Diabetics
Zerostomia secondary to other source
Define Gingivitis
Inflammation of marginal gingiva (gums)
Etiology of Gingivitis
Anaerobes
Pathology of Gingivitis
Gingival soft tissue inflammation/infection
Signs/Symptoms of Gingivitis
Edema
Erythema
Pyorrhea
Pain
Treatment of Gingivitis
Penicillin or Clindamycin
NSAID
Prevention of Gingivitis
Brushing/flossing
Antibacterial mouth rinses
Removal of impacted food debris
Routine dental visits
Signs/Symptoms of Acute Necrotizing Ulcerative Gingivitis
Halitosis
Ulcerations of the interdental papillae
Treatment of Acute Necrotizing Ulcerative Gigivitis
Penicillin (PO) + Metronidazole
Clindamycin (alone)
Pathophysiology of Ludwig’s Angina
Rapidly spreading cellulitis of sublingual and submandibular spaces
Signs/Symptoms of Ludwig’s Angina
Febrile
Drooling/trismus
Edema in sublingual area
Treatment of Ludwig’s Angina
IV antibiotics
Penicillin or Unasyn + metronidazole (Flagyl)
Presentation of Herpetic Lesions
Cold sores or painful vesicles on tongue/buccal mucosa
Etiology of Herpetic Lesions
HSV-1
HSV-2
Treatment for Herpetic Lesions
Acyclovir
Valacyclovir
Etiology of Herpangina
Coxackie virus
Clinical Features of Herpangina
Painful Fever Malaise Sore throat Vesicles on soft palate
Treatment of Herpangina
Supportive
Analgesics
Etiology of Oral Candidiasis (Thrush)
Candida species
High Risk Populations for Oral Candidiasis (Thrush)
Neonates
Prolonged antibiotic use
Immunocompromised
Signs/Symptoms of Oral Candidiasis (Thrush)
White plaques on tongue/oral mucosa
“Burning” tongue
“Raw” throat
Treatment of Oral Candidiasis (Thrush)
Topical clotrimazole troches
Topical nystatin
Oral fluconazole
Define Hairy Tongue
Elongations of filiform papillae of dorsal surface
Etiology of Aphthous Stomatitis (Ulcers)
Auto-immune
CMV
Hormones
Nutritional deficiency
Management of Aphthous Stomatitis (Ulcers)
Sucralfate (Carafate) Acidophilus Folate Vitamin B12 Stress relief Licorice Corticosteroids
Define Geographic Tongue
Rapid loss and regrowth of filiform papillae causes denuded red patches to “wander” across the surface of the tongue
Pathophysiology of Oral Leukoplakia
Benign epithelial hyperplasia
Strongly associated with HIV
Clinical Signs of Oral Leukoplakia
Asymptomatic lesions on the lateral surfaces of tongue
Treatment for Oral Leukoplakia
High dose acyclovir
Etiology of Oral Cancer
Tobacco
Alcohol
HPV
Detection of Oral Cancer
Ulcerative oral lesions with fail to resolve in 2 weeks should be biopsied
Oral Side Effects of Medications
Xerostomia
Pigmentation changes
Hyperplasia
Mucositis
Causes of Halitosis
Bronchiectasis Lung Abscess Acute primary herpetic gingivostomatitis Acute necrotizing ulcerative gingivitis periodontal disease Dental caries Smoking Hepatic failure Azotemia DKA H. pylori gastric infection Esophageal CA Metal poisoning
Pharmacologic Causes of Xerpstomia
Diuretics
Antihistamines
TCA’s
Clinical Presentation of Xerostomia
Oral dryness Burning of the tissues Difficulty eating/swallowing Tongue irritation Painful ulcerations Increased caries Increased periodontal disease
Treatment of Xerostomia
Saliva substitutes
Salivary stimulation
Pigmentation Change Causes
Tetracycline Sedative OCP Antimalarials Amalgam tattoo Heavy metal pigmentations
Medications which may cause gingival hyperplasia
Phenytoin
Calcium Channel Blockers
Cyclosporin
Etiology of Mucositis
Chemotherapy
Radiation to H&N
Clinical Manifestations of Mucositis
Edema
Painful chewing/swallowing of food
Oral Problems with Diabetic Patients
Acute gingival abscess Gingival proliferations Dry burning mouth Gingival tenderness/bleeding lip dryness Tooth mobility Periodontal disease
Prevention of Oral Disease in Diabetics
Tight glucose control
Oral Problems with Pernicious Anemia
Glossitis
Oral Problems with Iron Deficiency Anemia
Glossitis
Angular cheilits/stomatitis
Oral Problems with Vitamin Deficiencies
Oral mucositis Ulcers Glossitis Burning sensation in the tongue Petechiae Gingival swelling/bleeding Teeth loosening Ulcerations
Signs/Symptoms of Mononucleosis
Palatal petechiae
Pharyngitis
Lethargy
Sore throat
Oral Problems with AIDS/HIV Infections
Oral candidiasis Necrotizing ulcerative periodontal disease Stomatitis Hairy Leukoplakia Oral Lymphoma Oral Kaposi's sarcoma
Signs/Symptoms of Acute Leukemia
Gingival bleeding Necrotic Ulcers Gingival Enlargement Bluish gingival appearance Oral infections Marked discomfort
Oral Symptoms After Radiation
Mucositis with ulcers, candidiasis, bacterial infections, and xerostomia
Presentation of Cheilosis (cheilitis)
Inflammation and/or fissuring of the lips
Etiology of Cheilosis (cheilitis)
Environmental irritation
Metabolic/Nurtritional
Poor fitting dentures
Infection
Management of Cheilosis (cheilitis)
Eliminate cause
Main Pathophysiology of Sialoadenitis
Infections of salivary glands may be viral (mumps) or bacterial (secondary to obstruction)
Clinical Presentation of Sialoadenitis
Edema
Pain
Purulent drainage
Clinical Presentation of TMJ Dysfunction
Female adults Unilateral pain Difficulty chewing or opening mouth widely Burning sensation of tongue/palate Buxism Tinnitus Vertigo Acute tenderness over TMJ
Management of TMJ Dysfunction
Physiotherapy
Pureed diet 1-2 weeks
Analgesics
Muscle relaxants
