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ENT > Oral Facial Lecture > Flashcards

Oral Facial Lecture Flashcards

1
Q

What are some primary factors contributing to oral disease?

A
  • smoking
  • alcohol
  • systemic dz = infections, DM, anemia, bowel dz, autoimmune dz
  • medications (dexamethasone)
  • stress/hormonal changes
  • genetics
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2
Q

What is oral frictional hyperkeratosis?

A

-excessive growth of stubbornly attached keratin.

habit of cheek biting, chewing or tongue thrusting

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3
Q

what are some broad causes that may cause oral dz?

A
  • local infection
  • mucosal dermatologic changes
  • halitosis
  • pharmaceutical-induced changes
  • systemic dz manifestations
  • dental trauma
  • Ca channel blockers (may cause swollen gums)
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4
Q

Examples of Local infections

A
  • dental caries/acute pulpitis
  • gingivitis/periodontitis
  • dental abscess
  • necrotizing periodontal dz (Vincents angina)
  • Ludwigs angina
  • fever blister or cold sores
  • herpangina
  • thrush
  • hairy tongue
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5
Q

MC bacterial cause of dental caries?

A

streptococcus mutans

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6
Q

Dental Caries/Acute pulpitis

  • sx
  • prevention
  • tx
  • high risk population
A

Sx: hot/cold sensitivity, continuous throbbing pain

Prevention: flouride, brushing, flossing, mouthwash, routine cleanings

Tx: simple caries: restoration
Pulpitis: abx and NSAIDS, root canal may be necessary

High risk populations: chemotherapy, diabetics, xerostomia

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7
Q

Gingitivits/periodontis

  • cause
  • sx
A

cause: anaerobes
sx: usually painless, increased bleeding with brushing, soft tissue separation (pocket formation)

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8
Q

Periodontal abscess

  • sx
  • tx
  • prevention
A

sx: edema, erythema, pyorrhea, pain

Tx: oral abx (PCN or clindamycin) and NSAIDS prn.

Prevention: good oral hygiene

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9
Q

Acute necrotizing ulcerative gingivitis

  • aka
  • sx
  • tx
A

aka: vincents angina (Trench mouth)
- sx: halitosis, ulcerations of the interdental papillae
- Tx: PCN + metronidazole, clindamycin

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10
Q

Ludwigs Angina

  • what this?
  • sx
  • tx
A

What: rapidly spreading cellulitis of sublingual and submandibular spaces. grape fruit under the jaw.

Sx: febrile, drooling, trismus, edema in Sublingual area spreading down the neck.

Tx: PCN or ampicilling/sulbactam (unasyn) plus metronidazole

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11
Q

Herpetic lesions

  • presentation
  • etiology
  • tx
A

presentation: Cold sores or painful vesicles on tongue/buccal mucosa, white coated tongue, ulcerative gingivitis, lip and facial lesions.
etiology: HSV1 or 2

Tx: acyclovir or valacyclovir

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12
Q

Herpangina

  • etiology
  • sx
  • tx
A

etiology: picornovirus specifically coxsackie virus

Sx: PAINFUL*, fever, malaise, sore throat, vesicles on the soft palate, last 7-10days

Tx: supportive (analgesics)

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13
Q

How long must lesions be present to be considered potentially cancerous?

A

2weeks

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14
Q

Oral Candidiasis

  • etiology
  • sx
  • tx
A

etiology: candida sp from prolonged abx use, immunocompromised pts, and neonates.
sx: white plaques on tongue/oral mucosa, “burning tongue”, “raw throat”

Tx: topical fungal: clotrimazole or nystatin

oral: fluconazole (diflucan)

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15
Q

Hairy tongue

-what is this?

A

-elongation of filiform papillae, coloration of black hairy tongue is d/t tobacco, food, or infection with chromogenic organisms (MC fungi)

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16
Q

Aphthous stomatitis

  • aka
  • etiology
  • management
A

Aka: canker sore

Etiology: autoimmune process, CMV, hormones, nutritional deficiencty (Vit B def)

Management: vit B12, stress relief, licorice, corticosteroids, folate, acidophilus, sucralfate

17
Q

Geographic tongue

  • sx
  • pathophys
A

sx: asymptomatic
pathophys: rapid loss and regrowth of filiform papillae causes denuded red patches to “wander” across the surface of the tongue.

18
Q

Oral leukoplakia

  • pathophysiology
  • sx
  • tx
A

patho: benign epithelial hyperplasia (white growths along the side of the tongue)
sx: asymptomatic lesions on the lateral surfaces of the tongue
tx: acyclovir (zovirax)

19
Q

Oral Cancer

-etiology

A

etiology: tobacco, ETOH use, HPV

20
Q

Potential oral side effects of pharmaceuticals?

A
  • xerostomia
  • pigmentation changes
  • hyperplasia
  • mucositis
21
Q

Causes of Halitosis

A

Lower resp infections: bronchiectasis, lung abscesses

oral infection: acute primary herpetic gingivostomatitis, acute nectrozing ulcerative gingivitis, periodontal dz, dental caries

smoking

hepatic failure (fishy)

azotemia (ammonia)

DKA

H. pylori gastric infection

esophageal cancer

metal poisoning (garlicky)

22
Q

Xerostomia

  • pharmological causes
  • sx
  • tx
A

cause: diuretics, drugs with anticholinergic effects (antihistamines, TCAs)
sx: oral dryness, burning of tissues, diff eating or swallowing, tongue irritation, painful ulceration, progressively increasing caries and periodontal dz
tx: saliva substitutes, salivary stimulation with sugarless hard candies …. biotiene may give some wetting of the mouth.

23
Q

what do tetracyclines, sedatives, antimalarials, amalgam tattoo, oral birth control, and heavy metal pigmentation have in common?

A

-causes pigmentation changes of the gums, teeth, or tongue.

24
Q

What medications cause gingival hyperplasia? tx?

A
  • phenytoin, ca channel blocker, and cyclosporine

tx: surgical removal of the tissue is effective but hyperplasia recurs if drug is continued.

25
Q

Mucositis

  • etiology
  • sx
A

etiology: chemo agents, radiation to head and neck cancers
sx: edema, painful chewing/swallowing of food.

26
Q

Diabetes can cause what oral problems? Prevention?

A

peridontal abscess

gingival hypertrophy

dry burning mouth

gingival tenderness /bleeding

lip dryness

tooth mobility

peridontal dz

Prevention: tight glycemic control

27
Q

Anemia:

-sx of Pernicious anemia (vit B12 def) and iron deficiency?

A

Pernicious: glossitis: smooth, beefy-red, and sore/tender tongue.

Iron deficiency:
–glossitis: reddened, edematous, smooth, shiny, and tender tongue & angular cheilitis/stomatitis: erosion, tenderness and edema at corners of mouth

28
Q

Tooth loosening and ulcerations are MC in what disorder?

A

-vitamin C deficiency

29
Q

Mononucleosis

-signs and sx

A

hard palate petechiae, pharyngitis (w/ or w/o exudate), lethargy, sore throat

30
Q

What oral dz is pathopgnomonic for HIV/AIDS

A

oral kaposi’s sarcoma and oral lymphoma

31
Q

Acute Leukemia

-sx

A

-gingival bleeding, necrotic ulcers, gingival hyperplasia, bluish gingival appearance

32
Q

Cheilitis

  • what is this?
  • cause
  • tx
A

What: inflammation and/or fissuring of the lips

cause:
- chapping
- metabolic/nutritional
- poor fitting dentures
- infection

tx:
eliminate the cause

33
Q

Sialoadenitis

  • what
  • sx
A

What; infection of salivary glands may be viral (mumps) or bacterial.

obstructed salivary duct resulting in inflammation/infection of salivary gland.

sx:
- edema, pain, purulent drainage

34
Q

TMJ Dysfunction

  • sx
  • tx
A

Sx: unilateral pain (dull, aching, worsening as day goes on) in the jaw

  • joint crepitus
  • acute otalgia
  • diff chewing or opening mouth widely
  • bruxism* (teeth grinding)
  • tinnitus*
  • leads to changes in bite and height of teeth
  • tenderness over TMJ

Tx:

  • warm moist compress 15mins for 7-10d
  • pureed diet 1-2weeks
  • analgesics and muscle relaxants.

ENT (10 decks)

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