Oral Manif Flashcards
Chronic inflammation
biofilm bacteria causing inflammation
produce cell inflammation mediators
internal stiffening can lead MI and stroke
years to elevated systemic inflammation lead to destructive effects on target tissues
systemic disease and the oral cavity
mucosal inflammation, ulceration, bleeding
opportunistic infections
xerostomia
poor wound healing, perio
hyperpituitarism - acromegaly
patient’s in 40’s enlarged hands and feet, deep voice (schwartzenager) enlarged maxilla and mandible separation of teeth and malocclusion thick lips and tongue
hyperthyroidism - grave’s disease
more common in women rosy complexion, sweating, osteoporosis bugging eyes premature loss of primary teeth, premature eruption of permanent teeth progressive caries and perio burning tongue
hypothyroidism
cretinism (kids), myxedema (adults)
autoimmune, iodine deficiency, drug induced
thick lips, enlarged tongue
delay eruption
hyperparathyroidism
primary (tumor) / secondary (kidney failure)
middle aged adults, women
elevated serum calcium and reduced serum phosphorous
uni or multilocular radiolucencies filled with giant cells
loss of lamina dura
loose teeth
hypoadrenalism
addison’s disease
autoimmune or tumor etiology
bronzing of the skin
melanotic macula said on oral mucosa
diabetes type I
early onset
destruction of beta cells of pancreas
insulin deficiency, requires insulin
poor wound healing, eyes, cardiovascular, kidneys, nerves
type II diabetes
late onset
insulin resistance (loss of receptors)
controlled by diet, exercise, oral hypogylcemics
poor wound healing, eyes, cardiovascular, kidneys, nerves
diabetes oral complications
candidiasis parotid gland enlargement xerostomia severe caries and perio abscesses and infections
anemia
reduction of circulating red blood cells associated with nutritional deficiency pallor of skin ulceration angular cheilitis erythema and atrophy burning tongue
specific anemias (thalassemia/mediterranean/cooley)
inherited (mediterranean cultures)
prominent cheekbones, prominent premaxilla, protrusion of anterior teeth
salt and pepper trabeculae, thin lamina dura, circular radiolucencies
sickle cell
inherited
weakness, shortness of breath, fatigue, joint pain, nausea
loss of trabeculae, large irregular marrow spaces
aplastic
after chemotherapy or radiation therapy
petechiae or purpuritic spots
polycythemia
increase in circulating red blood cells
more common in white men under stress
headache dizziness, pruritis
mucosa is deep red or purple, bleeds easily
neutropenia
white blood cell reduction
fever, chills, jaundice, weakness, sore throat
oral infections, necrotizing ulceration, gingival bleeding, perio, lymphadenopathy
luekemias
excess abnormal white blood cells
fever, weakness, bleeding, weight loss, anorexia
pallor of lips and gingiva, gingival enlargement, oral infections, necrotizing gingivitis, perio, bleeding, petechiae, ecchymoses
purpura
deficiency of blood platelets, platelet dysfunction
drugs, allergy, autoimmune, kidney failure, vitamin C deficiency
skin easily bruised, hemorrhagic lesions
oozing of blood at gingival margins
petechiae, hemorrhagic blisters
scaling contraindicated if lab tests do not confirm control of condition
hemophilia
blood coagulation, resulting in severely prolonged clotting time
inherited
easily bruised, hemorrhagic lesions
spontaneous bleeding, petechiae
risk of hemorrhage after scaling or surgical procedures
scaling contraindicated if lab tests do not confirm control of condition
celiac spruce
sensitivity to dietary gluten
mucosal irrational leads to general malnutrition
diarrhea, nervousness, parathesia of extremities
glossitis
ulceration of oral mucosa
immunodeficiency states
primary (genetic) or secondary (malnutrition, AIDs, chemotherapy)
frequent infections
mucositis, ulcerated mucosa, candidiasis, malignancies
frequent follow-up and education
treatments for head/neck cancer
xerostomia
mucositis, ulcerated mucosa, pain on swallowing, loss of taste, candidiasis, caries, perio
risk for osteoradionecrosis
oral evaluation and exam prior to radiation therapy
frequent follow-up and education
xerostomia
antihypertensives, antipsychotics, antihistamines, anxiolytics
mucositis, ulcers, pain, loss of taste, candidiasis, caries, perio
oral evaluation and exam
may require adjustment of drug regimen or dosage
frequent follow up and patient education
gingival hyperplasia
nifedipine, dilantin, cyclosporine caries and perio oral evaluation and exam may require surgical removal of excess tissue, adjustment of drug regimen or dosage frequent follow up and education
staining of tissues
tetracycline (irreversible internal, brownish, taken up during tooth formation)
chlorhexidine (external staining reversible, greenish discoloration of teeth and gingiva)
Dental erosions (abfraction)
GERD, bulimia, citrus products
smooth and glassy teeth
pulp exposure causes sensitivity
rinse with water after reflux/vomiting
attrition
bruxism, malocclusion, parafunctional habits
indicate stress, emotional, psychological disturbances
recurrence, restoration
abrasion
loss of tooth structure at cervical area
adverse toothbrushing or foreign objects rubbing
sensitivity
lichen planus
autoimmune syndromes bluish white lines or papules on buccal mucosa, threadlike branches psychological disturbances diabetes gi disturbances
apthous ulcer
immunological deficiencies
emotional stress, trauma
topical steroids
herpes zoster
systemic viral infection follows path of nerve axons
unique unilateral presentation
fever, lymphadenitis, pain
strophic glossitis
painful burning tongue
complete loss of papillae
bald tongue
candidiasis
fungal infection, ill-fitting dentures, debilitation, immune compromise, diabetes, and drug therapy
pseudomembranous (whites or yellow appearance, removed by cotton swab)
strophic and erythematous
angular cheilitis
fissuring and maceration at the comissures of the lips
due to bacteria and fungi
adverse drug reactions
hyperplasia
apthous ulcers, hairy tongue, herpetic lesions, fungal infections, mucositis, xerostomia
change medication, addition of new medications, alternative medications
kaposi’s sarcoma
multiple bluish nodules with hemorrhages resembling hemangiomas
tender and painful on palpation
malignant lymphomas, other cancers, part of AIDs complex
