Oral Manifestations of Systemic Disease Flashcards
Extra-Oral Examination
- Facial Symmetry, speech and eye movement
- Bilateral palpation of lymph nodes and salivary glands
- Examination of TMJ
Important lymph nodes to cover
- Supraclavicular
- Up the deep cervical chain
- Submandibular
- Submental
- Pre-auricular
- Posterior auricular
- Occipital
Intra-Oral examination
- Lips
- Labial mucosa
- Buccal Mucosa
- Hard palate
- Soft palate
- Tongue (all surfaces)
- Folds at the back of the tongue
- Floor of mouth
- Gingiva
- Hard tissues
Abnormal colour of teeth. Examples and colour changes
-Tetracycline used during odontogenesis
Stains yellow to brown/grey
-Fluorosis (especially if visiting highly fluoridated areas eg Sudan)
Opaque white or brown patches
-Porphyria (rare hereditary condition)
Purplish red
-Jaundice
Yellow or greenish
-Dentinogenesis/Amelogenesis imperfecta
Purplish or brownish but increased translucency
Dental Hypoplasia examples and description
-Congenital syphilis
Notched and peg-shaped incisors
Cusps of molars may be closer together with the crown widest at the base (Moons molars)
-Severe childhood fevers
Horizontal grooves or pits particularly in the incisors
-Severe fluorosis
Rough pitting, white and brown opacities
-Severe rickets
Grooving and pitting of the enamel
-Hypoparathyroidism
Ectodermal defects leading to grooving and pitting of the enamel due to less PTH
Abnormal colour of the oral mucous membrane. examples
-Anaemia
Red beefy sore tongue
-Cyanosis
Blue pigmentation
-Jaundice
Yellowing tinge
-Keratosis
White
-Ethnicity
Brownish, darker tinge
-Amalgam tattoo, old silver point RCT, melanoma
Blue/brown patch
Excessive gingival/mucosal bleeding. Examples
-Purpura/Bruising Acute leukaemia and HIV/AIDS Steroids Excessive gingival bleeding Subcutaneous and submucosal
-Clotting disorders
Excessive gingival bleeding
Anticoagulant
Purpura not present
Acute gingivitis causes
Acute leukaemia Immunodeficiencies AIDS Agranulocytosis Uncontrolled diabetes
Gingival hyperplasia drug causes
Nifedipine
Cyclosporin
Phenytoin
Stomatitis. Systemic infections/conditions causes
Measles (in prodromal stage) Chickenpox Syphilis Herpes Zoster Herpes Simplex TB Actinomycoses Oro-facial granulomatosis/crohn's
Diseases that cause stomatitis
- Pemphigus
- Mucous membrane pephigoid
- Erythema multiforme
- Lichen planus
Apthous stomatitis causes
-Iron, vitamin B12 or folic acid deficienct
Keratosis causes
- Lichen planus
- Lupus
- Immunosupression
- Renal failure
- Tertiary syphilis
Glossitis causes
-Anaemic
Iron deficiency
-Vitamin deficiencies
Riboflavin deficiency
Malabsorption syndrome
Effects of HIV/AIDS or other immunosupressive causes
Common:
- Cervical lyphadenopathy
- Candidasis
- Kaposis sarcoma
- Hairy leucoplakia
Less common:
- Angular cheilitis
- Herpes simplex
- Recurrent ulcers
- Lymphoma
- Parotitis
- Histoplasmal ulcers
