Oral Medicine Flashcards
what are 3 viral causes of orofacial soft tissue infections
primary herpes
herpangina
hand foot and mouth
what are the bacterial causes of orofacial soft tissue infections
staphylococcal
streptococcal
syphilis
what is primary herpetic gingivostomatitis caused by
HSV 1
what are the signs and symptoms of primary herpetic gingivostomatitis
fluid filled vesicles
severe oedematous marginal gingivitis
fever
headache
malaise
cervical lymphadenopathy
how do you treat primary herpetic gingivostomatitis
bed rest
soft diet/hydration
paracetamol
antimicrobial gel or mouthwash
aciclovir for immunocompromised
how long does primary herpetic gingivostomatitis last
14 days
what is primary herpetic gingivostomatitis triggered by
sunlight
stress
other causes of ill health
what causes herpangina and hand, foot and mouth
coxsackie A virus
what is herpangina
vesicles in the tonsillar/pharyngeal region lasting 7-10 days
what is hand, foot and mouth
ulceration on gingivae/tongue/cheeks and palate
maculopapular rash on hands and feet
lasts 7-10 days
what are the 10 key facts of oral ulceration
onset
frequency
number
site
size
duration
exacerbating dietary factors
lesions in other areas
associated medical problems
treatment so far
what are the causes of oral ulceration
infection
immune mediated disorders - crohns
vesiculobulbous disorders
inherited or acquired immunodeficiency disorders
neoplastic/haematological
trauma
vitamin deficiencies
recurrent aphthous stomatitis
what do recurrent aphthous ulcerations look like
round or ovoid in shape with grey or yellow base
what are the 3 patterns of recurrent aphthous ulcers
minor
major
herpetiform
what are the aetiological factors for recurrent ulceration
hereditary predisposition
haematological and deficiency disorders
GI disease
minor trauma in susceptible individual
stress
allergic disorders
hormonal disturbance
what investigations for recurrent ulcers
diet diary
FBC
haematinics
coeliac screen
how do you manage recurrent ulcers
diet analysis
low ferritin - 3 months iron
low folate/B12 - refer to paediatrician
what are exacerbating factors with ulcers
nutritional deficiencies
traumatic factors
sharp or spicy food
what pharmacological managementfor ulcers is available in GDP
prevention of superinfection - corsodyl
protect healing ulcers - genigel topical gel
symptomatic relief - difflam spray/LA spray
what is orofacial granulomatosis
non caseating giant cell granulomas which can either occur with or without crohns disease
what are the clinical features of OFG
lip swelling
full thickness
swelling of non-labial facial tissues
peri-oral erythema
cobblestone appearance of buccal mucosa
liner oral ulceration
mucosal tags
lip/tongue fissuring
angular cheilitis
what are investigations for OFG
measure growth
FBC
haematinics
patch testing
diet diary
faecal calprotectin
how do you manage OFG
symptomatic relief for oral ulcers
dietary exclusion
manage nutritional deficiencies
topical steroids
oral steroids
what is geographic tongue
shiny red areas on tongue with loss of filliform papillae surrounded by white margins
what can geographic tongue cause in children
intense discomfort
discomfort with spicy food/tomato or citrus fruit and juice
how do you manage geographic tongue
bland diet during flare ups
what are the 4 main types of solid swellings
fibroepithelial polyp
epulides
congenital epulis
HPV associated mucosal swellings
what is a fibroepithelial polyp
firm pink lump mainly in cheeks, lip or tongue which remains a constant size
what is fibroepithelial polyp initiated by
minor trauma
how do you cure fibroepithelial polyp
surgical excision
what is epulides
common solid swelling of oral mucosa
benign hyperplastic lesions
what are the 3 main types of epulides
fibrous epulis
pyogenic granuloma
peripheral giant cell granuloma
what is a fibrous epulis
pedunculated or sessile mass
firm consistency
similar colour to surrounding gingivae
inflammatory cell infiltrate and fibrous tissue
what is a pyogenic granuloma
soft deep red/purple swelling which is often ulcerated and can haemorrhage easily
what is a peripheral giant cell granuloma
pedunculated or sessile swelling
typically dark red and ulcerated
arises interproximally and has an hour glass shape
what is a congenital epulis
rare lesion in neonates in anterior maxilla
granular cells covered with epithelium but it is benign
what are the 2 types of HPV associated swellings
verruca vulgaris and squamous cell papilloma
what is a verruca vulgaris
solitary or multiple intra oral lesions associated with skin warts
most commonly on keratinised tissue but can be removed surgically
what is a squamous cell papilloma
small pedunculated cauliflower like growths which are benign
what are the 4 main types of fluid swelling
mucoceles
ranula
bohns nodules
epstein pearls
what are the two variants of mucocele
mucous extravasation cyst
mucous retention cysts
what is a ranula
mucocele but in floor of mouth
what do ranulas arise from
minor salivary glands or ducts of sublingual/submandibular gland
what investigations are needed for a ranula
ultrasound or MRI
what are bohns nodules
gingival cysts filled with keratin on alveolar ridge
remnants of dental lamina
what are epstein pearls
small cystic lesions found along palatal mid line
what is TMJDS characterised by
pain
masticatory muscle spasm
limited jaw opening
what is the history for TMJDS
description of presenting symptoms
when did discomfort begin
pain worse at any time during the day
exacerbating factors
habits
stress
how do you examine TMJDS extraorally
palpation of muscles of mastication both at rest and when teeth clenched
palpation of TMJ at rest and when opening and closing
check for deviation of jaw
extent of normal opening
what is intraoral exam of TMJDS
assessment of dental wear facets
signs of clenching/grinding - scalloped tongue/buccal mucosa ridges
how do you manage TMJDS
explain condition
reduce exacerbating factors
bite raising appliance
allow over worked muscles to rest - soft diet
what is used for symptomatic relief of TMJDS
ibuprofen
alternating use of hot and cold packs
