Oral Medicine Flashcards
What are the clinical signs & symptoms of primary herpes?
Vesicles on mucosa Fiery red gingivae Halitosis Painful mouth Refusal to eat & brush teeth
What is the treatment for primary herpes?
Supportive only Fluids Paracetamol/ibuprofen Bed rest Reassurance Aciclovir in early stages?
How long is the incubation period for herpangina?
2-9 day incubation
What are the signs and symptoms of herpangina?
Fever, malaise, muscle pain
Pinhead vesicles (larger ulcers) on tonsils, uvula and soft palate
No gingivitis
What are the clinical signs of hand foot and mouth?
Vesicular rash on limbs, fingers and toes
Oral lesions on tongue or buccal mucosa
Ulcers are shallow, painful and self-limiting
What is the cause of HPV?
Verruca vulgaris
Papillomas
Focal epithelial hyperplasia (Hecks disease)
What are the clinical signs of HPV?
‘Cauliflower’ appearance of gingivae
Localised
Increased incidence in immunocompromised
Warts on lips and tongue
What are the three types of ulceration?
Minor apthae
Major apthae
Trauma
What causes minor apthae?
Stress
Family history
HLA type
Immunological-altered T cell ratio
What are minor apthae?
Recurrent ulcers on non-keratinised mucosa
Usually 1-10 in number and heal in 1-3 weeks
Do not leave scarring
Most common in 2nd decade of life
What is the treatment for minor apthae?
Short term - no Rx
Long term - topical steroids, beclomethazone inhaler
What is major apthae?
Ulcers that are persistent - can last up to 3 months
Usually seen in older patients
Heal with scarring
What is an eruption cyst?
A blue coloured cyst (dilation of follicular space around crown) that forms superficial to the crown of an erupting tooth
Compressible
Can become infected
Usually resolves when tooth erupts
When and where are eruption cysts most common?
Age 2-6 years
Maxilla
What are the clinical signs of a traumatic ulcer?
Non-recurrent
Less well defined
Irregular outline
What is a ranula?
A type of muco else found on the floor of the mouth.
A swelling of connective tissue consisting of collected mucin from a ruptured salivary gland caused by local trauma.
What is geographic tongue?
Red zones of depapillation on the tongue that move around. White margins due to heavy infiltration.
How would you treat a ranula?
No Rx
Surgery if necessary but caution due to lingual nerve
How would you treat geographic tongue?
Reassurance
Avoid foods that cause discomfort
Pt may grow out of it
What is a haemangioma?
A benign tumour (endothelial proliferation)
Present at birth or soon after
Grow rapidly
Most will involute spontaneously
How would you treat a haemangioma?
Cauterise or sclerose
Surgery has too high a risk of bleeding
What is a fibro-epithelial polyp?
Exaggerated response to trauma
Squamous cell epithelium overlying fibrous CT
What is a pyogenic granuloma?
Fibro-endothelial growth from the gingival margin
Red/purple, very vascular
Mimics haemangioma
What is the cause of orofacial granulomatosis?
Allergy
Mycobacterium
Autoimmune
What are the signs of orofacial granulomatosis?
Lip swelling Cobblestone mucosa Deep penetrating ulcers Mucosal tags Gingivitis Pyostomatitis (formation of micro abscesses under the mucosa)
What would a biopsy of orofacial granulomatosis show?
Biopsy showing non-caseating granulomas
Langhans type giant cells
Lymphocytic infiltrate
What is the treatment for orofacial granulomatosis?
Patch testing
Dietary avoidance
Systemic steroids
What is hereditary gingival fibromatosis?
Non-specific progressive enlargement of gingiva
May be localised or generalised
May be isolated or part of a syndrome
