Oral Medicine

Question 1

What types of infection are seen in children?

Answer 1

• Primary herpetic gingivostomatitis
• Herpangina (Coxsackie virus A)
• Hand, foot and mouth disease
• HPV
• Candida

Question 2

What are the clinical features of primary herpes?

Answer 2

• Vesicles on mucosa and gingivae fiery red
• Ulcer 1-3mm diameter
• Mouth v painful = refuse to eat, brush teeth
• Halitosis

Question 3

What is the treatment for primary herpes?

Answer 3

Supportive only

• Fluids
• Pain control
• Bed rest
• Aciclovir = only in v early stages/ immunocompromised

Question 4

What are the clinical features of herpangina?

Answer 4

• Fever, malaise, muscle pain
• Pinhead vesicles on tonsils, uvula, soft palate
• Ulcers (heal 5-7 days)

Question 5

What are the clinical features of hand foot and mouth?

Answer 5

• Vesicular rash on limbs, fingers and toes
• Oral lesions = tongue, buccal mucosa
• Ulcers = shallow, painful, self-limiting

Question 6

What are the clinical features of HPV infection?

Answer 6

• Wart on lip/ tongue

- ‘Cauliflower appearance’

Question 7

What are main aetiologies of ulcers seen in children?

Answer 7

• Minor apthae
• Major apthae
• Trauma

Question 8

What are the clinical features of minor apthae?

Answer 8

• Recurrent ulcers on non-keratinised mucosa
• Labial/ buccal mucosa, FOM
• 1-10 in number
• Well demarcated
• Red halo, yellow base
• 1-3 weeks healing with no scarring

Question 9

What are the causes of minor apthae?

Answer 9

• Iron deficiency (growing demands, menstrual blood loss in F)
• Stress
• FH
• Genetic
• Immunological

Question 10

What are the treatment for minor aphthae ulcers?

Answer 10

• Iron replacement therapy

- Treat symptoms e.g. Difflam mw, prevent secondary infections

Question 11

What is an eruption cyst?

Answer 11

• AKA superficial dentigerous cyst
• Bluish swelling over erupting tooth
• Odontogenic origin
• Commonly seen over erupting tooth (dilation of follicular space around crown)
• Resolves when tooth erupts

Question 12

What are some features of a traumatic ulcer?

Answer 12

• Self-harm/ accidental origin
• Mucoceles common
• Lower lip
• Non-recurrent
• Less well defined (irregular outline)

Question 13

What is leukaemia?

Answer 13

• Malignant cancer of bone marrow origin

- Results in high numbers of abnormal WBC (immature- lymphoBLASTS)

Question 14

What dental presentation may be seen in a child with undiagnosed leukaemia?

Answer 14

• Gingival bleeding (excessive bleeding)
• Primary herpes appearance
• Easily bruised
• Fatigue
• Lymph enlargement

Question 15

What are some hereditary conditions (dental) seen in children?

Answer 15

• Geographic tongue
• Hereditary gingival fibromatosis
• Haemangioma

Question 16

What is the treatment for geographic tongue?

Answer 16

• No success treatment

- Treat symptoms

Question 17

What is hereditary gingival fibromatosis?

Answer 17

• Non-specific progressive enlargement of gingivae
• May be localised or generalised
• May be isolated or part of syndrome

Question 18

What are some other causes of gingical fibromatosis?

Answer 18

• Drugs = phenytoin, ciclosporin