Oral Medicine Flashcards
Name 3 Oro-facial soft tissue infections (3)
- Primary Herpes
- Herpangina
- Hand Foot and Mouth
What causes Primary Herpes?
- Herpes Simplex Virus I
* Transmitted by droplets
What are the symptoms of Primary Herpes?
- Fluid filled vesicles
- Severe oedematous marginal gingivitis
- Fever
- Headache
- Malaise
- Cervical Lymphadenopathy
How is primary herpes treated?
- Rest
- Soft diet & water
- paracetamol
- Antimicrobial Gel/mouthwash
- Aciclovir for immunocompromised children
What exacerbating factors can cause a primary herpes outbreak?
- Sunlight
- Stress
- Other causes of ill health
Herpangina & Hand Foot and Mouth are caused by which virus?
*Coxsackie A Virus
Where in the mouth does Herpangina affect?
*Vesicles in the tonsillar/Pharyngeal region
Where does Hand Foot and Mouth affect the body?
- Ulceration on the gingiva/tongue/cheeks/palate
* Maculopapular rash on the hands and feet
What is an oral ulceration?
Localised defect in the surface of the oral mucosa where the epithelium has been destroyed leaving inflamed connective tissue
What 10 things should we know about a patient with Oral Ulcerations?
- Onset
- Frequency
- Number
- Site
- Size
- Duration
- Exacerbating factors
- lesion in other areas
- associated medical problems
- Treatment so far
What can cause oral ulceration?
- Infection
- Immune mediated disorders
- Vesculobullous disorders
- inherited or acquired immunodeficiency disorders
- neoplastic/haematological
- Trauma
- Vitamin Deficiencies - iron, b12, folate
- Recurrent Apthous Stomatitis
What is the most common cause of ulceration in children?
Recurrent Apthous Ulceration
What 3 patterns does RAU take?
- Minor <10mm (heal 7-14 days)
- Major >10mm (Heal several weeks potentially)
- herpetiform 1-2mm (multiple ulcers)
What are the aetiological factors regarding RAU?
- hereditary predisposition
- Deficiency disorders
- Allergic disorders - Sodium Lauryl Sulphate
- Hormonal Disturbance
- stress
What investigations should you carry out to determine RAU?
- Diet Diary
- FBC
- Haematinics (Folate/B12/Ferritin)
- Coeliac Screen
How can you manage RAU?
- Avoid exacerbating food groups
- Iron supplementation for low ferritin
- Referral to paediatrician if low folate/B12
Orofacial Granulomatosis is associated with which disease?
*Crohns disease
What are the clinical features of OFG?
- Lip swelling
- Gingival Swelling
- Swelling of non labial facial tissues
- cobblestone appearance of buccal mucosa
- Lip/tongue fissuring
- angular chelitis
Those with OFG should avoid what?
- Cinnamon Compounds
* Benzoates
What investigations can you use to aid management of OFG?
- Measure Growth
- FBC
- Haematinics
- Patch Tests
- Diet Diary
How can OFG be managed?
- Oral hygiene support
- Dietary exclusion
- manage deficiencies
- Topical steroids
- Short courses of oral steroids
What is the most common type of mucosal lesion found on the tongue?
geographic tongue
what type of papillae are lost from geographic tongue?
filiform papillae
how can geographic tongue be managed?
Bland diet - avoid citrus/spice
What are some common causes of solid swellings?
- Fibroepithelial Polyp
- Epulides
- Congenital epulis
- HPV-Associated mucosal swellings
What is a fibroepithelial polyp?
- A benign lump
- mainly in cheeks
- Once established remains constant size
- caused by minor trauma
What is the most preferable course of treatment for a fibroepithelial polyp?
Surgical Excision
What are epiludes?
a benign hyperplastic lesions, caused by repeated irritation.
What is the preferred course of treatment for an epilude?
*excision and management of exacerbating factors
HPV can cause which associated swellings?
- Verruca Vulgaris
* Squamous Cell Papilloma
A patient with Masticatory muscle spasm, limited jaw opening and pain may have what?
*Temporomandibular Joint Dysfunction Syndrome
