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BDS3 PAEDIATRICS > PAEDIATRIC ORAL MEDICINE > Flashcards

PAEDIATRIC ORAL MEDICINE Flashcards

1
Q

what are examples of VIRAL oro-facial soft tissue infections?

A
  • primary herpes
  • herpangina
  • hand foot and mouth disease
  • varicella zoster
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2
Q

what are examples of BACTERIAL oro-facial soft tissue infections?

A
  • staphylococcal
  • streptococcal
  • syphilis
  • TB
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3
Q

what is an example of a FUNGAL oro-facial soft tissue infection?

A

candida

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4
Q

what is primary herpactic gingivostomatitis? what causes it?

A

ACUTE INFECTIOUS DISEASE
- Herpes Simplex Virus

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5
Q

how is the herpes simplex virus transmitted?

A

transmission by droplet formation with 7 day incubation period

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6
Q

how does herpes simplex virus present in children?

A

presents as cold sores

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7
Q

what are the signs and symptoms of primary herpetic gingivostomatitis?

A
  • Fluid filled vesicles which rupture to painful ragged ulcers on gingivae, tongue, lips, buccal & palatal mucosa
  • severe oedematous marginal gingivitis
  • fever
  • headache
  • malaise
  • cervical lymphadenopathy
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8
Q

what is the treatment for primary herpetic gingivostomatitis?

A
  • bed rest
  • soft diet/hydration
  • paracetamol
  • antimicrobial gel or mouthwash
  • aciclovir for immunosuppressed children
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9
Q

how long does primary herpetic gingivostomatitis typically last & what is the most common complication of it?

A
  • Lasts 14 days
  • Dehydration most common complication
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10
Q

If primary herpetic gingivostomatitis was to reoccur in adults, how would it present? how common is this? what are the triggers?

A
  • present as herpes labialis (cold sores)
  • 50-75% recurrence rate
  • triggers = sunlight, stress, ill health
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11
Q

how are cold sores/herpes labialis treated?

A

topical acyclovir cream

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12
Q

how does herpangina present?

A

vesicles in the tonsillar/pharyngeal region

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13
Q

how long does herpangina last?

A

7-10 days

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14
Q

how does hand, foot and mouth disease present?

A
  • first presentation usually sore throat
  • followed by ulceration on the gingivae/tongue/cheeks and palate
  • maculopapular rash on hands & feet
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15
Q

how long does hand, foot and mouth disease last?

A

7-10 days

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16
Q

what is the definition of oral ulceration?

A

a localised defect in the surface oral mucosa where the covering epithelium is destroyed leaving an inflamed area of exposed connective tissue

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17
Q

If oral ulceration in present in a child, what areas of history should be investigated with regards to the lesion?

A
  • onset
  • frequency
  • number
  • size
  • site
  • duration
  • exacerbating dietary factors
  • lesions in other areas
  • associated medical problems
  • treatment so far (helpful or unhelpful?)
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18
Q

what are causes of oral ulceration?

A
  • infection
  • immune mediated disorders
  • vesticulobullous disorders
  • inherited or acquired immunodeficiency disorders
  • neoplastic/haematological
  • trauma
  • vitamin deficiencies
  • no apparent cause
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19
Q

what is the most common cause of ulceration in children?

A

recurrent aphthous ulceration

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20
Q

how does recurrent aphthous ulceration present?

A

these ulcers are round or ovoid in shape with a grey or yellow base & have a varying degree of perilesional erythema

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21
Q

what are the 3 patters of RAU?

A

Minor: <10mm
Major: >10mm
Herpetiform: 1-2mm

22
Q

what are some aetiological factors in RAU?

A
  • hereditary predisposition
  • iron deficiency
  • coeliac
  • stress
  • hormonal disturbance
23
Q

a patient presents with RAU, what would your initial investigations be?

A
  • diet diary
  • full blood count
  • haematinics (folate/B12/ferritin)
  • coeliac screen (anti-transglutaminase antibodies)
24
Q

a patient presents with RAU, how could you prevent superinfection?

A

prescribe Corsodyl 0.2% Mouthwash

25
Q

a patient presents with RAU, how could you protect the healing ulcers?

A

prescribe:
- gengigel topical gel (hyaluronate)
- gelclair mouthwash (hyaluronate)

26
Q

a patient presents with RAU, how could you help them with symptomatic relief?

A

prescribe:
- Difflam spray (0.15% benzydamine hydrochloride)
- local anaesthetic spray

27
Q

what is orofacial granulomatosis?

A

Chronic inflammatory disorder that is either idiopathic or associated with systemic granulomatous conditions:
- Crohn’s disease
- Sarcoidosis

28
Q

what is the average age of onset for orofacial granulomatosis? who is more likely to get this disease?

A

Average age of onset = 11 years old
Males > Females

29
Q

what are some clinical features of OFG?

A
  • lip swelling (most common)
  • full thickness gingival swelling
  • swelling of the non labial facial tissues
  • peri-oral erythema
  • cobblestone appearance of the buccal mucosa
  • linear oral ulceration
  • mucosal tags
  • lip/tongue fissuring
  • angular cheilitis
30
Q

what are the allergens associated with OFG?

A
  • cinnamon compounds
  • benzoates
31
Q

You suspect a paediatric patient has OFG, what investigations would you carry out in order to diagnose this patient?

A
  • measure growth (paediatric growth chart)
  • full blood count
  • haematinics
  • patch testing (ID triggers)
  • diet diary (ID triggers)
  • faecal calprotectin
32
Q

A paediatric patient has OFG, how would you manage their disease?

A
  • oral hygiene support
  • symptomatic relief as per oral ulceration
  • advise dietary exclusion (no cure but helps with inflammation)
  • manage nutritional deficiencies
  • topical steroids
33
Q

what is Geographic Tongue? how does it present?

A
  • an idiopathic and non-contagious mucosal lesion of the tongue
  • shiny red areas on the tongue with loss of filiform papillae surrounded by white margins
34
Q

what are the side effects of geographical tongue?

A
  • discomfort (especially in children)
  • discomfort with spicy foods, tomato’s, citrus fruit or juice
35
Q

how is geographical tongue managed?

A

bland diet during flare ups

36
Q

what are examples of solid swellings that may be seen in paediatric patients mouths?

A
  • fibroepithelial polyp
  • epulides
  • congenital epulis
  • HPV-associated mucosal swellings
37
Q

what is a fibroepithelial polyp?

A
  • firm pink lump
  • found mainly in the cheeks, lips or tongue
  • constant size (no change)
38
Q

what is the cause of fibroepithelial polyps?

A

thought to be initiated by minor trauma

39
Q

what are epulides?

A

common solid swellings of the oral mucosa
- benign hyperplastic lesions

40
Q

what are the main types of epulides?

A
  • fibrous epulis
  • pyogenic granuloma
  • peripheral giant cell granuloma
41
Q

how do pyogenic granuloma’s present? what is the cause?

A
  • soft, deep red/purple swelling
  • often ulcerated
  • haemorrhage spontaneously or with mild trauma
  • probably a reaction to chronic trauma?
42
Q

how do peripheral giant cell granulomas present?

A
  • pedunculated or sessile swelling
  • dark red & ulcerated
  • usually arises interproximally & has an hour glass shape
43
Q

what are congenital epulis lesions?

A

very RARE lesion that occurs in neonates
- most commonly found on anterior maxilla
- granular cells covered with epithelium (large & closely packed)
- benign

44
Q

what are examples of HPV associated swellings?

A
  • verruca vulgaris
  • squamous cell papilloma
45
Q

what HPV types causes verruca vulgaris?

A

HPV 2 and 4

46
Q

what HPV types can cause squamous cell papillomas?

A

HPV 6 and 11

47
Q

what are mucoceles? what are the two types?

A

Benign, mucous containing cystic lesion of salivary glands
- mucous extravasation cyst
- mucous retention cyst

48
Q

what is a ranula?

A

Mucocele in the floor of the mouth

49
Q

what are Bohn’s Nodules?

A

gingival cysts that are remnants of the dental lamina
- filled with keratin
- occur on alveolar ridge
- found in neonates

50
Q

what are epstein pearls?

A

small cystic lesions found along the palatal mid-line
- thought to be trapped epithelium in the palatal raphe
- in 80% of neonates

BDS3 PAEDIATRICS (7 decks)

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