Paediatric Oral Medicine

Question 1

What are the 3 types of oro-facial soft tissue infections?

Answer 1

Viral
Bacterial
Fungal

Question 2

What are the main types of VIRAL oro-facial soft tissue infections?

Answer 2

Primary herpes
Herpangina
Hand foot and mouth

Question 3

what are the main signs and symptoms of primary herpetic gingivostomatitis? (herpes on gingiva swelling inside mouth)

Answer 3

• Fluid filled vesicles that are painful when ruptured around the mouth (ulceration)
• fever
• headache

Question 4

how do you treat primary herpetic gingivostomatitis?

Answer 4

Treatment:
- rest
- hydrate and soft diet
- antimicrobial gel/mouthwash
- paracetamol

Question 5

what happens when the herpes virus isnt actively causing cold sores?

Answer 5

• Remains dormant in epithelial cells
• triggered by: sunlight, stress, ill health

Question 6

what causes herpetic gingivostomatitis?

Answer 6

herpes simplex virus 1

Question 7

what does the coxsackie A virus cause?

Answer 7

Herpangina
hand, foot and mouth ulceration

Question 8

what is herpangina and how long does it last?

Answer 8

ulceration in the tonsillar/pharyngeal region

7-10 days

Question 9

what is hand foot and mouth disease?

Answer 9

ulceration on gingivae, tongue, cheeks and palate

maculopapular rash on the hands and feet

Question 10

what are the main causes of oral ulceration?

Answer 10

infection [viral, bacterial]

immune mediated disorders [crohns, coeliac..]

vesiculobullous disorders

trauma

deficiencies (iron, b12, folate)

haematological

Question 11

What is recurrent apthous ulceration?

Answer 11

most common cause of ulceration in children

round/oval shape, painful

Question 12

what are exacerbating factors for oral ulcerations?

Answer 12

nutritional deficiencies
traumatic factors
sharp/spicy food
allergic factors

Question 13

what are pharmacological management techniques for oral ulcers?

Answer 13

• preventing further infection (corsodyl mouthwash)
• protect healing ulcers (topical gel or mouthwash)
• symptomatic relief (Local anaesthetic spray, soothing gels)

Question 14

what is orofacial granulomatosis (OFG) and its clinical features?

Answer 14

• uncommon chronic inflammatory disease
• swelling of lips mouth and face

OFG and oral crohns have identical clinical features

Question 15

what is the aetiology of OFG?

Answer 15

• largely unknown
• foreign body reactions

Question 16

how do you diagnose OFG?

Answer 16

• clinical exam
• lip biopsy not essential
• investigations: measure growth, blood count)

Question 17

how do you manage OFG?

Answer 17

can be difficult,
- oral hygiene support, topical steroids, corticosteroids, surgical intervention as a last resort

Question 18

what is geographic tongue?

Answer 18

mucosal lesion of tongue, non contagious and idiopathic (arises spontaneously)

Question 19

what are some types of solid swellings?

Answer 19

Fibroepithelial polyps (skin tag)
Epulides (hyperplasia)
Congenital epulis (benign tumour in oral cavity)
HPV-associated mucosal swellings

Question 20

what is a fibroepithelial polyp?

Answer 20

known as a skin tag, common, usually caused by minor trauma, surgical excision removes

Question 21

what are epulides?

Answer 21

common solid swelling of oral mucosa
benign hyperplasia lesions

Question 22

what are some examples of oral fluid swellings?

Answer 22

mucoceles (oral mucous cyst)
ranula (formed under tongue)
bohn’s nodules (keratin filled cyst)
epstein pearls (whitish yellow cysts)

Question 23

what are the characteristics of TMJ dysfunction syndrome (TMJDS)

Answer 23

pain
masticatory muscle spasm
limited jaw opening

Question 24

how can you manage a patient with TMJDS?

Answer 24

explain condition

reduction of exacerbating factors (avoiding clenching, stress, etc)

allow overworked muscles to rest (avoid wide opening, soft diet etc)