Systemic Disease And The Mouth Flashcards
Hutchinson teeth are abnormal permanent upper central incisors that are peg-shaped and notched, usually with obvious thinning and discoloration of enamel in the area of the notching; they are widely spaced and shorter than the lateral incisors; the width of the biting surface is less than that of the gingival margin. What condition is this characteristic of
Congenital infeciton e,g syphillis
What is porphyria and what affect can it have on the teeth
a rare hereditary disease in which there is abnormal metabolism of the blood pigment haemoglobin. Porphyrins are excreted in the urine, which becomes dark; other symptoms include mental disturbances and extreme sensitivity of the skin to light.
This change in the amount of HAEM and product in the blood can be encompassed into the dental tissues p giving a darker appearance
If you see giant cells lesions what systemic function would you want to check
Check parathyroid function - these lesions could be a result of excess parathyroid stimulation of osteoclasts
Radiographically how might hyperparathyroidism be seen?
Loss of lamina dura
Addisons disease can cause raised levels of ACTH how may this manifest in the mouth and why
Raised levels of ACTH stimulates melanin and can cause a reactive Melanosis of the mucosa
How can you screen for chrons and what’ group is this unreliable in
Facecal calprotecin assay
- inflammatory protein calprotectin will be released into the bowel if disease is present
Raised calproteicn in young child could be due to a variety of causes as they as constantly being exposed to new pathogens so not reliable
Why is growth monitoring for children taken as part of chrons screening
If the patient as active small bowel chrons - they will fail to resorb nutrients correctly and this will reduce thier rate of growth
What is orofacial granulomatotis managed
3 month empirical dietary exclusion ; benzoate and cinnamon
Topical treatment to angular cheltitis ; miconazole
Topical treatment to lip or facial erythema - tacrolimus
Lupus and lichen planus present in the mouth similarly what is one clincal feature that could distinguish them and how are they confirmed
Lichen planus does not tend to present on the palate however in lupus there can be a connective tissue band seen
They are differed by immunogical assays of the blood
Patient presents to you with cluster of ulceration on dorsum of the tongue
What is this likely to be and why?
This is KERATINISED tissue and therefore this is not apthous ulcers - so viral replcation
Likely to be herpes simplex on tongue but this is unusual
What medication can cause shallow painful ulcers on the tongue that have no erythematous halo
Nicorandil - angina medciation
What type of hypersensitivity reaction is happening in angio-oedema
Type 1
Dengranulation of mast cells in response to an allergen
Vasoactive compounds into tissues increase- leading to vascular permeability - increase in fluid exudate
What are some clincal signs of OFG
Significant erythema or perioral tissues
Full thickness gingivitis
Bilateral angular chelitis - both lips swollen and fissured
Swelling in FOM - staghorning
Linear ulcer at depth of sulus - when biopsed will be filled with granulomatous disease
