The mouth Flashcards
Give four signs you would look for in the mouth that could indicate disease?
- Ulceration
- Lump
- White patch
- Red Patch
Give four signs in the mouth that could indicate an iron deficiency:
• recurrent oral ulceration Oral dysaesthesia • oral candida (thrush) • angular cheilitis (cuts at the side of the mouth) • Smooth tongue
Give 6 possible reasons for an iron deficiency:
GI bleeding Excess menstrual loss Poor diet Malabsorption Malignancy
How does Chron’s disease commonly manifest in the mouth?
Recurrent mouth ulcers.
Cobblestone mucosa
Oral granulomatosis
Can also manifest as a result of a deficiency.
What is oral granulomatosis? What can cause it?
Swelling around the lips and cheeks
Can be caused by an alley, or by other disease process such as Chron’s or sarcoidosis.
How can GORD manifest in the mouth?
Dental enamel damage
Mucosal irritation and fibrosis
How long should an ulcer persist for before you refer a patient?
2 weeks.
Give 7 risk factors for oral cancer
Tobacco Alcohol Diet/nutrition HPV (for some cancers) UVL Candida Syphilis
Where are the high risk sites when looking for mouth cancer?
Soft (not keratanizing) sites such as the ventral tongue, floor of the mouth and lateral tongue
Give 6 potentially malignant lesions that can be found in the mouth:
Erythroplakia Eyrthrolekoplakia Leukoplakia Erosive lichen planus Submussous fibrosis Dyskeratosis congenita
Give 6 warning signs for oral cancer:
- Red/white/combination lesion
- Persisting ulcer
- Numbness in lips and face
- Pain in mouth or neck
- Change in voice
- Dysphagia
Give come other manifestations or oral cancer”
- Drooping eyelid or facial palsy
- Fracture of mandible
- Double vision
- Blocked or bleeding nose
- Facial swelling
What four key questions should always be asked to a person with a suspicious oral lesion?
- How long has it been there?
- Is it painful?
- Do you smoke or drink?
- What colour is the lesion?
Where does the oral cavity extend from/to and what does it contain?
It extends from the lips to the pharynx and contains the tongue teeth and gums.
What is the commonest cause of ulceration in the mouth?
Idiopathic apthous
What are GI causes of ulceration?
IBD and coeliac disease
What are infective causes of ulceration in the mouth?
Viral- HSV, HIV, coxsackie
Fungal- candidiasis
Baceterial- syphilis and TB
What are systemic diseases which can cause ulceration in the mouth?
Reactive arthritis, behcet’s syndrome, systemic lupus erythematosus
What causes transient oral white patches?
Candida infection
Occasionally seen in systemic lupus erythematosus
Mechanical, irritative or chemical trauma
What can cause persistent white patches in the mouth?
Leucoplakia- associated with alcohol and particularly with smoking- premalignant
Oral lichen planus presents as white striae
What is glossitis?
What is is associated with?
It is a red, smooth, sore tongue.
It is associated with B12, folate or iron deficiency and is also seen in infections due to candida and in riboflavin and nicotinic acid deficiency.
What is the most common cause of bleeding gums?
Chronic ginigivitis.
This follows accumulation of bacterial plaque and resolves when the plaque is removed.
Why do dental caries occur?
They occur as a result of bacterial damage to tooth structures leading to tooth decay and cavities.
The main cause in man is streptococcus mutans, which is cariogenic only in the presence of dietary sugar.
What can dental caries progress to?
Pulpitis and pulp necrosis, and spreading infection can cause dentoalveolar abscesses.
What causes erosion of the teeth?
Exposure to acid, in bulimia nervosa or rarely in patients with GORD.
Which disease associated with a bleeding disorder could cause spontaneous oral mucosal bleeding, particularly around the teeth and gums?
Leukaemia
What can cause oral effects of peptic ulcer disease?
Iron deficiency and vomiting (caused by pyloric stenosis)
What is an oral sign of coeliac disease?
Recurrent ulceration due to malabsorption
How can ulcerative colitis manifest orally?
Ulcers
Which HPV viruses are associated with oropharyngeal cancer?
HPV 16 and 18
How does the prognosis of HPV associated oropharyngeal cancer compare with non HPV oropharyngeal cancer?
It is better
