Viral Infections Of Oral Cavity

Question 1

Viral infections of the oral cavity?

Answer 1

Herpes simplex
Herpes zoster
Varicella zoster
Hand foot and mouth
Mumps
Infective mononucleosis- glandular fever

Question 2

Varicella zoster; who is it most common in? Signs and symptoms? Management?

Answer 2

• Common in children
• Vesicular and itchy papules but painless, fever and malaise
• Self managed; hydration, good diet, plenty of rest and NSAIDS (paracetamol/ibruprofen)

Question 3

What is the primary and reactivation of varicella zoster?

Answer 3

Chickenpox is primary infection and shingles is the reactivation

Question 4

How does shingles present, who is it common in and what is the patient management?

Answer 4

Prevents as rash like 1 side of face or back.
Usually triggered by trauma, drugs or immunosuppressants
More common in elderly
Self manage; hydration, balanced diet, NSAIDS, rest

Question 5

What is Ramsay hunt?

Answer 5

Shingles of facial nerve
Rare
Unilateral facial palsy
Painful and can lead to paralysis or hearing loss on 1 side of face

Question 6

Oral presentation of shingles?

Answer 6

Lesion of one side of mouth/tongue.
May complain of toothache due to hypersensitivity

Question 7

Which viruses are mainly caused by group A coxsackie?

Answer 7

Hand foot and mouth
Herpangina

Question 8

How is hand foot and mouth transmitted?

Answer 8

Air, coughing, sneezing, touching of contaminated objects

Question 9

Herpangina; who is it most common in? How is it transmitted? Signs and symptoms? Management?

Answer 9

Common in children 3-10
Transmitted orally or through droplets
Ulcer sores on soft palate, malaise and sort throat
Self managed with; NSAIDS, rest, hydrations, soft diet

Question 10

What diseases are often cause by Epstein Barr virus?

Answer 10

Infective mononucleosis
Burkitts lymphoma
Nasopharyngeal carcinoma

Question 11

Epstein Barr; who is it most common in? Signs and symptoms? Management?

Answer 11

Most common in early childhood
Lies dormant and people remain infected without any symptoms
Sore throat, fever, fatigue, swollen lymph nodes
Self manage; NSAIDS, rest, hydration, soft diets

Question 12

How to differentiate between Herpangina and gingival stomatitis?

Answer 12

Gingival stomatitis has ulcers/vesticles more anteriorly and Herpangina is more on the soft palate

Question 13

Paramyxoviridae viruses?

Answer 13

Measles, mumps

Question 14

Mumps; who is it most common in? Signs and symptoms? Management?

Answer 14

Usually a childhood illness
Painful swelling of parotid salivary glands lasting 1-2 weeks, difficultly chewing, tiredness, fatigue
Takes 2-3 weeks for symptoms to appear
Self managed; rest, hydration, NSAIDS, soft diet

Question 15

How does mumps transmit?

Answer 15

Coughing, sneezing, talking

Question 16

What is the most highly infectious disease known?

Answer 16

Measles

Question 17

Measles; transmittion? Signs and symptoms? Management? Common in?

Answer 17

Air, droplets, surface touching
Exanthematous rash - can appear in mouth
Enters through respiratory tract
Headache, fever, sore throat, Kopliks spots
Most common in children

Question 18

Herpes simplex 1 and 2 differences

Answer 18

Herpes simplex 1 causes orofacial lesions or above the belt.
Herpes simplex 2 causes genital lesions or below the belt.

Question 19

What is the primary and secondary herpes simplex 1?

Answer 19

Primary; Primary gingivostomatitis, herpetic whitlow.

Secondary; cold sores - herpes labialis

Question 20

What stimulates the reactivation of herpes simplex 1?

Answer 20

Stress
Trauma
Sunlight
Menstruation
Immunosuppression
Fatigue

Question 21

What is encephalitis?

Answer 21

Swelling of brain, can lead to death

Question 22

Where does herpes labialis lie dormant?

Answer 22

Trigeminal ganglion (nerve bundles) until reactivated

Question 23

What do we advise patients with cold sores to do?

Answer 23

Rearrange their appointment due to transmission risk

Question 24

Common methods advised to patients to alleviate symptoms?

Answer 24

Eat cool and soft foods
Avoid triggers if any
NSAIDS
Cold compress
Sun block
Hydration
Rest

Question 25

Herpes simplex/labialis; Signs and symptoms?

Answer 25

• Tingling, burning or itchy area around the mouth
• Red fluid filled blister on lip, gum or around mouth that break open and leak
• Turn yellow, crust and heal within 10-14 days
• Sore throat, fever, swollen glands

Question 26

Herpes simplex/labialis patient management?

Answer 26

• Rearrange dental appointment for patient comfort and for risk of transmission
• recommend; rest, hydration, uv protection, soft diet, anti viral creams, no kissing, no oral sex, use tissue when coughing/sneezing, good hand hygiene

Question 27

Additional advice for viral infections in oral cavity?

Answer 27

Isolation
No kissing or oral sex
Use a tissue
No sharing cutlery, food or towels
Do not touch area to avoid spreading
Good hand hygiene and cleaning practices

Question 28

Why is it best to reschedule a patients appointment is the were infected with herpes labialis?

Answer 28

The risk of spreading the virus is quite high with the use of aerosol instruments. Even without aerosol, the risk of reopening the cold sore if high and therefore increasing the transmission risk so best to avoid until area has healed.