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BDS4 Oral Medicine > 22 - Systemic disease and the mouth > Flashcards

22 - Systemic disease and the mouth Flashcards

1
Q

What are the common reasons for dental manifestations of systemic disease in children?

A
  • congenital conditions or infections
  • illness or metabolic disorder
  • pigmentation from substance in the blood
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2
Q

Give an example of a congenital condition or infection that has a dental manifestation.

A
  • syphilis
  • TORCH infection
  • ectodermal dysplasia
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3
Q

What is a TORCH infection?

A

T - toxoplasmosis
O - other ie syphilis, Hep B
R - rubella
C - cytomegalovirus (CMV)
H - herpes simplex

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4
Q

Give an example of an illness or metabolic disorder that has a dental manifestation.

A
  • severe childhood illness
  • cancer treatment
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5
Q

Give an example of pigmentation from substances in the blood that have a dental manifestation.

A
  • bilirubin (jaundice)
  • tetracycline (antibiotics)
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6
Q

How does ectodermal dysplasia present orally?

A
  • hypoplasia
  • hypodontia
  • can have affect on salivary glands
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7
Q

What are Hutchinson’s incisors?

A
  • caused by syphilis infection
  • permanent teeth are peg like
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8
Q

What presentation can perinatal illness have?

A
  • calcification across teeth is affected
  • seen at different stages of development
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9
Q

What is porphyria?

A
  • rare metabolic disease that allows porphyrins to build up in the blood
  • teeth are discoloured red/brown
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10
Q

How does high levels of bilirubin present orally?

A
  • teeth are discoloured yellow/green
  • must be significant jaundice for several years
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11
Q

How does tetracycline staining present?

A
  • dark band across teeth if antibiotic is taken for a long period during tooth development
  • these antibiotics are not recommended for children
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12
Q

How can systemic disease present with oral mucosal changes?

A
  • giant cell granuloma
  • oralfacial granulomatosis
  • RAS
  • dermatoses (lichen planus)
  • immune deficiency
  • drug reactions
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13
Q

What are giant cell granulomas?

A
  • osteoclast related lesions that can be seen on radiograph
  • can form due to irritation
  • parathyroid function should be checked
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14
Q

What is the result of hyperparathyroidism?

A
  • loss of cortical bone
  • PTH is released in excess to raise serum calcium by activating osteoclasts
  • can be seen in oral radiographs by the loss of lamina dura
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15
Q

How does Addison’s disease manifest orally?

A
  • pigmentation of the mucosa
  • caused by raised ACTH which stimulates melanocytes to cause reactive melanosis
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16
Q

What effects do haematinic deficiencies have orally?

A
  • oral ulceration
  • painful tongue
17
Q

What is orofacial granulomatosis?

A
  • peri-oral erythema and swelling
  • associated with the ginger gene and dietary allergens
18
Q

What is oral presentation of orofacial granulomatosis?

A
  • perioral erythema
  • lip swelling
  • lip fissures
  • angular cheilitis
  • erythematous full thickness gingivitis (not plaque induced)
  • stag horning
  • linear ulceration along labial sulus (not related to trauma)
19
Q

Define stag horning in OFG.

A

Oedema of FOM

20
Q

What makes up a Crohn’s screening?

A
  • altered bowel habits or abdominal pain
  • growth monitoring
  • faecal calprotectin
21
Q

What allergens are associated with OFG?

A
  • benzoates
  • sorbate
  • cinnamon
  • chocolate
22
Q

What is the management of OFG?

A
  • 3 month diet exclusion
  • topical treatment of of angular chelitis/fissure
  • topical treatment of lip swelling or facial erythema
23
Q

What is used for topical treatment of angular chelitis and lip fissures?

A
  • miconazole cream
  • hydrocortisone cream
24
Q

What is used for topical treatment of lip swelling or facial erythema?

A
  • tacrolimus ointment 0.03%
  • intralesional steroids to lip
  • systemic immune modulation
25
Q

How does lupus present in the mouth?

A

Similar appearance to lichen planus

26
Q

How does systemic sclerosis present in the mouth?

A
  • loss of elasticity around mouth
  • peri-oral stricture
  • dental treatment requires long term planning due to lack of access
  • low maintenance dentition required
27
Q

What vasculitis diseases present in the mouth?

A
  • giant cell arteritis
  • polyarteritis nodosa
  • Kawasaki disease
  • Wegener’s granulomatosis
28
Q

How does immune deficiency present in the mouth?

A
  • opportunistic infections
  • reactivation of HSV
  • ulceration
29
Q

What can cause haematinic deficiencies?

A
  • poor dietary intake
  • malabsorption (GI diseases eg coeliac)
  • blood loss (Crohn’s, UC, cancer)
  • increased demand (growth spurt)
30
Q

What are the common oral effects of medical therapy?

A
  • dry mouth
  • oral ulceration
  • lichenoid reaction
  • angio-oedema
  • osteonecrosis
31
Q

What is angio-oedema?

A
  • rapid swelling within an hour od perioral tissue
  • complement cascade is affected by ACE inhibitor drug
  • subsides within hours/day

BDS4 Oral Medicine (31 decks)

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