Systemic Disease And The Mouth Flashcards

1
Q

What are the two common dental manifestations of systemic disease?

A

Disruption to tooth structure formation

Disruption to tooth structure content

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2
Q

What is this?

A

Ectodermal dysplasia

Genetic disorder affecting tissues derived from ectoderm e.g. tooth enamel, oral epithelium, sweat glands, nails and hair, epidermis

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3
Q

What dental presentations may show in someone with ectodermal dysplasia?

A

Conical shaped teeth

Hypodontia

Microdontia

Altered eruption pattern

Thin enamel

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4
Q

What is a congenital infection? What typical dental presentation may there be?

A

Infection Picked up by unborn foetus or newborn infant e.g. congenital syphillis

  • generally caused by viruses picked up by baby at any time during pregnancy / childbirth
  • changes to incisors, making them more bulbous ‘Hutchinson’s incisors’
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5
Q

What is perinatal illness? Give an example

A

Illness affecting pregnant individual or child in the weeks just before or after childbirth

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6
Q

How may perinatal illness present dentally in a child?

A

Affect laying down of cementum and enamel of tooth, and possibly the calcification of the enamel of the tooth

Dark band = hypoplastic and hypomineralised enamel and dentine

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7
Q

Why may altered pigmentation of children’s teeth be present?

A

Metabolic disease - porphyria
- Affects amount of HAEM and HAEM products in blood. These can be incorporated into dental tissues

Bilirubin pigmentation
- perinatal jaundice

External pigmentation from substances - tetracycline
- linear band of grey affecting teeth
- tetracycline no longer indicated in children

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8
Q

What are giant cell lesions?

A

Sites of large multi-nucleated giant cells within affected tissues

Peripheral
- within soft tissues surrounding maxilla and mandible

Central
- within the mandible or maxilla bone

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9
Q

Characteristics and causes of giant cell lesion?

A

Benign, localised area of tissue destruction with large multinucleated giant cells

(Within bone = central)
(Within soft tissues = peripheral)

  • response to local trauma / irritation
  • excess parathyroid function stimulating osteoclasts leading to reduced cortical Bone
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10
Q

What dental implication can hyperparathyroidism also show?

A

Loss of lamina dura around apex of tooth and all round tooth

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11
Q

How can excess ACTH occur? What dental implications?

A

Adrenocorticotropic hormone

Cushings - tumour in pituitary causes excess ACTH

Addisons - not enough cortisol produced so ACTH is high to produce more

Widespread melanin pigmentation in oral mucosa, refer to GMP for investigation into pituitary issue

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12
Q

How does OFG typically present?

A

Perioral erythema

Perioral swelling / oedema

Lip swelling

Angular chelitis

Fissured ulcer in bottom of labial sulcus, not related to trauma

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13
Q

Difference between crohns and OFG? Good test for crohns?

A

OFG with abdominal pain / altered bowel habit = oral crohns

So abdominal pain and altered bowels

Often OFG symptoms on their own around 7/8 followed by crohns symptoms appearing thereafter

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14
Q

Good test for crohns?

A

Faecal calprotectin assay
- raised

Crohns growth chart

Abdominal pain

Endoscopy

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15
Q

What is thought to cause OFG?

A

Dietary allergens
- cinnamon
- chocolate
- benzoate (tomato and tomato products)
- sorbate

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16
Q

Management of OFG?

A

3 month dietary exclusion

Topical tx of angular chelitis
- miconazole / hydrocortisone cream

Topical tx of facial swelling or erythema
- topical steroids

17
Q

Why might a patient present with haemophilic deficiencies?

A

Poor diet and dietary intake

Malabsorption due to GI disease, coeliac or crohns

Blood loss - peptic ulcer, liver disease etc

Increased demand - child growth spurts

18
Q

How can haematinic deficiencies often present to dentist?

A

Changes in recurrent ulceration patterns

Lichen planus

Burning mouth syndrome

geographic tongue

19
Q

What is angio-oedema

A

Rapid swelling of the face with multiple possible causes such as:
- drug reactions to: ace inhibitors, NSAIDS, DMARDS, penicillin
- food allergies
- insect bites or stings

  • often subsides within an hour - 24 hours
  • poor regulation of complement cascade due to inhibition of controlling enzymes