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Flashcards in Oral Facial Lecture Deck (34)
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1

What are some primary factors contributing to oral disease?

-smoking
-alcohol
-systemic dz = infections, DM, anemia, bowel dz, autoimmune dz
-medications (dexamethasone)
-stress/hormonal changes
-genetics

2

What is oral frictional hyperkeratosis?

-excessive growth of stubbornly attached keratin.

habit of cheek biting, chewing or tongue thrusting

3

what are some broad causes that may cause oral dz?

-local infection
-mucosal dermatologic changes
-halitosis
-pharmaceutical-induced changes
-systemic dz manifestations
-dental trauma
-Ca channel blockers (may cause swollen gums)

4

Examples of Local infections

-dental caries/acute pulpitis
-gingivitis/periodontitis
-dental abscess
-necrotizing periodontal dz (Vincents angina)
-Ludwigs angina
-fever blister or cold sores
-herpangina
-thrush
-hairy tongue

5

MC bacterial cause of dental caries?

streptococcus mutans

6

Dental Caries/Acute pulpitis
-sx
-prevention
-tx
-high risk population

Sx: hot/cold sensitivity, continuous throbbing pain

Prevention: flouride, brushing, flossing, mouthwash, routine cleanings

Tx: simple caries: restoration
Pulpitis: abx and NSAIDS, root canal may be necessary

High risk populations: chemotherapy, diabetics, xerostomia

7

Gingitivits/periodontis
-cause
-sx

cause: anaerobes

sx: usually painless, increased bleeding with brushing, soft tissue separation (pocket formation)

8

Periodontal abscess
-sx
-tx
-prevention

sx: edema, erythema, pyorrhea, pain

Tx: oral abx (PCN or clindamycin) and NSAIDS prn.

Prevention: good oral hygiene

9

Acute necrotizing ulcerative gingivitis
-aka
-sx
-tx

aka: vincents angina (Trench mouth)

-sx: halitosis, ulcerations of the interdental papillae

-Tx: PCN + metronidazole, clindamycin

10

Ludwigs Angina
-what this?
-sx
-tx

What: rapidly spreading cellulitis of sublingual and submandibular spaces. grape fruit under the jaw.

Sx: febrile, drooling*, trismus*, edema in Sublingual area spreading down the neck.

Tx: PCN or ampicilling/sulbactam (unasyn) plus metronidazole

11

Herpetic lesions
-presentation
-etiology
-tx

presentation: Cold sores or painful vesicles on tongue/buccal mucosa, white coated tongue, ulcerative gingivitis, lip and facial lesions.

etiology: HSV1 or 2

Tx: acyclovir or valacyclovir

12

Herpangina
-etiology
-sx
-tx

etiology: picornovirus specifically coxsackie virus

Sx: PAINFUL*, fever, malaise, sore throat, vesicles on the soft palate, last 7-10days

Tx: supportive (analgesics)

13

How long must lesions be present to be considered potentially cancerous?

2weeks

14

Oral Candidiasis
-etiology
-sx
-tx

etiology: candida sp from prolonged abx use, immunocompromised pts, and neonates.

sx: white plaques on tongue/oral mucosa, "burning tongue", "raw throat"

Tx: topical fungal: clotrimazole or nystatin

oral: fluconazole (diflucan)

15

Hairy tongue
-what is this?

-elongation of filiform papillae, coloration of black hairy tongue is d/t tobacco, food, or infection with chromogenic organisms (MC fungi)

16

Aphthous stomatitis
-aka
-etiology
-management

Aka: canker sore

Etiology: autoimmune process, CMV, hormones, nutritional deficiencty (Vit B def)

Management: vit B12, stress relief, licorice, corticosteroids, folate, acidophilus, sucralfate

17

Geographic tongue
-sx
-pathophys

sx: asymptomatic

pathophys: rapid loss and regrowth of filiform papillae causes denuded red patches to "wander" across the surface of the tongue.

18

Oral leukoplakia
-pathophysiology
-sx
-tx

patho: benign epithelial hyperplasia (white growths along the side of the tongue)

sx: asymptomatic lesions on the lateral surfaces of the tongue

tx: acyclovir (zovirax)

19

Oral Cancer
-etiology

etiology: tobacco, ETOH use, HPV

20

Potential oral side effects of pharmaceuticals?

-xerostomia
-pigmentation changes
-hyperplasia
-mucositis

21

Causes of Halitosis

Lower resp infections: bronchiectasis, lung abscesses

oral infection: acute primary herpetic gingivostomatitis, acute nectrozing ulcerative gingivitis, periodontal dz, dental caries

smoking

hepatic failure (fishy)

azotemia (ammonia)

DKA

H. pylori gastric infection

esophageal cancer

metal poisoning (garlicky)

22

Xerostomia
-pharmological causes
-sx
-tx

cause: diuretics, drugs with anticholinergic effects (antihistamines, TCAs)

sx: oral dryness, burning of tissues, diff eating or swallowing, tongue irritation, painful ulceration, progressively increasing caries and periodontal dz

tx: saliva substitutes, salivary stimulation with sugarless hard candies .... biotiene may give some wetting of the mouth.

23

what do tetracyclines, sedatives, antimalarials, amalgam tattoo, oral birth control, and heavy metal pigmentation have in common?

-causes pigmentation changes of the gums, teeth, or tongue.

24

What medications cause gingival hyperplasia? tx?

-phenytoin, ca channel blocker, and cyclosporine

tx: surgical removal of the tissue is effective but hyperplasia recurs if drug is continued.

25

Mucositis
-etiology
-sx

etiology: chemo agents, radiation to head and neck cancers

sx: edema, painful chewing/swallowing of food.

26

Diabetes can cause what oral problems? Prevention?

peridontal abscess

gingival hypertrophy

dry burning mouth

gingival tenderness /bleeding

lip dryness

tooth mobility

peridontal dz

Prevention: tight glycemic control

27

Anemia:
-sx of Pernicious anemia (vit B12 def) and iron deficiency?

Pernicious: glossitis: smooth, beefy-red, and sore/tender tongue.

Iron deficiency:
--glossitis: reddened, edematous, smooth, shiny, and tender tongue & angular cheilitis/stomatitis: erosion, tenderness and edema at corners of mouth

28

Tooth loosening and ulcerations are MC in what disorder?

-vitamin C deficiency

29

Mononucleosis
-signs and sx

hard palate petechiae, pharyngitis (w/ or w/o exudate), lethargy, sore throat

30

What oral dz is pathopgnomonic for HIV/AIDS

oral kaposi's sarcoma and oral lymphoma