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Diseases of the Oral Cavity (Oral Floor Abscess (Ludwig`s angina)…
Diseases of the Oral Cavity
Inflammation
ETIOLOGY
Viruses
Herpes simplex
caused by HSV type 1
transmitted by contact or droplet infection
Primary infection acquired
in childhood as herpetic gingivostomatitis (apthous stomatitis)
local lesions (bullae)
on the oral mucosa is preceded by
fever and lethargy
consistent with a flulike infection. Often
accompanied by regional lympadenitis
Most of cases are diagnosed as teething problems
Herpetic gingivostomatitis
Diagnosis – history and clinical examination.
Treatment – topical antiseptics
Complications – secondary bacterial superinfection -> herpes impetiginatus ->
heals by scarring
in contrast to nonsuperinfected cases
Varicella-Zoster
caused by HSV type 1
transmitted by contact or droplet infection
Chickenpox
skin rash consisting of erythematus papules and thin-walled vesicles with watery contens, covering the body (especially on the head and trunk)
Aphtha-like vessicles appear on the oral mucosa – especially on the hard palate, buccal mucosa, and gingiva
Herpangina (Vesicular pharyngitis, ulcerative pharyngitis)
Type A coxsackievirus
affects young children; usually in spring and fall
Fever, Malaise, Headache,Muscle pain
Bullus eruptions surrounded by a red halo on the oral mucosa, affecting the anterior Facial pillars, uvula and palatine tonsils
Treatment
Purely symptomatic:
• anti inflammatory agents
• mouth rinses with chamomile
Fungi Contact, allergens, Bacteria, Autoimmune
Oral Floor Abscess (Ludwig`s angina)
progressing polymicrobial cellulitis of the sublingual and submandibular spaces
- Results in life-threatening air way compromise
Can
spread to the deep cervical sof tissues and mediastinum
Pathogenesis: Bacterial infection caused by
Streptococcus or Staphylococcus
- Diabetic or immunosuppresed patients at risk
Symptoms:
edematous swelling in the submental to submandibular Areas
Trismus
Difficulty swallowing and speaking („muffled speech”)
fever
Dyspnea with acute respiratory distress
Diagnosis: Imaging, ENT examination
Treatment:
drainage of the abscess via the intraoral and transcervical route
Antibiotic mixed spectrum of aerobic and anaerobic organisms
Secure the airway =Tracheotomy
Lingual Abscess
Surgical treatment = drainage & Antibiotic
Candidiasis
weakened host resistance due to:
• radiation or cytostatic therapy,
•Diabetes mellitus,
•Long-term antibiotic use
•Corticosteroid inhalations
Clinical examination
whitish,firmly adherent plaques that can be scraped from the mucosa, leaving the erythomatus, bleeding surface
Treatment:
Topical anti-fungal agents (nystatin solution, amphotericin-B Lozenges)
Superficial tongue lesions
Hunter`s glossitis (atrophic glossitis)
inflamation of the
tongue base
Accompanying of pernicious anemia
shiny appearance with partial atrophy of the filliform papillae
Symptoms: Burning of the tongue, Dry mouth, Altered sense of taste
Burning mouth syndrome (BMS)
Tongue is most commonly affected („burning tongue”)
Concomitant xerostomia and dysgeusia are occasionally reported
Causes
LOCAL:
Dentures
Candidiasis
Geographic tongue
Allergic mucosal reactions
Toxic mucosal reactions
Radiotherapy
PSYCHOGENIC:
•Depression
•Cancerophobia
•Emotional stress
SYSTEMIC:
•Iron-deficiency anemia
•Vitamin B12 deficiency
•Vitamin B1, B2 and B6 deficiency
•Folic acid deficiency
•Sjogren Disease
•Menopause
•Diabetes mellitus
•HIV infection
Matar