Oral Health Disorders

Summary of Disorders of the Mouth

This summary provides an overview of common disorders affecting the mouth, including stomatitis, tooth decay, dental plaque, dental abscesses, parotitis, and oral cancer. Understanding these conditions, their causes, symptoms, and treatments is crucial for healthcare professionals. This information is intended to provide a foundational understanding of oral health disorders.

Stomatitis

• Stomatitis is a generalized inflammation of the mouth.
• Types of Stomatitis:
  • Simple catarrhal stomatitis: Inflammation of the mucous membranes with increased mucus flow, more common in children. Causes include poor oral hygiene, hot foods/drinks, wounds, corrosion from acids/alkali, systemic infections, and bacteria. Symptoms include low-grade fever, dry mucous membrane, sores, pain, and craving for cold drinks. Treatment involves antipyretics, antiseptic mouthwash, a soft diet, and addressing underlying conditions.
  • Vincent's stomatitis: Severe inflammation of the mouth and gums, considered severe gingivitis. Causes include bacteria, poor oral hygiene, and immunosuppression. Symptoms include pain, swelling, bleeding gums, redness, bad taste, halitosis (bad breath), and fever. Diagnosis involves physical examination. Treatment includes oral antibiotics, antiseptic mouthwash, hydrogen peroxide rinses, regular brushing, and professional dental cleaning.
  • Monilia stomatitis (oral thrush): A mouth infection caused by Candida albicans, a yeast-like fungus. Predisposing factors include lowered immunity and prolonged antibiotic use. Symptoms include lesions on the mucous membrane and gums that bleed easily. Treatment includes hydrogen peroxide and saline mouthwashes, cotrimoxazole tablets, nystatin suspension/pastilles, fluconazole, and oral hygiene.
  • Hepatic stomatitis: A contagious viral infection causing ulcers and inflammation, common in children. Causes include herpes virus hominis, Epstein-Barr virus, and varicella-zoster virus. Symptoms include blisters, decreased food intake, dysphagia, drooling, fever, irritability, pain, swollen gums, and ulcers. Diagnosis is made through history taking and physical examinations. Treatment includes antiviral medication (acyclovir), a liquid diet, and topical anesthetics (lignocaine) with caution.

Tooth Decay

• Tooth decay is an erosion process initiated by bacteria acting on fermentable carbohydrates, producing acid that dissolves tooth enamel.
• It begins with a small hole in a fissure or area difficult to clean, and if unchecked, penetrates the enamel into the dentine and cavity.
• In the cavity, blood vessels and nerves are affected, causing severe pain.
• An abscess may form within the tooth or at the root.
• Pain and soreness are common with an abscess, and the patient's face may swell.
• The extent of damage depends on dental plaque, acid strength, saliva's neutralizing ability, acid contact time, and tooth susceptibility.

Dental Plaque

• Dental plaque is a gelatin-like substance that adheres to the teeth.
• Investigations include X-rays to determine the extent of the disease.
• Treatment options include dental fillings, dental implants, and dental extraction.
• Preventive Measures:
  1. Effective teeth cleaning
  2. Drinking fluoridated water
  3. Refraining from smoking
  4. Controlling diabetes and using pit and fissure sealants
• IEC (Information, Education, and Communication):
  • Brush teeth with a soft toothbrush at least twice daily.
  • Floss daily.
  • Use an anti-plaque mouthwash.
  • Visit the dentist every 6 months.
  • Avoid alcohol and tobacco.
  • Maintain adequate nutrition and avoid sweets.
  • Replace your toothbrush every 2 months.

Dental Abscess

• A dental abscess is a buildup of pus in the teeth or gums caused by an infection, requiring urgent dental treatment.
• The infection can result from an untreated cavity, injury, or old dental work.
• Signs & Symptoms:
  • Pain
  • Bad breath
  • Fever
• Treatment:
  • Incision and drainage (I & D)
  • Antibiotics (cloxacillin)
  • Tooth extraction
  • Analgesics (ibuprofen)
  • Oral care

Parotitis

• Parotitis is inflammation of one or both parotid glands.
• Causes:
  • Bacterial infection (Staphylococcus aureus)
  • Mycobacterium tuberculosis
  • Mumps virus
  • HIV
  • Blockage of the parotid duct
  • Systemic infection
• Signs and Symptoms:
  • Swollen and painful gland at the jaw angle
  • Dry mouth
  • Severe pain when swallowing
  • Purulent exudates from the gland
  • Erythema
  • Ulcers
  • Fever
• Diagnosis:
  • History taking
  • Physical examination
• Treatment:
  • Antibiotics
  • Mouth washes
  • Warm salty water rinses
  • Warm compresses
  • Increased fluid intake
  • Drainage if an abscess develops

Oral Cancer

• Oral cancers are cancers of the lips, tongue, floor of the mouth, mucosa, hard and soft palates, pharyngeal wall, and tonsils.
• More common after 40 years and more prevalent in men (male to female ratio of 2.1). Most oral malignancies occur on the lower lip in men.
• Causes:
  • Idiopathic but with predisposing factors
  • Tobacco use
  • Excessive alcohol intake
  • Chronic irritation (jagged tooth)
  • Poor dental care
  • Constant exposure to ultraviolet radiation
• Clinical Manifestations:
  • Leukoplakia (white patch)
  • Erythroplakia (red velvety patch)
  • Ulcerations
  • A sore that bleeds easily and does not heal
  • Rough area felt with the tongue
  • Pain in the mouth
  • Dysphagia
  • Difficulty moving the jaw
  • Lip appears as an undulated shape
  • Painless ulcer on the lip
  • Carcinoma of the tongue manifests as an ulcer or thickening
  • Soreness or pain on the tongue
• Later signs:
  • Increased salivation
  • Slurred speech
  • Dysphagia
  • Toothache
  • Ear ache
• Diagnosis:
  • Biopsy
  • Oral exfoliative cytology
  • Toluidine blue test
  • CT and MRI scans
• Surgical Management:
  • Surgery is the effective treatment. Procedures depend on tumor size.
    • Partial mandibulectomy
    • Hemiglossectomy (removal of half of the tongue)
    • Radical neck dissection
    • Glossectomy (removal of the tongue and floor of the mouth)
  • A tracheotomy is usually performed along with radical neck resection.
  • Drainage tubing may be inserted.
  • An NG tube may be inserted for feeding.

Conclusion:

This summary has covered several key disorders of the mouth, including various forms of stomatitis, the process and prevention of tooth decay, the complications arising from dental plaque and abscesses, the causes and management of parotitis, and the manifestations and treatments for oral cancer. Understanding these conditions is essential for promoting oral health and providing appropriate care.