TONGUE DIAGNOSIS Introduction
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Oral Diagnosis: the Clinician's Guide
Wright An imprint of Elsevier Science Limited Robert Stevenson House, 1-3 Baxter's Place, Leith Walk, Edinburgh EH I 3AF First published :WOO Reprinted 2002. 238 7X69. fax: (+ 1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com). by selecting'Customer Support' and then 'Obtaining Permissions·. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress ISBN 0 7236 1040 I _ your source for books. journals and multimedia in the health sciences www.elsevierhealth.com Composition by Scribe Design, Gillingham, Kent Printed and bound in China Contents Preface vii Acknowledgements ix 1 The challenge of diagnosis 1 2 The history 4 3 Examination 11 4 Diagnostic tests 33 5 Pain of dental origin 71 6 Pain of non-dental origin 99 7 Trauma 124 8 Infection 140 9 Cysts 160 10 Ulcers 185 11 White patches 210 12 Bumps, lumps and swellings 226 13 Oral changes in systemic disease 263 14 Oral consequences of medication 290 Index 299 Preface The foundation of any form of successful treatment is accurate diagnosis. Though scientifically based, dentistry is also an art. This is evident in the provision of operative dental care and also in the diagnosis of oral and dental diseases. While diagnostic skills will be developed and enhanced by experience, it is essential that every prospective dentist is taught how to develop a structured and comprehensive approach to oral diagnosis. -
Guideline # 18 ORAL HEALTH
Guideline # 18 ORAL HEALTH RATIONALE Dental caries, commonly referred to as “tooth decay” or “cavities,” is the most prevalent chronic health problem of children in California, and the largest single unmet health need afflicting children in the United States. A 2006 statewide oral health needs assessment of California kindergarten and third grade children conducted by the Dental Health Foundation (now called the Center for Oral Health) found that 54 percent of kindergartners and 71 percent of third graders had experienced dental caries, and that 28 percent and 29 percent, respectively, had untreated caries. Dental caries can affect children’s growth, lead to malocclusion, exacerbate certain systemic diseases, and result in significant pain and potentially life-threatening infections. Caries can impact a child’s speech development, learning ability (attention deficit due to pain), school attendance, social development, and self-esteem as well.1 Multiple studies have consistently shown that children with low socioeconomic status (SES) are at increased risk for dental caries.2,3,4 Child Health Disability and Prevention (CHDP) Program children are classified as low socioeconomic status and are likely at high risk for caries. With regular professional dental care and daily homecare, most oral disease is preventable. Almost one-half of the low-income population does not obtain regular dental care at least annually.5 California children covered by Medicaid (Medi-Cal), ages 1-20, rank 41 out of all 50 states and the District of Columbia in receiving any preventive dental service in FY2011.6 Dental examinations, oral prophylaxis, professional topical fluoride applications, and restorative treatment can help maintain oral health. -
Mouth Esophagus Stomach Rectum and Anus Large Intestine Small
1 Liver The liver produces bile, which aids in digestion of fats through a dissolving process known as emulsification. In this process, bile secreted into the small intestine 4 combines with large drops of liquid fat to form Healthy tiny molecular-sized spheres. Within these spheres (micelles), pancreatic enzymes can break down fat (triglycerides) into free fatty acids. Pancreas Digestion The pancreas not only regulates blood glucose 2 levels through production of insulin, but it also manufactures enzymes necessary to break complex The digestive system consists of a long tube (alimen- 5 carbohydrates down into simple sugars (sucrases), tary canal) that varies in shape and purpose as it winds proteins into individual amino acids (proteases), and its way through the body from the mouth to the anus fats into free fatty acids (lipase). These enzymes are (see diagram). The size and shape of the digestive tract secreted into the small intestine. varies in each individual (e.g., age, size, gender, and disease state). The upper part of the GI tract includes the mouth, throat (pharynx), esophagus, and stomach. The lower Gallbladder part includes the small intestine, large intestine, The gallbladder stores bile produced in the liver appendix, and rectum. While not part of the alimentary 6 and releases it into the duodenum in varying canal, the liver, pancreas, and gallbladder are all organs concentrations. that are vital to healthy digestion. 3 Small Intestine Mouth Within the small intestine, millions of tiny finger-like When food enters the mouth, chewing breaks it 4 protrusions called villi, which are covered in hair-like down and mixes it with saliva, thus beginning the first 5 protrusions called microvilli, aid in absorption of of many steps in the digestive process. -
Tongue -Tie (Ankyloglossia) and Lip -Tie (Lip Adhesion)
Tongue -Tie (Ankyloglossia) and Lip -Tie (Lip Adhesion) What is Tongue-Tie? Most of us think of tongue -tie as a situation we find ourselves in when we are too excited to speak. Actually, tongue- tie is the non medical term for a relatively common physical condition that limits the use of the tongue, ankyloglossia. Lip -tie is a condition where the upper lip cannot be curled or moved normally. Before we are born, a strong cord of tissue that guides development of mouth structures is positioned in the center of the mouth. It is called a frenulum. As we develop, this frenulum recedes and thins. The lingual (tongue) or labial (lip) frenulum is visible and easily felt if you look in the mirror under your tongue and lip. In some children, the frenulum is especially tight or fails to recede and may cause tongue/lip mobility problems. The tongue and lip are a very complex group of muscles and are important for all oral function. For this reason having tongue tie can lead to nursing, eating, dental, or speech problems, which may be serious in some individuals. When Is Tongue and Lip- Tie a Problem That Needs Treatment? Infants A new baby with a too tight tongue and/or lip frenulum can have trouble sucking and may have poor weight gain. If they cannot make a good seal on the nipple, they may swallow air causing gas and stomach problems. Such feeding problems should be discussed with Dr. Sierra. Nursing mothers who experience significant pain while nursing or whose baby has trouble latching on should have their child evaluated for tongue and lip tie. -
Clinical Review Nursingingeneralpractice
The health benefits of nose breathing Item Type Article Authors Allen, Ruth Publisher Nursing in General Practice Journal Nursing in General Practice Download date 01/10/2021 07:15:20 Link to Item http://hdl.handle.net/10147/559021 Find this and similar works at - http://www.lenus.ie/hse clinical review nursingingeneralpractice The health benefits of nose breathing DR Alan RUth, BehaviouRal Medicine PRactitioneR “For breath is life, and if you breathe well you will live long on earth.” sanskrit Proverb For the most part people are unaware of their breathing and take it for granted that they do it correctly. t has been estimated that approximately one third of people ing. However, it has been estimated that up to 30-50% of modern don’t breathe well enough to sustain normal health. These adults breathe through the mouth, especially during the early people do not get enough oxygenation of their cells, tissues morning hours. and organs. In the book Behavioural and Psychological Ap- Mouth breathing is common in individuals whose nasal proaches to Breathing Disorders, Dr Chandra Patel describes passages are blocked or restricted. A deviated nasal septum Ithe problem with breathing as follows: or small nostril size can lead a person to breathe through their “We start life with a breath, and the process continues mouth instead of their nose. However, breathing through the automatically for the rest of our lives. Because breathing mouth most of the time was not nature’s intention. Many studies continues on its own, without our awareness, it does not have demonstrated that chronic mouth breathing can result in a necessarily mean that it is always functioning for optimum number of adverse health consequences (see Table 1). -
Oral Lesions in Sjögren's Syndrome
Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23 (4):e391-400. Oral lesions in Sjögren’s syndrome patients Journal section: Oral Medicine and Pathology doi:10.4317/medoral.22286 Publication Types: Review http://dx.doi.org/doi:10.4317/medoral.22286 Oral lesions in Sjögren’s syndrome: A systematic review Julia Serrano 1, Rosa-María López-Pintor 1, José González-Serrano 1, Mónica Fernández-Castro 2, Elisabeth Casañas 1, Gonzalo Hernández 1 1 Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain 2 Rheumatology Service, Hospital Infanta Sofía, Madrid, Spain Correspondence: Departamento de Especialidades Clínicas Odontológicas Facultad de Odontología Universidad Complutense de Madrid Plaza Ramón y Cajal s/n, 28040 Madrid. Spain [email protected] Serrano J, López-Pintor RM, González-Serrano J, Fernández-Castro M, Casañas E, Hernández G. Oral lesions in Sjögren’s syndrome: A system- atic review. Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23 (4):e391-400. Received: 18/11/2017 http://www.medicinaoral.com/medoralfree01/v23i4/medoralv23i4p391.pdf Accepted: 09/05/2018 Article Number: 22291 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background: Sjögren’s syndrome (SS) is an autoimmune disease related to two common symptoms: dry mouth and eyes. Although, xerostomia and hyposialia have been frequently reported in these patients, not many studies have evaluated other oral manifestations. -
Taste and Smell Disorders in Clinical Neurology
TASTE AND SMELL DISORDERS IN CLINICAL NEUROLOGY OUTLINE A. Anatomy and Physiology of the Taste and Smell System B. Quantifying Chemosensory Disturbances C. Common Neurological and Medical Disorders causing Primary Smell Impairment with Secondary Loss of Food Flavors a. Post Traumatic Anosmia b. Medications (prescribed & over the counter) c. Alcohol Abuse d. Neurodegenerative Disorders e. Multiple Sclerosis f. Migraine g. Chronic Medical Disorders (liver and kidney disease, thyroid deficiency, Diabetes). D. Common Neurological and Medical Disorders Causing a Primary Taste disorder with usually Normal Olfactory Function. a. Medications (prescribed and over the counter), b. Toxins (smoking and Radiation Treatments) c. Chronic medical Disorders ( Liver and Kidney Disease, Hypothyroidism, GERD, Diabetes,) d. Neurological Disorders( Bell’s Palsy, Stroke, MS,) e. Intubation during an emergency or for general anesthesia. E. Abnormal Smells and Tastes (Dysosmia and Dysgeusia): Diagnosis and Treatment F. Morbidity of Smell and Taste Impairment. G. Treatment of Smell and Taste Impairment (Education, Counseling ,Changes in Food Preparation) H. Role of Smell Testing in the Diagnosis of Neurodegenerative Disorders 1 BACKGROUND Disorders of taste and smell play a very important role in many neurological conditions such as; head trauma, facial and trigeminal nerve impairment, and many neurodegenerative disorders such as Alzheimer’s, Parkinson Disorders, Lewy Body Disease and Frontal Temporal Dementia. Impaired smell and taste impairs quality of life such as loss of food enjoyment, weight loss or weight gain, decreased appetite and safety concerns such as inability to smell smoke, gas, spoiled food and one’s body odor. Dysosmia and Dysgeusia are very unpleasant disorders that often accompany smell and taste impairments. -
Comparative Study of the Clinical and Anti-Microbial Efficacy of Tongue Cleaners
Braz J Oral Sci. 6(22):1407-1410 Braz J Oral Sci. July-September 2007 - Vol. 6 - Number 22 Comparative study of the clinical and anti-microbial efficacy of tongue cleaners Juliana dos Reis Derceli1* Juliana Rico Pires2* Abstract Candida species have frequently been isolated from the oral cavities of Tatiane Arruda Tardivo1* a variety of patients, such as elderly people, dentures users, Elaine Maria Sgavioli Massucato3* immunocompromised and health patients. Yeasts may be associated Silvana Regina Perez Orrico3* with immune response and local factors such as poor oral hygiene. It Denise Madalena Palomari Spolidorio4* was evaluated effectiveness of tongue cleaner showing which types 1Undergraduate student would be preferred by patients, changes in tongue coating and in saliva 2Ms DDS - Department of Diagnostic and Surgery yeasts counting. Thirty patients were selected and randomly distributed 3PhD - Department of Diagnostic and Surgery into three groups. This crossover blind study evaluated the effect of 4BSc PhD –Department of Physiology and tongue cleaning using: a plastic and a steel tongue scraper and a nylon Pathology soft-bristle toothbrush. All patients were instructed to use the cleaners * School of Dentistry at Araraquara, São twice a day for one week (fifteen-day wash-out period). Saliva and Paulo State University – UNESP, Brazil tongue coating samples were collected from each patient from each test period, the yeasts were counted by colony forming units per mL (CFU/mL) and the species were identified. The patients were questioned about cleaner preference. An increase in the percentage of patients with no tongue coating after scraping was observed. A reduction in the mean number of Candida species in tongue coating was observed Received for publication: June 12, 2007 only after nylon soft-bristle toothbrush cleaner. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
Xylitol—The Sweet Secret for Your Teeth and Waistline
70 Featured Featured 1 Xylitol–the sweet secret Xylitol—the sweet secret Healthy Hygiene Hints 2 Tongue cleaning Community News 2 for your teeth and waistline Christmas wishes Added sugar may be the single unhealthiest ingredient in the today’s diet. Over the past 20 years, there has been a push to consume xylitol instead of sugar and its appearance means it can be sprinkled or used in place of traditional sugar in cooking and baking in the exact same quantity. This month... In the lead up to Christmas, it’s So what do we know about Xylitol? the portal blood supply to the liver, difficult to avoid sugary treats. where it is converted to glucose which Luckily, there’s an alternative Xylitol is an all-natural alternative to provides energy. sweetener that not only avoids the sugar and can be found in berries and perils of traditional sugar, but can other fruits, some vegetables and in the How does Xylitol impact oral health? actually provide benefits to your oral woody fibres of birch tree and corncobs. health and to your waistline! In fact, our bodies produce up to 15g of When it comes to children in particular, several clinical trials undertaken around Be sure to read our feature to learn xylitol daily during normal metabolism. the benefits and how you can use the year 2000, showed that when mums- this special ingredient. Traditionally, it has been used in chewing to-be chewed gum containing Xylitol gums, toothpastes and mouthwash as it regularly, it actually resulted in a reduced Another way to stay on top of your has a strong sweetening effect but no number of Streptococcus Mutans (the your dental hygiene this Christmas— aftertaste. -
Efficacy of a Triclosan/Copolymer Dentifrice and a Toothbrush with Tongue Cleaner in the Treatment of Oral Malodor: a Monadic Clinical Trial
Open Journal of Stomatology, 2013, 3, 63-69 OJST http://dx.doi.org/10.4236/ojst.2013.31012 Published Online March 2013 (http://www.scirp.org/journal/ojst/) Efficacy of a triclosan/copolymer dentifrice and a toothbrush with tongue cleaner in the treatment of oral malodor: A monadic clinical trial Prem K. Sreenivasan1, Violet I. Haraszthy2, Joseph J. Zambon2*, William DeVizio1 1Colgate Palmolive Company, Piscataway, USA 2University at Buffalo, School of Dental Medicine, Buffalo, USA Email: *[email protected] Received 20 January 2013; revised 28 February 2013; accepted 9 March 2013 ABSTRACT 1. INTRODUCTION Aim: Oral malodor (halitosis) is a widespread condi- Oral malodor, also referred to as oral halitosis, is an un- tion caused by oral bacteria, particularly sulfur com- pleasant or offensive odor emanating for the oral cavity. pound-producing species. This study assessed the It is a common world-wide complaint and a significant effect of a triclosan/copolymer-containing dentifrice reason for professional consultation and referrals [1]. and a novel toothbrush with attached tongue cleaner Halitosis is frequently self-diagnosed and is a source of on oral malodor and on the bacteria colonizing the social embarrassment, psychological discomfort, and dorsal surface of the tongue. Materials and Methods: altered behavior and it can influence diet and habits [2,3]. 14 adult subjects with oral malodor defined as orga- It is estimated that 85% of oral malodor originates in the noleptic scores ≥ 3 (scale 0 - 5) and mouth air sulfur oral cavity with the remainder associated with a number levels ≥ 250 ppb participated in this study. Subjects of extra-oral sources including systemic diseases. -
Addisonian Pigmentation of the Oral Mucosa
PEDIATRIC DERMATOLOGY Series Editor: Camila K. Janniger, MD Addisonian Pigmentation of the Oral Mucosa Samir S. Shah, MD; Catherine H. Oh, MD; Susan E. Coffin, MD, MPH; Albert C. Yan, MD Cutaneous pigmentation is a hallmark of Addison Free thyroxine and thyrotropin levels were within disease. When present, the hyperpigmentation reference range. generally localizes to sun-exposed surfaces. This case highlights a less well-recognized Comment cutaneous feature that is pathognomonic for the Addison disease, a chronic primary insufficiency of disease: oral mucous membrane hyperpigmenta- the adrenal glands, results in both glucocorticoid and tion. We describe this unique type of discolor- mineralocorticoid deficiency. Historically, tuberculo- ation in detail and contrast it with other forms of sis accounted for most cases of Addison disease.1 oral pigmentation. Autoimmune destruction of the adrenal glands, also Cutis. 2005;76:97-99. known as autoimmune adrenalitis, is now the most common cause of Addison disease in both children and adults.2,3 Autoimmune destruction of other Case Report endocrine tissues can occur concurrently. These A 9-year-old girl presented with a 4-month history polyglandular autoimmune syndromes are associated of painless black patches on the tongue and gingiva. with hypoparathyroidism, pernicious anemia, and The patches had persisted despite treatment with chronic mucocutaneous candidiasis (type 1); diabetes oral fluconazole, which had been prescribed empiri- mellitus (type 2); or thyroiditis (type 3).4 Type 3, cally for presumed oral candidiasis. Results of a phys- however, consists of an autoimmune thyroiditis ical examination revealed scattered, asymptomatic, syndrome in the absence of Addison disease.5 bluish-black macules on the dorsal surface of the Although most children (75%) presenting with isolated tongue, the mucosal surface of the lower lip, and the Addison disease are boys,6 type 1 autoimmune poly- hard palate (Figure).