DOCSLIB.ORG

The Prevalence of Oral Mucosal Lesions in Patients Visiting a Dental School in Southern India

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Prevalence of Oral Mucosal Lesions in Patients Visiting a Dental School in Southern India [Downloaded free from http://www.ijdr.in on Wednesday, January 07, 2015, IP: 14.96.59.215] || Click here to download free Android application for this journal ORIGINAL RESEARCH The prevalence of oral mucosal lesions in patients visiting a dental school in Southern India Anuna Laila Mathew, Keerthilatha M Pai, Amar A Sholapurkar, Manoj Vengal Department of Oral Medicine AABSTRACTBSTRACT and Radiology, Manipal College of Dental Sciences, Manipal, The purpose of the present study was to evaluate the prevalence of oral mucosal lesions in Karnataka - 576 104, India Manipal, Karnataka State, India. A total of 1190 subjects who visited the department of oral medicine and radiology for diagnosis of various oral complaints over a period of 3 months were interviewed and clinically examined for oral mucosal lesions. The result showed the presence of one or more mucosal lesions in (41.2%) of the population. Fordyce’s condition was observed most frequently (6.55%) followed by frictional keratosis (5.79%), fissured tongue (5.71%), leukoedema (3.78%), smoker’s palate (2.77%), recurrent aphthae, oral submucous fibrosis (2.01%), oral malignancies (1.76%), leukoplakia (1.59%), median rhomboid glossitis (1.50%), candidiasis (1.3%), lichen planus (1.20%), varices (1.17%), traumatic ulcer and oral hairy leukoplakia (1.008%), denture stomatitis, geographic tongue, betel chewer’s mucosa and irritational fibroma (0.84%), herpes labialis, angular cheilitis (0.58%), and mucocele (0.16%). Mucosal lesions like tobacco-related lesions (leukoplakia, smoker’s palate, oral submucous fibrosis, and oral Received : 21-07-07 malignancies) were more prevalent among men than among women. Denture stomatitis, herpes Review completed : 02-09-07 labialis, and angular cheilitis occurred more frequently in the female population. Accepted : 21-11-07 PubMed ID : ???????? Key words: Abnormalities, mucosal lesions, prevalence Although the terms dental health and oral health are used 2005 to 1st June 2005 were included in the study. The patients almost synonymously when stating the goals for oral health, were divided into four groups based on age: 2-20 years, such statements are usually valid only for dental health. This 21-40 years, 41-60 years, and 61-80 years old. All the subjects may lead to severe underestimation of the need for total oral were examined clinically and questioned regarding any health care.[1] When planning measures for improving oral habits like smoking, pan chewing, and alcohol intake, and health, the lack of data may lead to a risk of overlooking the frequency and duration of the habit. Patients in whom diseases of the soft tissues in, and adjacent to, the oral cavity. an intraoral examination was not possible due to inadequate Prevalence data of oral mucosal lesions are available from mouth opening were excluded from the study. History many countries, but the information is usually restricted to was obtained from parents or relatives for patients who very few lesions in each survey. Only two studies,[2,3] with were not able to communicate either due to age or disease. sufÞ ciently large number of individuals, have presented data The patients were examined clinically by two trained on a broad spectrum of oral mucosal lesions in a general examiners using artiÞ cial light, mouth mirror, gauze, etc.; population. the diagnosis was made based on history, clinical features, and investigations, according to the WHO guidelines and Hence, the aim of the present study was to evaluate the color atlas. Biopsies were advised for suspicious lesions. prevalence of oral mucosal lesions in patients who visited the Department of Oral Medicine and Radiology, Manipal RESULTS AND DISCUSSION College of Dental Sciences, Manipal, India. A total of 1190 patients (747 men and 443 women) in the age MATERIALS AND METHODS range 2-80 years represented the population in this 3-month study conducted in our department. The different age- A total of 1190 outpatients seeking dental treatment at groups and the number of subjects in each was as follows: the Department of Oral Medicine and Radiology, Manipal 2-20 years old (n = 243, 21-40 years old (n = 527), 41-60 years st College of Dental Sciences, Manipal, India, from 1 March old (n = 325), 61-80 years old (n = 95). Reference to the color Correspondence: atlas while making the clinical examination and diagnosis Dr. Amar A Sholapurkar, resulted in a high proportion of both intra-examiner and E-mail: [email protected] inter-examiner agreement for the presence of lesions 99 Indian J Dent Res, 19(2), 2008 [Downloaded free from http://www.ijdr.in on Wednesday, January 07, 2015, IP: 14.96.59.215] || Click here to download free Android application for this journal Prevalence of oral mucosal lesions Mathew, et al. and their categorization. Out of 1190 subjects, 1167 were Fordyce’s condition dentulous and 13 were totally edentulous (1.1%). Forty-Þ ve Fordyce’s condition was observed in 6.5% of our population subjects were denture wearers. One hundred and Þ fteen and was more frequently observed on the buccal and lip (9.7%) were presently smokers, 22 (1.9%) were ex-smokers, mucosa. It was more prevalent in men (8.9%) than in women and 1053 (88.4%) were nonsmokers. Among the current (2.48%). Corbet,[4] however, had reported a prevalence of smokers, there was a high proportion of heavy smokers 0.6%, which was very different from our Þ nding. (21 or more cigarettes/day). The habit of tobacco chewing was present in 123 subjects. The frequency of tobacco Fissured tongue chewing was more prevalent in males than in females (98 Fissured tongue was seen in 5.7% of our population. This males and 25 females) and was more prevalent in the 21-40 included all subjects with Þ ssures of at least 2-mm depth age-group. Ex-pan chewers were 21 in number. on the dorsal aspect of the tongue. This prevalence is lower than that found by Darwazeh and Pillai (11.4%)[5] and also Table 1 shows the demographic data. Tables 2 and 3 shows by Marij a in Slovenia[6] (21.1%). In our population, the the prevalence of oral mucosal variants and abnormalities presence of Þ ssured tongue increased with age and was more according to age and gender. No mucosal abnormalities prevalent among men than in women which is in accordance were detected in 58.8% of subjects. The most prevalent with the Þ ndings of Aboyons and Ghaemma Ghami in Iran[6] normal variant was Fordyce’s granules (6.55%), followed and Darwazeh and Pillai in Jordan.[5] by Þ ssured tongue (5.71%), Leukoedema (3.78%), and varices (1.17%).The most prevalent lesion was frictional Leukoedema keratosis (5.79%), followed by smoker’s palate (2.77%), In our study population, the prevalence of leukoedema aphthous stomatitis (2.1%), oral submucous fibrosis was 3.7%. Males were more affected than females. It was (2.01%), oral malignancies (1.76%), leukoplakia (1.59%), especially prevalent in the 41-60 years age-group (5.35% and median rhomboid glossitis (1.5%), oral candidiasis (1.3%), 1.1%, respectively, in males and females). The prevalence lichen planus (1.26%), traumatic ulcer (1.01%), denture was more among smokers than nonsmokers, with an increase stomatitis (0.84%), geographic tongue (0.84%), betel in age. A correlation between leukoedema and smoking, chewers mucosa (0.84%), irritational Þ broma (0.84%), tobacco chewing, and alcoholism could be demonstrated in angular cheilitis (0.58%), herpes labialis (0.58%), and our study as was seen in some groups of people in the study mucocele (0.16%). by Karen in Thailand.[7] Table 1: Demographic data of 1190 patients (2-80 years old) Patients no. according to 2-20 21-40 41-60 61-80 Total Total age and gender M - 135; F - 108 M - 332; F - 195 M - 210; F - 114 M - 70; F - 26 M - 747; F - 443 1190 Dentate patients M - 135 M - 332 M - 206 M - 63 M - 736 1177 F - 108 F - 195 F - 113 F - 25 F - 441 Totally edentulous M - 0 M - 0 M - 4 M - 7 M - 11 13 F - 0 F - 0 F - 1 F - 1 F - 2 Denture wearers M - 1 M - 4 M - 8 M - 10 M - 23 45 F - 0 F - 2 F - 15 F - 5 F - 22 Present smokers M - 5 M - 50 M - 55 M - 5 M - 115 115 F - 0 F - 0 F - 0 F - 0 F - 0 Ex- smokers M - 0 M - 5 M - 10 M - 7 M - 22 22 F - 0 F - 0 F - 0 F - 0 F - 0 Tobacco chewers M - 5 M - 46 M - 39 M - 8 M - 98 123 F - 0 F - 5 F - 15 F - 5 F - 25 Ex-pan chewers M - 0 M - 7 M - 6 M - 4 M - 17 21 F - 0 F - 0 F - 1 F - 3 F - 4 Alcoholics M - 1 M - 10 M - 9 M - 0 M - 20 20 F - 0 F - 0 F - 0 F - 0 F - 0 Table 2: Prevalence of oral mucosal variants in 1190 patients (2-80 years old) Mucosal fi ndings Gender 2-20, n (%) 21-40, n (%) 41-60, n (%) 61-80, n (%) Total, n (%) Total, n (%) Fordyce’s granules M 3 (2.2) 30 (9.03) 28 (13.3) 6 (8.5) 67 (8.9) 78 (6.55) F 3 (2.77) 6 (3.07) 2 (1.73) 0 11 (2.48) Fissured tongue M 1 (0.74) 11(3.37) 18 (8.57) 14 (20) 44 (57.14) 68 (5.71) F 3 (2.77) 7 (3.58) 10 (8.69) 4 (16) 24 (5.41) Leukoedema M 0 7 (2.10) 29 (13.3) 4 (5.7) 40 (5.35) 45 (3.78) F 1 (0.9) 2 (1.02) 1 (0.86) 1 (4) 5 (1.12) Varices M 0 1 (0.30) 3 (1.42) 10 (14.2) 14 (1.87) 14 (1.17) F 0 0 0 0 0 Indian J Dent Res, 19(2), 2008 100 [Downloaded free from http://www.ijdr.in on Wednesday, January 07, 2015, IP: 14.96.59.215] || Click here to download free Android application for this journal Prevalence of oral mucosal lesions Mathew, et al.
Load more

Recommended publications
  • Cutaneous Manifestations of HIV Infection Carrie L
    Chapter Title Cutaneous Manifestations of HIV Infection Carrie L. Kovarik, MD Addy Kekitiinwa, MB, ChB Heidi Schwarzwald, MD, MPH Objectives Table 1. Cutaneous manifestations of HIV 1. Review the most common cutaneous Cause Manifestations manifestations of human immunodeficiency Neoplasia Kaposi sarcoma virus (HIV) infection. Lymphoma 2. Describe the methods of diagnosis and treatment Squamous cell carcinoma for each cutaneous disease. Infectious Herpes zoster Herpes simplex virus infections Superficial fungal infections Key Points Angular cheilitis 1. Cutaneous lesions are often the first Chancroid manifestation of HIV noted by patients and Cryptococcus Histoplasmosis health professionals. Human papillomavirus (verruca vulgaris, 2. Cutaneous lesions occur frequently in both adults verruca plana, condyloma) and children infected with HIV. Impetigo 3. Diagnosis of several mucocutaneous diseases Lymphogranuloma venereum in the setting of HIV will allow appropriate Molluscum contagiosum treatment and prevention of complications. Syphilis Furunculosis 4. Prompt diagnosis and treatment of cutaneous Folliculitis manifestations can prevent complications and Pyomyositis improve quality of life for HIV-infected persons. Other Pruritic papular eruption Seborrheic dermatitis Overview Drug eruption Vasculitis Many people with human immunodeficiency virus Psoriasis (HIV) infection develop cutaneous lesions. The risk of Hyperpigmentation developing cutaneous manifestations increases with Photodermatitis disease progression. As immunosuppression increases, Atopic Dermatitis patients may develop multiple skin diseases at once, Hair changes atypical-appearing skin lesions, or diseases that are refractory to standard treatment. Skin conditions that have been associated with HIV infection are listed in Clinical staging is useful in the initial assessment of a Table 1. patient, at the time the patient enters into long-term HIV care, and for monitoring a patient’s disease progression.
    [Show full text]
  • The Treatment of Herpes Labialis with a Diode Laser (970 Nm) — a Field Study
    I clinical article The treatment of herpes labialis with a diode laser (970 nm)—a field study DrSimoneSuppelt AbstrAct Herpes labialis is an infection caused by the herpes simplex virus HSV 1 and, less frequently, HSV 2. In dental prac - tices the diode laser is mainly used in periodontology, endodontics and minimally invasive surgery. Many of those affected by herpes are unaware that laser treatment can successfully alleviate their symptoms. In this field study, 11 patients who suffer from acute herpes were treated with a 970 nm diode laser. The areas which the patients described as being affected by herpes were irradiated at a distance of 1 –3 mm (2.0 W, 10 Hz, 50 % duty cycle, 320 µm optical fiber). Several patients felt the symptoms subside during the treatment. For the majority of patients, the symptoms did not occur again after treatment. All of the patients were satisfied with the treatment. Laser treatment of herpes labialis using a 970 nm diode laser is an effective way for me to help my patients both quickly and simply. Keywords Diode laser, 970 nm, herpes labialis, HSV Introduction An outbreak of herpes labialis can be accompanied by var - ious symptoms. As a rule, in the early stages such symptoms With a wavelength of 970 nm and a maximum output of include dry lips and a tingling/itching sensation. In subsequent 7W cw, the SIROLaser Advance dental diode laser has a wide stages, swelling and a feeling of tightness occur which can range of indications. In my practice, the laser is mainly used rapidly be accompanied by a sensation of burning or other in periodontology and endodontics to reduce germs in pock - sense of pain.
    [Show full text]
  • Metronidazole Induced Aphthous Ulcer with Angular Cheilitis
    Pharmacy & Pharmacology International Journal Case Report Open Access Metronidazole induced aphthous ulcer with angular cheilitis Abstract Volume 4 Issue 3 - 2016 Metronidazole is an antiprotozoal drug, which has broad spectrum cidal activity Aruna Bhushan,1 Ved Bhushan ST2 against anaerobic protozoa and microaerophillic bacteria. Aphthous ulcer is a very 1Associate Professor, Department of Pharmacology, India rare side effect with metronidazole. Here we report a case of 55 year old male suffered 2Professor of Surgery, KLE- Centrinary Charitable Hospital, from metronidazole induced aphthous ulcer with angular cheilitis. India metronidazole, adrs, cheilites Keywords: Correspondence: Aruna Bhushan, Associate Professor, Department of Pharmacology, BIMS, Karnataka, India, Tel 9480538661, Email [email protected] Received: April 04, 2016 | Published: April 19, 2016 Introduction complex and Anti histaminic CPM (chlorpheniramine maleate 10mg tablets) twice daily was started. Patient was also prescribed topical Metronidazole, chemically a nitroimidazole is an antiprotozoal anesthetics Zytee (choline salicylate and benzalkonium chloride drug, which has broad spectrum cidal activity against anaerobic solution 10ml gel) small quantity to be applied on affected area twice protozoa, anaerobic and microaerophillic bacteria. It was introduced daily. in 1959 for trichomoniasis, and later found to be highly active amoebicide. Metronidazole after entering the cell by diffusion, its The patient gradually and progressively improved within 5-7days nitro group is reduced by certain redox proteins to a highly reactive lesions resolved within 7-10days and completely recovered in 2weeks. nitro radical, which acts as an electron sink competes with the biological electron acceptors generated by cell mitochondria and Discussion hence interferes with energy metabolism. The drug is completely Metronidazole is a frequently prescribed drug for amoebiasis, absorbed orally, metabolized in liver followed by renal excretion.
    [Show full text]
  • HIV Infection and AIDS
    G Maartens 12 HIV infection and AIDS Clinical examination in HIV disease 306 Prevention of opportunistic infections 323 Epidemiology 308 Preventing exposure 323 Global and regional epidemics 308 Chemoprophylaxis 323 Modes of transmission 308 Immunisation 324 Virology and immunology 309 Antiretroviral therapy 324 ART complications 325 Diagnosis and investigations 310 ART in special situations 326 Diagnosing HIV infection 310 Prevention of HIV 327 Viral load and CD4 counts 311 Clinical manifestations of HIV 311 Presenting problems in HIV infection 312 Lymphadenopathy 313 Weight loss 313 Fever 313 Mucocutaneous disease 314 Gastrointestinal disease 316 Hepatobiliary disease 317 Respiratory disease 318 Nervous system and eye disease 319 Rheumatological disease 321 Haematological abnormalities 322 Renal disease 322 Cardiac disease 322 HIV-related cancers 322 306 • HIV INFECTION AND AIDS Clinical examination in HIV disease 2 Oropharynx 34Neck Eyes Mucous membranes Lymph node enlargement Retina Tuberculosis Toxoplasmosis Lymphoma HIV retinopathy Kaposi’s sarcoma Progressive outer retinal Persistent generalised necrosis lymphadenopathy Parotidomegaly Oropharyngeal candidiasis Cytomegalovirus retinitis Cervical lymphadenopathy 3 Oral hairy leucoplakia 5 Central nervous system Herpes simplex Higher mental function Aphthous ulcers 4 HIV dementia Kaposi’s sarcoma Progressive multifocal leucoencephalopathy Teeth Focal signs 5 Toxoplasmosis Primary CNS lymphoma Neck stiffness Cryptococcal meningitis 2 Tuberculous meningitis Pneumococcal meningitis 6
    [Show full text]
  • VALTREX (Valacyclovir Hydrochloride) Caplets Hypersensitivity to Valacyclovir (E.G., Anaphylaxis), Acyclovir, Or Any Initial U.S
    Valacyclovir oral suspension (25 mg/mL or 50 mg/mL) can be prepared from HIGHLIGHTS OF PRESCRIBING INFORMATION the 500 mg VALTREX Caplets. (2.3) These highlights do not include all the information needed to use VALTREX safely and effectively. See full prescribing information for --------------------- DOSAGE FORMS AND STRENGTHS -------------- VALTREX. Caplets: 500 mg (unscored), 1 gram (partially scored) (3) -------------------------------CONTRAINDICATIONS------------------------ ® VALTREX (valacyclovir hydrochloride) Caplets Hypersensitivity to valacyclovir (e.g., anaphylaxis), acyclovir, or any Initial U.S. Approval: 1995 component of the formulation. (4) ---------------------------RECENT MAJOR CHANGES -------------------- ----------------------- WARNINGS AND PRECAUTIONS ---------------- Indications and Usage, Pediatric Patients (1.2) 9/2008 • Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome Dosage and Administration, Pediatric Patients (2.2, 2.3) 9/2008 (TTP/HUS): Has occurred in patients with advanced HIV disease and in ----------------------------INDICATIONS AND USAGE--------------------- allogenic bone marrow transplant and renal transplant patients receiving VALTREX is a nucleoside analogue DNA polymerase inhibitor indicated for: 8 grams per day of VALTREX in clinical trials. Discontinue treatment if Adult Patients (1.1) clinical symptoms and laboratory findings consistent with TTP/HUS • Cold Sores (Herpes Labialis) occur. (5.1) • Genital Herpes • Acute renal failure: May occur in elderly patients (with or without •
    [Show full text]
  • Spectrum of Lip Lesions in a Tertiary Care Hospital: an Epidemiological Study of 3009 Indian Patients
    Brief Report Spectrum of Lip Lesions in a Tertiary Care Hospital: An Epidemiological Study of 3009 Indian Patients Abstract Shivani Bansal, Aim: Large‑scale population‑based screening studies have identified lip lesions to be the most Sana Shaikh, common oral mucosal lesions; however, few studies have been carried out to estimate the prevalence Rajiv S. Desai, of lip lesions exclusively. The aim of present study is to highlight the diversity of lip lesions and determine their prevalence in an unbiased Indian population. Materials and Methods: Lip lesions Islam Ahmad, were selected from 3009 patients who visited the department over a period of 3 years (January Pavan Puri, 2012 to December 2014). Age, sex, location of lip lesions, a detailed family and medical history, Pooja Prasad, along with the history of any associated habit was recorded. Biopsy was carried out in necessary Pankaj Shirsat, cases to reach a final diagnosis. The pathologies of the lip were classified based on the etiology. Dipali Gundre Results: Among 3009 patients, 495 (16.5%) had lip lesions ranging from 4 years to 85 years with a Department of Oral Pathology, mean age of 39.7 years. There were 309 (62.4%) males and 185 (31.9%) females. Lower lip was the Nair Hospital Dental College, most affected region (54.1%) followed by the corner of the mouth (30.9%) and upper lip (11.7%). Mumbai Central, Mumbai, In 3.2% of the cases, both the lips were involved. Of the 495 lip lesions, the most common were Maharashtra, India Potentially Malignant Disorders (PMDs) (37.4%), herpes labialis (33.7%), mucocele (6.7%), angular cheilitis (6.1%), and allergic and immunologic lesions (5.7%).
    [Show full text]
  • Severe Herpes Simplex Virus Type-I Infections After Dental Procedures
    Med Oral Patol Oral Cir Bucal. 2011 Jan 1;16 (1):e15-8. Extraction-related herpes Journal section: Oral Medicine and Pathology doi:10.4317/medoral.16.e15 Publication Types: Case Report http://dx.doi.org/doi:10.4317/medoral.16.e15 Severe herpes simplex virus type-I infections after dental procedures Lara El Hayderi, Laurent Raty, Valerie Failla, Marie Caucanas, Dilshad Paurobally, Arjen F. Nikkels Department of Dermatology, University Medical Center Liège, Belgium Correspondence: Department of Dermatology University Medical Center of Liège El Hayderi L, Raty L, Failla V, Caucanas M, Paurobally D, Nikkels AF. B-4000 Liège, Belgium. Severe herpes simplex virus type-I infections after dental procedures. [email protected] Med Oral Patol Oral Cir Bucal. 2011 Jan 1;16 (1):e15-8. http://www.medicinaoral.com/medoralfree01/v16i1/medoralv16i1p15.pdf Received: 05-01-2010 Article Number: 16956 http://www.medicinaoral.com/ Accepted: 30-03-2010 © 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: Recurrences of herpes labialis (RHL) may be triggered by systemic factors, including stress, men- ses, and fever. Local stimuli, such as lip injury or sunlight exposure are also associated to RHL. Dental extraction has also been reported as triggering event. Case reports: Seven otherwise healthy patients are presented with severe and extensive RHL occurring about 2-3 days after dental extraction under local anaesthesia. Immunohistochemistry on smears and immunofluorescence on cell culture identified herpes simplex virus type I (HSV-I).
    [Show full text]
  • Comparative Evaluation of the Efficacy of Systemic Levamisole And
    Journal of Advanced Clinical & Research Insights (2019), 6, 33–38 ORIGINAL ARTICLE Comparative evaluation of the efficacy of systemic levamisole and antioxidant in the management of oral submucous fibrosis – A randomized control trial Anuja Anil Shinge1, Preeti Kanchan-Talreja1, Deepa Das1, Amita Navalkar1, Prakash S. Talreja2, Ashutosh Kakade3 1Department of Oral Medicine and Radiology, Y.M.T. Dental College and Hospital, Navi Mumbai, Maharashtra, India, 2Department of Periodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India, 3Department of Pharmacology, M.G.M Medical College and Hospital, Navi Mumbai, Maharashtra, India Keywords: Abstract Cap. Antoxid, tab. levamisole, oral submucous Background: Oral submucous fibrosis (OSF) is a chronic, disabling disease involving fibrosis the entire oral mucosa, mainly reported in Indian population. A number of treatment Correspondence: modalities have been tried, but none of these have been completely therapeutic. Dr. Anuja Anil Shinge, Department of Levamisole, an immunomodulator, has been reported to be beneficial in oral mucosal Oral Medicine and Radiology, Y.M.T. lesions, but there are hardly any studies reported in literature for OSF patients, and Dental College and Hospital, Dr. G. D. Pol hence, the study was taken up. Foundations, Kharghar, Institutional Area, Aim: This study aims to compare the efficacy of levamisole with antioxidant for the Navi Mumbai - 410210. assessment of burning sensation and mouth opening in OSF patients. E-mail: [email protected] Materials and Methods: A total of 60 patients clinically diagnosed of OSF were selected for the study. We assessed patients for burning sensation and mouth opening. Patients Received: 02 February 2019; were divided into four groups according to staging of OSF (More et al., classification), Accepted: 11 March 2019 then randomly subdivided into three groups to dispense medicines.
    [Show full text]
  • 1. Oral Infections.Pdf
    ORAL INFECTIONS Viral infections Herpes Human Papilloma Viruses Coxsackie Paramyxoviruses Retroviruses: HIV Bacterial Infections Dental caries Periodontal disease Pharyngitis and tonsillitis Scarlet fever Tuberculosis - Mycobacterium Syphilis -Treponema pallidum Actinomycosis – Actinomyces Gonorrhea – Neisseria gonorrheae Osteomyelitis - Staphylococcus Fungal infections (Mycoses) Candida albicans Histoplasma capsulatum Coccidioides Blastomyces dermatitidis Aspergillus Zygomyces CDE (Oral Pathology and Oral Medicine) 1 ORAL INFECTIONS VIRAL INFECTIONS • Viruses consist of: • Single or double strand DNA or RNA • Protein coat (capsid) • Often with an Envelope. • Obligate intracellular parasites – enters host cell in order to replicate. • 3 most commonly encountered virus families in the oral cavity: • Herpes virus • Papovavirus (HPV) • Coxsackie virus (an Enterovirus). DNA Viruses: A. HUMAN HERPES VIRUS (HHV) GROUP: 1. HERPES SIMPLEX VIRUS • Double stranded DNA virus. • 2 types: HSV-1 and HSV-2. • Lytic to human epithelial cells and latent in neural tissue. Clinical features: • May penetrate intact mucous membrane, but requires breaks in skin. • Infects peripheral nerve, migrates to regional ganglion. • Primary infection, latency and recurrence occur. • 99% of cases are sub-clinical in childhood. • Primary herpes: Acute herpetic gingivostomatitis. • 1% of cases; severe symptoms. • Children 1 - 3 years; may occur in adults. • Incubation period 3 – 8 days. • Numerous small vesicles in various sites in mouth; vesicles rupture to form multiple small shallow punctate ulcers with red halo. • Child is ill with fever, general malaise, myalgia, headache, regional lymphadenopathy, excessive salivation, halitosis. • Self limiting; heals in 2 weeks. • Immunocompromised patients may develop a prolonged form. • Secondary herpes: Recurrent oral herpes simplex. • Presents as: a) herpes labialis (cold sores) or b) recurrent intra-oral herpes – palate or gingiva.
    [Show full text]
  • Orofacial Disease: Update for the Dental Clinical Team: 6. Complaints Affecting Particularly the Lips Or Tongue
    ORAL MEDICINE ORAL MEDICINE Orofacial Disease: Update for the Dental Clinical Team: 6. Complaints Affecting Particularly the Lips or Tongue Crispian Scully and Stephen Porter Lip Pits Abstract: Certain lesions are exclusively or typically found in specific sites; these are discussed in this and the next two articles in this series. Dimples are common at the commissures but lip pits are uncommon and are distinct Dent Update 1999; 26: 254-259 pits sited more centrally on either side of the philtrum, ranging from 1 to 4 mm in Clinical Relevance: The lips vary very much between ethnic groups and it is diameter and depth, present from infancy, important to know the normal appearance as well as signs of pathological disease. often showing a familial tendency and sometimes associated with sinuses or pits on the ears. Rarely they become infected and present as recurrent or refractory listers and spots are the most many illnesses, particularly febrile cheilitis. Surgical removal may be indicated B common complaints affecting the diseases. Black and brown hairy tongue for cosmetic purposes. lips. Blisters on the lips are usually appears to be caused by the accumulation caused by herpes labialis but this must of epithelial squames and the proliferation be differentiated from carcinoma and of chromogenic micro-organisms. The Cleft Lip other less common causes. In some tongue may be sore for a variety of Cleft lip and/or palate are the most people, sebaceous glands (Fordyce reasons, but especially because of common congenital craniofacial spots) may be seen as creamy-yellow erythema migrans, lichen planus, glossitis abnormalities, and are discussed dots along the border between the and burning mouth syndrome.
    [Show full text]
  • Oral Diseases Associated with Human Herpes Viruses: Aetiology, Clinical Features, Diagnosis and Management
    www.sada.co.za / SADJ Vol 71 No. 6 CLINICAL REVIEW < 253 Oral diseases associated with human herpes viruses: aetiology, clinical features, diagnosis and management SADJ July 2016, Vol 71 no 6 p253 - p259 R Ballyram1, NH Wood2, RAG Khammissa3, J Lemmer4, L Feller5 ABSTRACT Human herpesviruses (HHVs) are very prevalent DNA ACRONYMS viruses that can cause a variety of orofacial diseases. EM: erythema multiforme Typically they are highly infectious, are contracted early in HHV: human herpes virus life, and following primary infection, usually persist in a latent form. Primary oral infections are often subclinical, but may PCR: polymerase chain reaction be symptomatic as in the case of herpes simplex virus- HSV, HHV-1: herpes simplex virus induced primary herpetic gingivostomatitis. Reactivation VZV, HHV-3: varicella-zoster virus of the latent forms may result in various conditions: herpes EBV, HHV-4: Epstein-Barr virus simplex virus (HSV) can cause recurrent herpetic orolabial CMV, HHV-5: cytomegalovirus lesions; varicella zoster virus (VZV) can cause herpes zoster; Epstein-Barr virus (EBV) can cause oral hairy Key words: herpes simplex virus, human herpes virus-8, leukoplakia; and reactivation of HHV-8 can cause Kaposi varicella zoster virus, Epstein-Barr virus, recurrent herpes sarcoma. In immunocompromised subjects, infections labialis, recurrent intraoral herpetic ulcers, treatment, val- with human herpesviruses are more extensive and aciclovir, aciclovir, famcicylovir. severe than in immunocompetent subjects. HSV and VZV infections are treated with nucleoside analogues aciclovir, valaciclovir, famciclovir and penciclovir. These agents INTRODucTION have few side effects and are effective when started The human herpesvirus (HHV) family comprises a diverse early in the course of the disease.
    [Show full text]
  • Oral Signs of Systemic Disease CDA 2015 Lecture Notes
    2015-08-28 Oral Signs of Oral Signs of Systemic Disease Systemic Disease Why do you need to know? ! AHA! I diagnosed your systemic disease – less likely ! Helping your patients with known Karen Burgess, DDS, MSc, FRCDC systemic diseases - more likely Oral Pathology and Oral Medicine, Faculty of Dentistry, University of Toronto Department of Dentistry, Princess Margaret Hospital Department of Dentistry, Mt Sinai Hospital 2015-08-29 2015-08-29 2015-08-29 2015-08-29 2015-08-29 2015-08-29 Normal or Abnormal? Clinical description ! Type of abnormality (shape) ! The hardest part of oral pathology ! Number ! Colour ! Consistency ! Size - measure accurately ! Surface texture ! Location 2015-08-29 2015-08-29 2015-08-29 1 2015-08-28 Vocabulary Clinical description ! Ulcer ! Type of abnormality (shape) ! Vesicle/Bulla ! Number ! Macule ! Colour ! Patch ! Consistency ! Plaque ! Size - measure accurately ! Polyp- sessile or pedunculated ! Surface texture ! Location 2015-08-29 2015-08-29 2015-08-29 Description 2015-08-29 2015-08-29 2015-08-29 Differential Diagnosis Differential Diagnosis Differential Diagnosis ! Erythema multiforme ! Mucous membrane pemphigoid ! Primary herpes ! Erythema multiforme –"Any genital or eye lesions –"How long has it been present? ! Mucous membrane pemphigoid –"Any blisters? –"Any skin lesions? ! Pemphigus vulgaris ! Pemphigus vulgaris –"any skin lesions? ! Lichen planus ! Primary herpes –"Any blisters? –"How long has it been present? ! Lichen planus What information will help you narrow down –"Any other symptoms – malaise,
    [Show full text]