DISORDERS OF THE ORAL CAVITY

DISORDERS OF THE ORAL CAVITY

1. ORAL DISORDERS PRESENTED BY: V.RAMYA TUTOR SRMTCON

2. STRUCTURE OF THE MOUTH

3. INTRODUCTION Oral health is a very important component of a persons physical and psychological sense of well being. Peridontal diseases , which encompases both gingivitis and periodontitis (which involves the soft tissue and bone supporting the teeth),is the most common cause of tooth loss among adults

4. Incidence Ninety- five percent of the population in india suffers from periodontal disease.

5. DENTAL PLAQUE AND CARIES

6. DENTAL PLAQUE AND CARIES Tooth decay is an erosive process that begins with the action of bacteria on fermentable carbohydrates in the mouth, which produces acids that dissolve tooth enamel . Despite the fact tooth enamel is the hardest substance in the human body,caries and periodontal disease can occur for several reasons. Contributing factors include nutrition ,soft drink concumption,and genetic predisposition. In addition ,the extent of damage to the teeth may be related to the following:

7. DENTAL PLAQUE AND CARIES Presence of dental plaque,which is a gluey,gelatin like substance that adheres to the teeth. The initial action that causes damage to a tooth occurs under dental plaque Length of time acids are in contact with the teeth. Strength of acids and the ability of saliva to neutralize them. Susceptibility of the teeth to decay.

8. ABNORMALITIES OF THE LIPS Actinic cheilitis

9. SIGNS AND SYMPTOMS Irritation of the lips associated with scaling , crusting , fissure : white over growth of horny layer of epidermis. Considered a premalignant squamous cell skin cancer

10. POSSIBLE CAUSES AND SEQUELAE Exposure to sun ; More common in fair skinned people and in hose whose occupations involve sun exposure ,such as farmers. Chronic inflammatory lesion that may lead to squamous cell cancer of the lip.

11. NURSING CONSIDERATIONS Educate patient on importance of protecting lips from the sun by protecting ointment such as sun block. Instruct patient to have a periodic checkup by primary provider.

12. CHANCRE

13. SIGNS AND SYMPTOMS Reddened circumscribed lesion that ulcerates and becomes crusted.

14. POSSIBLE CAUSES AND SEQUELAE Primary lesion of syphilis.

15. NURSING CONSIDERATIONS Use comfort measures such as cold soaks to lip,mouth care. Administer antibiotics as prescribed Instruct patient regarding contagion. Use topical over the counter agents ( e.g,Blistex,carmex ) or antiviral agents ( e.g , acyclovir , penciclovir ) as prescribed.

16. CONTACT DERMATITIS I.e , allergic contact cheilitis

17. SIGNS AND SYMPTOMS Red area or rash: itching

18. POSSIBLE CAUSES AND SEQUELAE Allergic reaction to lipstick,cosmetic ointments, or tooth paste

19. NURSING CONSIDERATIONS Instruct patient to avoid possible causes Administer corticosteroids

20. Herpes simplex virus -1 Cold sore or fever blister

21. SIGNS AND SYMPTOMS Symptoms may be delayed up to 20 days after exposure ; singular or clustered , irregular, painful vesicles throughout the oral cavity and lips that may rupture.

22. POSSIBLE CAUSES AND SEQUELAE An opportunistic infection; Frequently seen in patients who are immunosuppressed May recur with menstruration ,fever or sun exposure

23. NURSING CONSIDERATIONS Use acyclovir ointment or systemic medications as prescribed. Administer analgesic agents as prescribed. Instruct patient to avoid irritating foods.

24. ABNORMALITIES OF THE MOUTH Leukoplakia

25. SIGNS AND SYMPTOMS White patches ; may be hyperkeratotic;typically painless

26. POSSIBLE CAUSES AND SEQUELAE Fewer than 2% are malignant ,but may progress to cancer (premalignant)

27. NURSING CONSIDERATIONS Insruct patient to see the primary provider if Leukoplakia persists > 2 weeks

28. ORAL HAIRY LEUKOPLAKIA

29. SIGNS AND SYMPTOMS White patches: with rough hairlike projections; typically found on lateral border of the tongue.

30. POSSIBLE CAUSES AND SEQUELAE Common among tobacco users possibly viral Related to smoking and the use of tobacco Associated with HIV infection

31. NURSING CONSIDERATIONS Eliminate the risk factors such as cigarettes,smokeless tobacco Instruct patient to see the primary provider if condition persists >2 weeks

32. LICHEN PLANUS

33. LICHEN PLANUS SIGNS AND SYMPTOMS Radiating while striations on the tongue and buccal mucosa ;often association with painful ulcerations and erythema.

34. POSSIBLE CAUSES AND SEQUELAE Chronic inflammatory condition of unknown case. Recurrence in common. May lead to a malignant process .

35. NURSING CONSIDERATIONS Apply topical corticosteroids such as fluocinolone acetonide gel. Avoid foods that irritate Administer corticosteroid systematically or intralesionally as prescribed. Instruct the patient of need for followup if condition is chronic .

36. CANDIDIASIS

37. CANDIDIASIS SIGNS AND SYMPTOMS Chessy white plaque that looks like milk curds ; when rubbed off ,it leaves an erythematous and often bleeding base.

38. POSSIBLE CAUSES AND SEQUELAE Candida albicans fungus; Predisposing factors include diabetes ,antibiotic therapy,and immunosuppression

39. NURSING CONSIDERATIONS Antifungal medications such as nystatin or clotrimazole may be prescribed as suspensions or troche ; when used as a suspension,instruct the patient to swish vigorously for at least one minute and the swallow. If these treatment fail, oral agents such as fluconazole may be prescribed.

40. APHTHOUS STOMATITIS (canker sore) (Classified as major or minor depending upon size )

41. SIGNS AND SYMPTOMS Shallow ulcer with a white or yellowcenter and typically a well defined red border ; seen on the inner side of the lip and cheek or on the tongue ; it begins with a burning or tingling sensation and slight swelling ; painful ; usually lasts 7- 10 days ( minor ) and heals without scar.

42. POSSIBLE CAUSES AND SEQUELAE Immune mediated inflammatory disorder associated with HIV infection. Associated with emotional or mental stress ,fatigue , hormonal factors , minor trauma ( e.g ,biting ), allergies , acidic foods and juices and dietary deficiencies.

43. NURSING CONSIDERATIONS Instruct the patient in comfort measures( e.g , saline rinses)and a soft or bland diet. Antibiotics or corticosteroids may be prescribed. Use over the counter benzocaine as indicated.

44. NICOTINE STOMATITIS (SNOCKERS PATCH)

45. SIGNS AND SYMPTOMS Two stages – begins as a red stomatitis ; over time, the tongue and mouth become covered with a creamy ,thick, white mucous membrane ,which may slough ,leaving a beefy red base.

46. POSSIBLE CAUSES AND SEQUELAE Chronic irritation by tobacco

47. NURSING CONSIDERATIONS Cessation of tobacco use; if condition exists >2 weeks A primary provider should be consulted and a biopsy may be needed.

48. ERYTHROPLAKIA

49. SIGNS AND SYMPTOMS Red patch uniformly raised with smooth velvety appearance without ulceration or bleeding on the oral mucous membrane ; in indian culture ,need to rule out betel nut chewing.

50. POSSIBLE CAUSES AND SEQUELAE More frequently turn to oral malignancy than Leukoplakia;seen in older adults ; warrants biopsy and further treatment.

51. NURSING CONSIDERATIONS Instruct the patient to visit the primary provider.

52. KAROSI SARCOMA

53. SIGNS AND SYMPTOMS Appears first on the oral mucosa as a red,purple,or blue lesion ; may be singular or multiple ; may be flat or raised Lesions can occur in other parts of the body; skin,lymph nodes, lungs,digestive tract.

54. POSSIBLE CAUSES AND SEQUELAE Cancer that develops from the cells that lines the blood vessels and lymph system Associated with HIV infection men who are sex with men,organ transplantation,and geographic region

55. NURSING CONSIDERATIONS Instruct patient regarding side effects of planned treatment of hiv

56. STOMATITIS

57. SIGNS AND SYMPTOMS Mild erythema and edema ; severe forms include painful ulcerations ,bleeding ,and secondary infection

58. POSSIBLE CAUSES AND SEQUELAE Inflammaton of the mucous linning of the mouth Associated with chemotherapy;radiation therapy; Severe drug allergy Myelo suppression ( bone marrow depression)

59. NURSING CONSIDERATIONS Prophylactic mouth care, including brushing, flossing, and rinsing,for any patient receiving chemotherapy or radiation therapy. Educate patient about proper oral hygiene, including the use of a soft – bristled toothbrush and nonabrasive toothpaste; for painful ulcers,

60. NURSING CONSIDERATIONS Oral swabs with spongelike applicators can be used in place of a toothbrush; Avoid alcohol - based mouth rinses and hot or spicy foods. Apply topical anti- inflammatory , antibiotic, and anesthetic agents as prescribed.

61. BIBLIOGRAPHY Brunner and Suddarth’s Text book of Medical – Surgical Nursing South Asian edition volume I ,Page referred 840 -843 Ansari and kaur ,Medical – Surgical Nursing ,Published by Pee vee , 2011 edition page referred 446-460. https:// www.slideshare.net/kpriyatham/diseases-of-mouth-palate-lips-cheek https://www.slideshare.net/ManpreetNanda1/diseases-of-oral-cavity-70539576 https://www.slideshare.net/kpriyatham/diseases-of-mouth-palate-lips-cheek