Oral disorders .pptx

For 2nd year B.Sc Nursing students

1. Oral Disorders Presented By: Mr . Nandish. S Asso . Professor Mandya Institute of Nursing Sciences

2. Cheilitis Definiton : It is an irritation & inflammation of lips associated with scaling, crusting, fissure and white over growth of horny layer of epidermis.

3. Types : Actinic Cheilitis : It is also termed as “Solar cheilosis ” as it is the result of chronic over – exposure to ultraviolet radiation in sunlight. It occurs on the lower lip. It causes dryness, scaling and wrinkled grey – white in appearance. It is common in people who spend lot of time outdoors.

4. 2) Angular Cheilitis : It is inflammation of one or both of the corners of mouth. It commonly affects elderly people. The common possible causes are nutritional deficiencies (Iron, Vitamin B, Folate ), infections (candida albicans , staphylococcus aureus ), use of dentures.

5. 3)Drug related cheilitis : It is also called as “drug induced ulcer of lip”. It is described as being characterized by painful or tender, well defined ulceration of the lip without induration. Common drugs which induce cheilitis are Indinavir , Protease inhibitors, Atorvastatin, Tetracycline, Streptomycin, etc.

6. 4) Exfoliative cheilitis : It is a rare reactive condition, presenting as continuous peeling of lips. It usually seen in patients with localised form of Psoriasis. It can also trigger by mouth breathing, lip biting, bacterial or yeast infection. Whatever the cause, excessive keratin formation results in abnormal peeling of lips.

7. Stomatitis : It refers to inflammation of the mucous lining / membrane of mouth with or without ulceration. It is derived from the word “stoma” means mouth. It is caused due to malnutrition ( malabsorption or nutritional deficiency like iron & vitamin B), autoimmunity, denture, chemotherapy, radiation therapy, severe drug allergy, herpes infection, pipe smokers, etc. It is characterised by mild erythema, edema , painful ulcerations, bleeding and secondary infection.

8. Management : Prophylactic mouth care like brushing, flossing & rinsing (cancer patients). Educate patient about proper oral hygiene including use of soft bristled toothbrush, non abrasive toothpaste, swabs with sponge like applicators can be used as replacement for brush. Avoid smoking & alcohol. Restrict hot and spicy foods. Apply topical anti – inflammatory, antibiotic & anesthetic agents.

9. Gingivitis : It is the non – destructive disease that causes inflammation of Gums. Without treatment, gingivitis can progress to periodontitis that results in tissue destruction and bone resorption around the teeth. Gingivitis is reversible with good oral hygiene.

10. Causes: Bacterial infections (both gram positive & gram negative), viral infections, fungal infections. Use of dentures Risk Factors : Aging Osteoporosis Low dental care utilization Poor oral hygiene Mouth breathing (during sleep) Smoking Stress Genetics Medications that dry mouth. Trauma

11. Signs & symptoms: Swollen gums Bright red gums Tender gums Bleeding after brushing Bad breath

12. Treatment : The focus of treatment is to remove plaque. It is performed by using scaling, root planning, curettage, mouth wash by using chlorhexidine & hydrogen peroxide and flossing. Using interdental brushes. Use toothpaste which contains Triclosan , chlorhexidine digluconate , combination of Thymol , Menthol, Eucalyptol and methyl salicylate. Oral irrigation daily with mouthwash containing antibiotic can control gingivitis. (Amoxicillin)

13. Glossitis : It is the inflammation of tongue with depapillation of the dorsal surface of the tongue leaving eryhtematous surface. It is also called as soreness of the tongue. It is termed as atrophic glossitis .

14. Causes : Anemia ( Iron deficiency , pernicious, megaloblastic ) Vitamin B Deficiency Bacterial, Viral or Fungal infections (Syphilis, candidiasis) Malnutrition / Malabsorption Exposure to irritants like tobacco / alcohol, hot foods. Allergic reaction to tooth paste, mouth wash, breath freshners .

15. Clinical manifestations: Smooth & shiny appearance of tongue. Tongue swelling Strawberry tongue Difficulty in chewing, swallowing & speaking. Burning sensation of tongue.

16. Treatment : Goal of treatment is to reduce inflammation. Good oral hygiene including brushing twice a day. Topical applicants (prednisone ) Antibiotics, Antifungal or Antiviral agents. Dietary supplements rich in iron, Vitamin B & E to be provided in excess. Avoid hot or spicy foods, alcohol & tobacco to minimize discomfort.

17. Parotitis : Salivary glands consists of Parotid glands, submandibular glands & sublingual glands. It is an inflammation of one or both parotid glands which are located on both the sides of face. It is the most common inflammatory condition of salivary glands.

18. Causes : Dehydration Infectious parotitis : 1) bacterial – Staphylococcus A ureus , E.Coli , Mycobacterium Tuberculosis. 2) viral – Paramyxovirus (Mumps) is a single stranded RNA Virus.other viruses include Hepatitis C, Adenovirus, Cytomegalovirus…. - Autoimmunity Blockage of Parotid Duct due to salivary stone, mucous plug, tumour ….. Masseteric hypertrophy (enlargement of Masseter muscle)

19. Clinical Manifestations: Swelling of the Face Dry mouth Fever Chills Tachycardia & Tachypnoea Headache Pain aggravates during eating. Redness & shining of overlying skin. Difficulty in swallowing.

20. Treatment : Adequate nutrition & more fluid intake. Good oral hygiene. Topical analgesics. Antipyretics. Antibiotic Therapy If antibiotic therapy is not effective, plan for parotidectomy (surgical procedure to drain glands).

21. Dental Caries / Tooth Decay: It is a prevalent common chronic infectious problem that results in breakdown of teeth due to acids produced by bacteria. Acid is produced when debris or sugar is found on the tooth surface. Around 48% of the population have dental caries in their permanent teeth at some point in their life time.

22. Causes : Four things for caries to form are – tooth surface, caries causing bacteria, fermentable carbohydrates (Sucrose) and time. Bacterias : the most common bacterias associated are streptococcus Mutans , Lactobacilli, Acidophilus and streptococcus Sobrinus . Dietary S ugars : organisms convert glucose, fructose & sucrose into acid (lactic acid) through glycolytic process called Fermentation .

23. Exposure: the frequency with which teeth are exposed to acidic environment. After meals or snacks bacterias act and decreases pH Teeth : M olar incisor hypo-mineralization is common factor which contributes in decay of Molar & Incisors. The process begin within days of eruption if the diet is sufficiently rich in suitable carbohydrates. Other Factors : Reduced salivary flow rate. Any changes in the metabolism of Teeth. Tobacco Smoking. Lower Socio – Economic status.

24. Diagnosis : History collection & Physical Examination (visual and tactile inspection) Dental Radiography Sharp end dental explorers Hypomineralization of teeth Laser speckle image

25. Prevention : Adequate oral hygiene : it consists of tooth brushing and flossing. It helps to prevent formation of plaque. Using of toothpaste containing Arginine have greater protection than regular Fluoride toothpaste. Dietary modification: decreasing the consumption of carbohydrate rich foods (candy, cookies, crackers, potato chips). Supplying more calcium and Fluoride in the food. visit dental clinic once in 6 months. Supervised tooth brushing upto the age of 8 years.

26. Treatment : Regular application of topical Fluoride. Repairing or replacement of filling. Stepwise caries removal. Local Anesthetics . Dental restoration (Amalgam, Composite Resin, Porcelain, Gold, Glass ionomer Cement, stainless steel) Endodontic Therapy (Root canal therapy). Extraction.

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