Oral Myiasis

Oral Myiasis a very Rare topic.

1. By :- Dr . Musaddika Shaikh Oral Myiasis

2. Topics Introduction What is Myaisis Classification of Myiasis Etiology Sign and symptoms Diagnosis Prevention Treatment

3. INTRODUCTION Oral Myiasis is rare pathology associated with poor oral hygiene, alcoholism, senility, suppurating lession and severe halitosis It arises from invasion of body tissues or cavities of maggots or larve of flies

4. What is myiasis ? Myiasis is parasictic infectation by fly larve which is also known as maggots Myiasis is greek word “ Myia ” meaning invasion of vital tissues of body They grow inside host while feeding on it’s on tissue Although flies are attracted to open wound, urine, feaces , but some species like myiatic fliescan create infestation in broken skin Most common myiatic flies are botfly, blowfly, screwfly

5. Classification of Myiasis A] Clinical classification:- i) Primary Myiasis – when larvae feed on living tissue ii) Secondary Myiasis – when larvae feed on dead tissue B] Depending on condition of invoved tissue:- i)Accidental Myiasis – when larve get ingested along with food ii)Semi-specific Myiasis – when larvae are laid on necrotic tissue of wound iii)Obligatory – required living tissue for larvae development iv)Facultative – required necrotic tissue for flies to lay eggs and incubate them C]Based on Anatomic sites:- i)Cutaneous Myiasis ii) Myaisis of External Orifies iii) Myaisis of Iternal Organs

6. Etiology 1. Variety of fly species 2. In conditions as follows:- a.Leprocy b.Carcinima c.Diabetes d.Mental retardation 3. Poor oral hygiene 4. Alcoholism 5. Halitosis 6. senility 7. Lymphocitic inflamation 8. Dental extraction 9. Drug addicts 10. Nosocomial infection 11. Mouth breathing during sleep 12. Trauma 13. Open wound 14. Incopetent lips

7. 1.Variety of fly species Flies belonging mainly to diptheria Sarcohagidae ( fleshflies ) Calliphoridae (blowflies) Dermatobia hominis (human botfly) Cordylobia anthropo-phaga (thumb fly) Chrysomya bezziana Cochliomyia hominivorax Musca domestica Oestrus ovis Wohlfahrtia magnifica

8. Sign and symtoms Redness Swelling Necrotic area Mobility of teeth in affected area Poor oral hygience Decayed tooth Halitosis Pain Severe Destruction Tender to palpate In some cases discharge can be seen Tabbing pain Mouth breather Protude maxillary incisors in some cases

9. D iagnosis A] Clinical Examination :- 1. Poor oral hygiene 2. Redness 3. Swelling 4. Tissue destruction 5. Maggots in affected area 6. Trauma 7. O pen lips 8. Difficulty in breathing 9. Tender to palpate

10. B]Radiographic Investigation :- 1. Orthopantamogram (OPG) 2. Tomography scan 3. Water’s Veiw 4. Intraoral Periapical

11. C] Haematological Investigation :- 1. Total White Blood Cells(WBC) Count 2. Total Red Blood Cells(RBC ) Count 3. Platelet Count 4. Haemoglobin Concentration(HB) D] Entomological Investigation :- It is process of collecting evidence based on insect It is done after removal of Maggots from oral cavity

12. Prevention Good Sanitation Personal Hygiene and Cleanliness Environmental Hygiene Cleanliness Proper Brushing of teeth and tongue twice a day Proper flossing of teeth Use of Mouth-wash Avoid Alcohol Avoid use of Drugs Treatment of incompetent lips ( Myofuctional Thearapy ) Special appliance for mouth breathing habit Proper treatment of Open Wounds,Trauma

13. Treatment A] Procedure for removing Maggots :- B] Removal of necrotic tissue C] Repair of tissues or any fracture D] Medications E] Instructions

14. A] Procedure of Removal of Maggots :- Patient is given General Anesthesia Cotton bud is dipped in Turpentine Oil and is applied to Lacerated mucosa for 10-12 min Maggots are removed with help of blunt tweezer and curved forceps Entomological Investigation is done

15. B] Removal of dead tissues :- Surgical Removal of Necrotic Tissues is done Then area is irrigated with saline,Hydrgen peroxide, and betadine with metronidazole After debridement repair can be done

16. C] Repair of Tissues or any Fracture :- First Patient is planned for open reduction Then internal Fixation is done Repair is done Patient is on medication for 5 days

17. D] Medications :- Patient is put on the following tablets 1. Ivermectin 6mg OD for 5 days 2. Doxycycline(Antibiotic) 100mg BD for 5 days 3. Metronidazole 100 ml 8h given for 5 days

18. E] Instructions :- Patient is advised to maintain proper oral hygiene Rinse wound with 0.2% Chlorhexidine mouthwash 3-5 times a day Patients is also advised to do oral prophalaxis Patient get discharged on 4 th day Follow up appointment is given Extra sutures are removed Patient is recalled periodically On 14 th day wound gets completely cleaned

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