Problems associated with oral cavity

COMMON PROBLEMS ASSOCIATED WITH ORAL CAVITY

1. COMMON PROBLEMS ASSOCIATED WITH ORAL CAVITY ANKIT KUMAR MALIK M.PHARMACY 2 nd sem DEPARTMENT OF PHARMACEUTICS SPER , JAMIA HAMDARD 1

2. INTRODUCTION The oral cavity includes the lips, the inside lining of the lips and cheeks ( buccal mucosa ), the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, and the bony roof of the mouth (hard palate). The area behind the wisdom teeth (called the  retro-molar trigone ) can be included as a part of the oral cavity, although it is often considered part of the oro -pharynx. Basic oral healthcare- Brush teeth twice a day. Floss teeth three times a week. Visit a dental practitioner or dental hygienist regularly. 2

3. Problems associated with oral cavity: Bad Breath This is a humiliating problem that most people suffer from. According to a research, it is revealed that nearly 85% of person suffers from persistent bad breath. Main reasons for bad breath are dry mouth, cavities, bacteria accumulation, oral cancer, consumption of food that contains ginger and onion. One can use mouthwash to reduce the problem or visit dentist. 3

4. . 2. Gum Problems It is also known as periodontal disease and the third most common oral problem. This problem may result in dangerous consequences like heart attack and strokes. It is a situation in which infection spread throughout the gums that damages the roots and result in bad breath, black flaky tooth, and bloody gums. 4

5. . 3. Tooth Decay The attack of cavities in our teeth is known as tooth decay. Tooth decay starts when food particulates remain stuck in the teeth. The food particulates combine with sugar present in saliva, start producing acid in the teeth. This acid production harms the teeth enamel and weakens the roots i.e., we should brush our teeth twice a day. 5

6. . 4. Oral Cancer Thousands of people suffer from this disease annually. Oral cancer affects mouth, lips , and throat. Regular oral check ups and proper care may reduce down the symptoms of oral cancer. 6

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8. 5. Burning Mouth Syndrome (BMS) This idiopathic condition is characterised by a burning sensation in the tongue or other parts of the mouth in the absence of medical or dental causes: Exclude local and systemic factors (such as xerostomia , infections, allergies, ill-fitting dentures, hypersensitivity reactions and hormone and vitamin deficiencies) before diagnosing BMS. Dryness and taste disturbance are also often present. Symptoms are sometimes relieved by eating and drinking (unlike mouth ulcers, which are more painful on eating). 8

9. 6.Geographic tongue (benign migratory glossitis ) This is a common idiopathic condition affecting up to 10% of children and adults. It presents with map-like red areas (hence its name) of atrophy of filiform tongue papillae. The areas and patterns may change rapidly (over hours). In this the tongue is often fissured. 9

10. 7. Leukoplakia This term was formerly used to describe all white lesions of the oral mucosa, but is now given to those cases of unknown cause or those cases that are considered to be premalignant. Referral for biopsy is required to exclude or diagnose malignancy. However, most white lesions in the mouth are relatively benign keratoses caused by friction from teeth, cheek biting or tobacco smoking. Various treatments have been used to try to encourage resolution of leukoplakic lesions and prevent malignant transformation, but their efficacy is unproven. Photodynamic therapy and cryotherapy are alternatives for the traditional surgical treatment oral leukoplakia . 10

11. . Hairy leukoplakia This is a white, asymptomatic lesion, usually on the lateral margin of the tongue. It is associated with the Epstein-Barr virus and with immuno -compromise. The lesions vary in appearance from smooth, flat, small lesions to irregular 'hairy' or 'feathery' lesions with prominent folds or projections, located on the margins, dorsal or ventral surfaces of the tongue or on buccal mucosa. Treatment options include systemic antiviral therapy ( eg , aciclovir 800 mg five times a day), topical therapy with podophyllin or retinoic acid, or cryotherapy . 11

12. 8. Dry mouth Also known as xerostomia , this is characterised by a dry mouth sensation and difficulty in speaking or swallowing, due to thick or sticky saliva. Individuals may also complain of halitosis. A wide range of conditions may cause this problem. Relatively common causes are listed below: Psychogenic causes including BMS. Age-related. Anti-cholinergic medication (particularly tricyclic antidepressants). Various other medication, including diuretics. 12

13. 9. Halitosis Halitosis is also commonly caused by gastro-oesophageal reflux disease and this needs to be investigated and managed appropriately. Other possible causes are acute or occult illness, including chest infection,  bronchiectasis , lung abscess, appendicitis, gastroenteritis, undiagnosed diabetes mellitus or liver disease. Possible treatments, depending on the cause, are smoking cessation, better oral hygiene, use of antiseptic mouthwashes and regular dental follow-up. 13

14. 10. Dental abscess This is a collection of pus in the tooth or within the surrounding structures. It most commonly originates in the centre (pulp) of the tooth - a periapical or dento alveolar abscess. A periodontal abscess originates in the tissue surrounding the tooth. Their pathophysiology and management are different but, in the context of primary care, they can be treated as the same entity. Results in worsening pain from hours to days. 14

15. Systemic diseases affecting the teeth and gingiva : Gastrointestinal disease  - the mouth is the first part of the alimentary canal and so, in theory at least, history and examination of the gastrointestinal tract should start with the mouth. For example - Crohn's disease Non-gastrointestinal systemic disease  - conversely, when looking at lesions in the mouth, bear in mind that there could be a systemic explanation. eg - mouth ulcers caused by leukaemia,  pemphigus  or systemic l lupus erythematosus . 15

16. . 3. Secondary problems affecting the mouth: The problem we are looking at in the mouth may actually be a secondary problem such as due to insufficient saliva (which is both lubricating and antibacterial, being a good source of immunoglobulin A ( IgA )). Disease of both teeth and gums is more common if saliva flow is impaired. This may occur in Sjögren's syndrome, where irradiation to treat cancer may have damaged the glands, in dehydration or when anticholinergic drugs are used. 16

17. 4. I atrogenic problems: Due to the activity of a physician or therapy. For example, an  iatrogenic  illness  is  an illness that  is  caused by a medication or physician Finally, drugs may affect both adults and children; for example, phenytoin can lead to hyperplasia of the gums. 17

18. REFERENCES Website AAP Health Topics, Oral Health : www.aap.org/healthtopics/oralhealth.cfm Preventive Oral Health Intervention for Pediatricians. Pediatrics 2008;122:1387-1394 www.philadelphia.edu.jo/.../The%20Mouth%20and%20Oral%20Cavity%202.ppt https://www.verywellhealth.com/top-common-dental-problems-1059461 https://www.ncbi.nlm.nih.gov/pubmed/2196616 18

19. THANK YOU 19