Background:
You
are reviewing Mrs. Rodriguez's medical history and observe an ulcerated
lesion on the left side of her lower lip. It has a red halo with a yellowish-looking
center. She tells you that it is painful and it appeared about 3 days
ago. She has also been experiencing a burning sensation on her tongue
for the last week and expresses concern about the condition. What is the
lesion on her lip? Can you safely treat her today? What could be the cause
of the burning sensation? How will you address her concerns?
As a dental hygienist you will
observe many changes in your patients' oral cavity. Although you will
not directly prescribe treatment for any oral conditions, you may need
to review treatment regimens or answer questions regarding oral lesions
with your patients. It is important for you as a dental professional to
be aware of common oral conditions, their treatments and any implications
they may have for the care you provide your patients. This lesson focuses
on the more common oral lesions and conditions that may affect patients
in your dental hygiene practice.
 |
Pharmacology
for Dental Hygiene Practice, ch. 12, pp. 172-180 |
Etiology
and Pathogenesis
This table includes some of the
more common oral conditions that you may encounter while you are treating
patients.
The table below shows .....
|
Oral Condition |
Etiology |
Pathogenesis |
|---|---|---|
|
Angular Cheilosis |
Candida albicans, streptococci and staphylocci, or vitamin B deficiency |
Begins as redness at the angles of the mouth and can progress to fissures, erosions, ulcers, or crusting with or without pain. |
|
Recurrent Aphthous Stomatitis ("canker sores") |
Etiology is unknown. Commonly seen in 20% of population. |
Painful ulcerations appearing on nonkeratinized surfaces in the oral cavity, including labial and buccal mucosa, tongue, floor of mouth, or soft palate. Duration: 7-10 days.
|
| Primary Herpetic gingivostomatitis and Recurrent Herpes simplex ("cold sores") |
Herpes Simple Virus I Predisposing factors: ultraviolet light, hormonal changes, emotional stress, viral infections, etc. 80-90% of adults are infected with HSV-1. |
Painful ulcerations that occur on keratinized surfaces in the oral cavity: attached gingiva, hard palate and lips. Typically occurs in same location in subsequent episodes. Mature lesions have a crust over erythematous base. Systemic symptoms such as fever can develop. Duration: 7-10 days. |
|
Oral Candidiasis ("thrush") |
Candida albicans |
White "curd"-appearing plaques attached to oral or vaginal mucosa that can be wiped off leaving an erythematous area. Most commonly occurs in infants, pregnant women, and immunocompromised patients. |
|
Alveolar Osteitis ("dry socket") |
Loss or necrosis of a blood clot that exposes bone in an extraction site. Possible causes: smoking, use of oral contraceptives or menstrual cycle phase. |
Very painful; patient may have fever, lymphadenopathy, and a foul odor. |
| Xerostomia ("dry mouth") | Drug induced; a result of aging or illness; or radiation therapy to head and neck. |
Salivary gland function is altered resulting in decreased saliva flow. Oral mucosa becomes dry, shiny and red. |
| Geographic Tongue (Benign Migratory Glossitis) |
Etiology is unknown. May be related to hormonal changes, stress, infection, psoriasis, or autoimmune diseases. |
Lesions appear as red rings with white centers on the tongue. Patterns change over time and sometimes even disappear for a while. May have a burning sensation. |
|
Glossodynia ("burning tongue") |
Etiology is unknown. May be related to xerostomia, candidiasis, hormonal changes, allergic reactions, psychogenic changes (depression) etc. |
Painful tongue which may include atrophy of filiform papillae and generalized redness. Often does not involve any observable changes in the tongue. Burning, stinging, or itching may occur. |
 |
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