Mouth Disorders and Ulcers Quiz
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Questions and Answers

Which of the following is a common characteristic of angular cheilitis?

  • Smooth, shiny gums
  • White patches on the tongue
  • Excessive saliva production
  • Soreness, redness, and cracks at the corners of the mouth (correct)

What are the common infective factors associated with angular cheilitis?

  • Both yeasts (Candida spp.) and bacteria such as Staphylococcus aureus and beta-haemolytic streptococci (correct)
  • Only bacterial infections
  • Only fungal infections
  • Viruses and protozoa

Which treatment is NOT typically considered a first-line option for angular cheilitis?

  • Both miconazole and fusidic acid creams can be used
  • Fusidic acid cream
  • Miconazole cream
  • Hydrocortisone cream (correct)

Besides angular cheilitis, what oral condition is mentioned as a separate entity?

<p>Gingivitis (A)</p> Signup and view all the answers

Which of these medical products is NOT mentioned as being available over-the-counter (OTC) in Ireland?

<p>Fusidic acid cream (B)</p> Signup and view all the answers

Which of the following best defines the most prevalent type of mouth ulcer?

<p>Minor aphthous ulcers, small and superficial lesions affecting a majority of patients. (B)</p> Signup and view all the answers

Which medication, used for mouth ulcers, is a derivative of salicylic acid and possesses analgesic properties?

<p>Choline salicylate (D)</p> Signup and view all the answers

What is a primary concern when using lidocaine for mouth ulcers based on the text?

<p>Mixed evidence of its effectiveness and maintaining it on the affected area. (A)</p> Signup and view all the answers

A patient presents with white, soft, elevated patches in their mouth that can be wiped off to reveal a red base. Which condition is most likely indicated?

<p>Chronic atrophic candidiasis (D)</p> Signup and view all the answers

Which of the following medications used for mouth ulcers is classified as a non-steroidal anti-inflammatory drug (NSAID)?

<p>Benzydamine (A)</p> Signup and view all the answers

Which of the following is a key distinguishing feature of chronic hyperplastic candidiasis compared to chronic atrophic candidiasis?

<p>It carries an increased risk of malignancy. (B)</p> Signup and view all the answers

What is the primary role of protectants like polyvinylpyrrolidone in the treatment of mouth ulcers?

<p>To provide a physical barrier to aid healing. (C)</p> Signup and view all the answers

Why is Miconazole gel required to be retained in the mouth to be effective for oral candidiasis?

<p>To maximize contact with the fungal infection. (C)</p> Signup and view all the answers

In which form is hydrocortisone typically formulated for treating mouth ulcers, according to the text?

<p>Muco-adhesive tablet (C)</p> Signup and view all the answers

What is the primary causative agent for oropharyngeal candidiasis, which is also known as oral thrush?

<p>Candida albicans (B)</p> Signup and view all the answers

A patient who uses warfarin is experiencing gingival bleeding and has an elevated INR. What is the most immediate action to consider?

<p>Monitor the INR and possibly adjust warfarin dosage. (A)</p> Signup and view all the answers

Which of the following options is NOT identified as a distinct risk factor for developing oropharyngeal candidiasis?

<p>High blood pressure (D)</p> Signup and view all the answers

What is the most common cause of gingivitis?

<p>Build-up of plaque (C)</p> Signup and view all the answers

If a patient has gingival hyperplasia, which of the following medications is the MOST likely cause?

<p>Phenytoin (B)</p> Signup and view all the answers

Which of the following is NOT a recommended treatment for xerostomia?

<p>Drinking caffeinated beverages (D)</p> Signup and view all the answers

A patient has a history of recurrent candidiasis and is experiencing a severe outbreak. Which treatment approach is most appropriate?

<p>Systemic fluconazole capsules (B)</p> Signup and view all the answers

Flashcards

Mouth ulcers (Aphthous Ulcers)

Common, painful superficial lesions in the mouth.

Minor Aphthous Ulcers

A type of mouth ulcer, accounting for the majority of cases.

Oropharyngeal Candidiasis (Thrush)

A common fungal infection of the mouth, often affecting those with weakened immune systems or dry mouth.

Hydrocortisone Mucoadhesive Tablet

A mucoadhesive tablet that delivers hydrocortisone directly to the mouth.

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Choline Salicylate

A derivative of salicylic acid with some analgesic properties, used topically for mouth ulcers.

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Benzydamine

A non-steroidal anti-inflammatory drug (NSAID) used topically for mouth ulcers.

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Polyvinylpyrrolidone (Aloclair)

A product containing polyvinylpyrrolidone, aloe, and hyaluronic acid, used as a spray, mouthwash, or gel for mouth ulcers.

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Lidocaine

A topical anesthetic used for mouth ulcers, but with mixed effectiveness.

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Angular Cheilitis

A condition characterized by soreness, redness, and cracks at the corners of the mouth. It's often related to dentures, but can also indicate nutritional deficiency or a weakened immune system.

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Mixed Infection

A type of infection common in Angular Cheilitis that involves both yeast and bacteria.

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Miconazole Cream

Miconazole is an antifungal medication often used to treat Angular Cheilitis. It works by killing the yeast that contributes to the infection.

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Fusidic Acid Cream

Fusidic acid is an antibacterial medication commonly used to treat Angular Cheilitis. It targets the bacteria involved in the infection.

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Hydrocortisone Cream

Hydrocortisone cream is a corticosteroid that can be added if other treatments are ineffective. It reduces inflammation and itching.

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What is gingivitis?

An inflammation of the gums, commonly caused by plaque buildup.

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What is xerostomia?

It refers to dryness in the mouth, often linked to decreased saliva production.

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Describe chronic atrophic candidiasis.

It is a fungal infection affecting dentures wearers, causing creamy white patches.

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Explain chronic hyperplastic candidiasis.

Commonly known as plaque-like candidiasis, it requires specialist referral due to an elevated chance of malignancy.

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What is the most effective treatment for gingivitis?

The most effective treatment for gingivitis involves a specific solution.

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What medications can induce gum bleeding?

Medications like warfarin, heparin, NSAIDs, and anti-platelets can cause gum bleeding.

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Describe the signs and symptoms of gingivitis.

It refers to swelling and reddening of the gums that bleed easily with minor injury, often accompanied by visible plaque or bad breath.

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What constitutes general advice for oral health?

It includes regular brushing, flossing, using fluoride toothpaste, and mouthwash, along with regular dental checkups.

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Study Notes

Disorders of the Mouth

  • The presentation covered various mouth disorders, including signs, symptoms, prevalence, aetiology, and treatment options.
  • Key learning outcomes included recognizing oral cavity conditions, describing their prevalence and pathology, selecting appropriate treatment, and explaining medication mechanisms.
  • The oral cavity includes the cheeks, hard and soft palates, and tongue.

Mouth Ulcers (Aphthous Ulcers)

  • Minor aphthous ulcers are the most common (80%), characterized as small (<1cm), round, grey-white, painful, shallow, and raised lesions.
  • They can occur singly or in small groups of up to 5.
  • Possible causes include unknown factors, genetics, stress, trauma, diet, nutrition, and infection.
  • A cautionary link exists between these ulcers and coeliac disease/inflammatory bowel disease.
  • Healing typically takes 7-14 days, with potential for recurrence.

Types of Mouth Ulcers

  • Different visual presentations of mouth ulcers were illustrated.

Treatment Options for Mouth Ulcers

  • Treatment options include various topical agents like antimicrobial agents, anaesthetics, analgesics, protectants, and corticosteroids.
  • Specific examples of topical antimicrobial agents include chlorhexidine mouthwash/gel (for those over 12), hexidine (e.g., Oraldene).
  • Lidocaine is an example of a topical anaesthetic, though its retention can be problematic. Choline salicylate and benzydamine are examples of topical analgesics.
  • Polyvinylpyrrolidone (Aloclair) is one type of protectant, while corticosteroids provide another treatment option. Carbenoxolone sodium is another common protectant type.

Fungal Infections of the Mouth

  • Opportunistic mucosal infection.
  • Candida albicans is a generally harmless yeast but can cause infection.
  • Oropharyngeal candidiasis (thrush) is usually acute but can be chronic.
  • Risk factors include diabetes, dry mouth, immunocompromised status, antibiotic use, inhaled corticosteroids, and ill-fitting dentures.
  • Different types of oral candidiasis (thrush) exist, including pseudomembranous, acute erythematous, chronic atrophic (denture stomatitis), and chronic hyperplastic.
  • Important to consider referral for chronic hyperplastic candidiasis due to an increased risk of malignancy.

Features of Oral Thrush

  • Typical presentation includes cream-white, soft, elevated patches that can be wiped off, revealing red mucosa underneath.
  • Pain, burning, and soreness are common symptoms.
  • Lesions may affect the tongue, palate, lips, and cheeks.

Treatment Options for Oral Thrush

  • Topical treatments such as Miconazole (Daktarin Oral Gel) and Nystatin Oral Suspension are antifungal options;
  • Fluconazole capsules are available as a systemic treatment option.

Gingivitis

  • Gingivitis is gum inflammation.
  • It is generally caused by a buildup of plaque.
  • It's treatable and preventable.
  • Common symptoms include mild, painless conditions, routine dental visits are important in diagnosis, including bleeding gums, gum swelling and reddening (that occurs easily with slight trauma), and possible plaque/halitosis (bad breath).
  • Additionally, some medications (e.g., Warfarin, heparin, NSAIDs, and antiplatelets) can cause gum bleeding.
  • Phenytoin and ciclosporin are associated with gum hypertrophy (gingival hyperplasia). The INR of warfarin patients needs to be monitored.

Gingivitis Treatments

  • Chlorhexidine is considered the most effective treatment (0.1% or 0.2%).
  • Other options include hexetidine and hydrogen peroxide.
  • General advice includes regular brushing and flossing, twice-daily brushing, fluoride toothpaste use, post-meal brushing, and regular dental visits.

Xerostomia (Dry Mouth)

  • Xerostomia is characterized by decreased saliva production.
  • It can be caused by various drugs.
  • The condition increases with age.
  • Patients with dry mouth are at a higher risk for dental/oral infections (particularly candidiasis).

Xerostomia Treatment

  • Dietary adjustments (avoiding caffeine and smoking), frequent water intake, sugar-free gum chewing, using a humidifier, or artificial saliva products (like Biotene, BioXtra, Glandosane) are treatment options.

Angular Cheilitis

  • Angular cheilitis is inflammation at the corners of the mouth, presenting as soreness, erythema, and fissuring.
  • Possible causes include yeast infections (Candida spp.) bacteria (Staphylococcus aureus, beta-haemolytic streptococci), nutritional deficiencies, and immunosuppression (denture stomatitis being another possible cause).
  • Usually self-limiting.

Angular Cheilitis Treatment

  • Treatment options include identifying the underlying cause (fungal or bacterial infection), and applying antifungal creams (e.g., miconazole), antibacterial creams (e.g., fusidic acid), or steroids (e.g., hydrocortisone) if other treatments are ineffective.

General Summary

  • A variety of oral disorders, including mouth ulcers, oral thrush, gingivitis, xerostomia, and angular cheilitis, were discussed.
  • Various treatments and formulations were presented, varying depending on the specific condition.

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Description

This quiz covers various mouth disorders, focusing on symptoms, causes, and treatments of mouth ulcers, particularly minor aphthous ulcers. Learn to recognize these conditions and their associated pathologies while understanding their prevalence and treatment options.

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