Oral Cavity Infections and Conditions

Oral Cavity Infections

• Herpes simplex infections are common but typically mild.
• Most orofacial herpes infections are caused by HSV-1.
• Acute herpetic gingivostomatitis involves vesicles and ulcerations of the oral cavity.
• Recurrent herpetic stomatitis is a recurring condition.

Oral Cavity Apthous Ulcers

• Common superficial ulcerations of oral mucosa.
• Characterized as single or multiple, shallow ulcerations.
• Heal spontaneously; often recurrent.
• More painful than serious.
• Glossitis, a beefy-red tongue, is observed in deficiency states.

Oral Candidiasis (Thrush)

• Superficial white patches or fluffy membrane.
• Membrane is often made up from matted organisms encased in fibrinosuppurative exudate.
• Underlying surface is easily detached and reddened.
• Candida is normal oral flora.
• Occurs in individuals with conditions like diabetes, neutropenia, or compromised immune systems (e.g., HIV).
• Most common fungal infection in the oral cavity

Oral Manifestations of Systemic Disease

• Hairy Leukoplakia is associated with immunocompromised patients (e.g., HIV).
• White, fluffy thickenings on the tongue's lateral parts.
• Epstein-Barr virus presence is common in most cases.
• Oral manifestations of systemic infections include Measles (Koplik spots), infectious mononucleosis, and diphtheria.
• Oral manifestations are also seen in various dermatologic conditions, like lichen planus , pemphigus, and erythema multiforme.

Oral Manifestations of Systemic Diseases Miscellaneous

• Haematologic disorders like pancytopenia, monocytic leukaemia, may present with oral manifestations.
• Phenytoin ingestion, or pregnancy can present with diverse oral manifestations.

Oral Manifestations of Systemic Diseases: Disorders

• Acute pharyngitis and tonsillitis, potentially with a gray-white exudative membrane and enlarged cervical lymph nodes.
• Diphtheria involves a characteristic dirty white fibrinosuppurative, tough inflammatory membrane over the tonsils and retropharynx.
• Human Immunodeficiency Virus (HIV) infection can create many opportunistic oral infections (including Candida and some fungal infections).
• Kaposi's sarcoma and hairy leukoplakia are sometimes seen along with oral lesions.

Oral Manifestations of Systemic Diseases: Other Infections

• Measles often appear with spotty enanthema, and ulcers on buccal mucosa about the Stensen duct area produce Koplik's spots.
• Scarlet fever: Characteristic includes fiery red tongue with prominent papillae (raspberry tongue), sometimes white coated with hyperemic papillae (strawberry tongue).
• Infectious mononucleosis has various oral presentations.

Oral Manifestations of Systemic Diseases: Dermatologic Conditions

• Lichen planus can occur with reticulated , lace-like white keratotic lesions (sometimes bullous and ulcerated) and may rarely be the sole manifestation in patients.
• Bullous pemphigoid and pemphigus display similar but distinct oral presentations.

Oral Manifestations of Systemic Diseases: Erythema Multiforme

• Erythema multiforme is a maculopapular eruption, potentially vesiculobullous.
• Sometimes triggered by infections, drug reactions, or underlying cancers.
• Stevens-Johnson syndrome is a severe form affecting the lips and oral mucosa

Oral Manifestations of Systemic Diseases: Miscellaneous

• Melanotic pigmentation may be observed in conditions like Addison's disease, hemochromatosis, fibrous dysplasia, Peutz-Jegher syndrome.
• Phenytoin ingestion and pregnancy may lead to gingiva enlargement or various fibroid changes.
• Rendu-Osler-Weber syndrome presents with multiple aneurysmal telangiectasias affecting the skin and mucous membranes including oral cavity.

Hematologic Disorders

• Pancytopenia (including agranulocytosis and aplastic anemia): severe oral infections such as gingivitis, pharyngitis and tonsillitis. The condition can extend to the neck (Ludwig angina)
• Leukemia, especially monocytic leukemia, can lead to infiltration and enlargement of the gingiva often with accompanying periodontitis.

Precancerous Lesions

• Leukoplakia is a white plaque or patch that is not easily removed.
• Erythroplakia refers to red velvety erosions; it's less common but more serious compared to leukoplakia.
• Factors such as the use of tobacco (cigarettes, pipes, cigars, and chewing tobacco) are leading causes.

Tumors and Precancerous Lesions

• Some tumors, like papillomas, hemangiomas, and lymphomas are also present in other body areas and are not specific to oral cavity.
• Only squamous-cell carcinoma and related precancerous lesions are discussed.

Leukoplakia

• Leukoplakia is defined by the WHO as a white patch or plaque that cannot be scraped off and cannot be clinically or pathologically classified as anything else.
• White patches caused by conditions such as lichen planus and candidiasis are not leukoplakias.

Oral Cavity Tumors

• Some oral lesions could also be pre-cancerous.
• Common types of oral cancer tumors include squamous cell carcinoma.
• Types of other cancers may include papillomas, hemangiomas and lymphomas, and other widespread neoplasms.

Odontogenic Tumors

• Odontogenic tumors are complex lesions derived from odontogenic epithelium, ectomesenchyme or both.
• One of the common types of odontogenic tumors includes ameloblastoma.
• Another common type is odontoma, which is a type of hamartoma (mass of abnormal cells).

Diseases of Salivary Glands

• Sialadenitis involves inflammation in the salivary glands.
• Sialolithiasis describes stone formation in the salivary ducts.
• Mucoceles are common salivary gland inflammatory lesions
• Viral sialadenitis commonly involves Mumps
• Bacterial sialadenitis often caused by Staphylococcus or Streptococcus
• Auto-immune Sjogren syndrome can lead to secondary salivary gland involvement.

Salivary Gland Tumors

• Benign pleomorphic adenomas are common parotid tumors
• Pleomorphic adenomas are also sometimes found in the submandibular and sublingual glands.
• The common Warthin's tumor in the salivary glands is primarily found in parotid glands.
• A malignant salivary gland tumor, potentially mucoepidermoid carcinoma, a mix of squamous cells and mucus cells.

Explore the various infections and conditions affecting the oral cavity, including herpes simplex, aphthous ulcers, and oral candidiasis. Understand their characteristics, common causes, and implications for health. This quiz covers essential knowledge for anyone studying dentistry or oral health.