Oral Health Quiz on Stomatitis Types

Introduction

• Common investigations and procedures in GIT disorders have been covered.
• Management of oral and oesophageal disorders will be discussed.
• Conditions covered include simple catarrhal stomatitis, Vincent's stomatitis, hepatic stomatitis, monilia stomatitis (oral thrush), parotitis, achalasia, gastroesophageal reflux, and hiccups.

Objectives

• Define stomatitis.
• Describe different types of stomatitis and their management.
• Discuss oesophageal disorders and their management.

Stomatitis

• Stomatitis is a generalized inflammation of the mouth.
• Types of stomatitis: simple catarrhal stomatitis, Vincent's stomatitis, hepatic stomatitis, monilia stomatitis (oral thrush), and parotitis.

Simple Catarrhal Stomatitis

• Inflammation of the mouth's mucous membranes, with increased mucus and exudates.
• More common in children than adults.

Causes of Simple Catarrhal Stomatitis

• Microorganisms (bacteria).
• Poor oral hygiene.
• Ingestion of hot foods or drinks.
• Foreign objects in the mouth.
• Exposure to strong acids or alkalis.
• Systemic infections.

Signs and Symptoms of Simple Catarrhal Stomatitis

• Low-grade fever.
• Dry mucous membranes.
• Sores in the mouth.
• Mouth pain (especially while eating).
• Reddened mucous membranes.
• Loss of appetite; craving for cold drinks.

Treatment of Simple Catarrhal Stomatitis

• Antipyretics (like panadol).
• Mouthwashes with antiseptics.
• Soft diet.
• Address the underlying systemic condition if applicable.

Vincent's Stomatitis

• Severe inflammation of the mouth and gums.
• Also considered severe gingivitis.

Causes of Vincent's Stomatitis

• Bacteria.
• Poor oral hygiene.
• Immunosuppression.

Signs and Symptoms of Vincent's Stomatitis

• Mouth pain.
• Swelling of affected areas.
• Bleeding gums.
• Reddened mucous membranes.
• Bad taste.
• Halitosis (bad breath).
• Fever (due to infection).

Diagnosis of Vincent's Stomatitis

• Physical examination (reveals mouth and gum swelling, inflamed gums, and gum redness).
• Dental x-rays.
• Patient history.

Treatment of Vincent's Stomatitis

• Oral antibiotics (like penicillin, erythromycin).
• Antiseptic mouthwashes.
• Hydrogen peroxide rinses.
• Regular brushing.
• Professional dental cleaning.

Hepatic Stomatitis

• Contagious viral infection of the mouth.
• Causes ulcers and inflammation.
• Primarily affects children.

Causes of Hepatic Stomatitis

• Herpes viruses (Herpes virus hominis)
• Epstein-Barr virus.
• Varicella-zoster virus.

Signs and Symptoms of Hepatic Stomatitis

• Mouth blisters (often on tongue or cheeks).
• Decreased food intake even with hunger.
• Dysphagia (difficulty swallowing).
• Drooling.
• Fever (may occur 1 to 2 days prior to blister/ulcer appearance).
• Irritability.
• Mouth pain.
• Swollen gums.
• Mouth ulcers (form after blisters pop).

Diagnosis of Hepatic Stomatitis

• History taking.
• Physical examination.

Treatment of Hepatic Stomatitis

• Antiviral medications (acyclovir).
• Liquid diet (cool-to-cold, non-acidic).
• Topical anaesthetics (lidocaine) for severe pain.
• Caution is required when administering topical anaesthetics to avoid swallowing issues and mouth/throat burns.

Monilia Stomatitis/Oral Thrush

• Mouth infection caused by a yeast-like fungus (Candida albicans).
• Common in people with lowered immunity or prolonged antibiotic use.

Predisposing Factors for Monilia Stomatitis

• Lowered immunity.
• Prolonged use of antibiotics (tetracycline, chloramphenicol).

Signs and Symptoms of Monilia Stomatitis

• Lesions in the mouth and on the gums which bleed easily on contact.

Treatment of Monilia Stomatitis

• Hydrogen peroxide and normal saline mouthwashes.
• Clotrimazole tablets (dissolved in the mouth 5 times daily).
• Nystatin suspension/pastilles, or amphotericin lozenges.
• Fluconazole for oropharyngeal candidiasis.
• Oral hygiene.

Parotitis

• Inflammation of one or both parotid glands.

Causes of Parotitis

• Bacterial infections (Staphylococcus aureus).
• Mycobacterium (tuberculosis).
• Mumps virus.
• HIV.
• Obstructions in the main parotid duct or its branches.
• Systemic infections.

Signs and Symptoms of Parotitis

• Swollen, painful glands, often visible at the jaw angle.
• Dry mouth.
• Severe pain while swallowing.
• Pus-like discharge from the gland.
• Skin redness (erythema).
• Ulcers.
• Fever.

Diagnosis of Parotitis

• Patient history.
• Physical examination (checking for enlarged glands).

Treatment of Parotitis

• Antibiotics.
• Mouthwashes.
• Warm salty water rinses for soothing and maintaining mouth moisture.
• Warm compresses.
• Increased fluid intake.
• Drainage of any abscesses (if needed).

Achalasia

• Gastrointestinal disorder characterized by the lack of peristaltic movement in the esophagus and the inability of the lower esophageal sphincter to relax.
• Results in the accumulation and stagnation of food and fluids in the esophagus, causing irritation and inflammation.

Cause of Achalasia

• Unknown exact cause, but possibly related to degeneration or malfunctioning of the nerve plexus in the esophageal muscle tissue.

Signs and Symptoms of Achalasia

• Progressive dysphagia (difficulty swallowing).
• Regurgitation of undigested food.
• Weight loss.
• Halitosis (due to regurgitation of ingested food).
• Coughing when lying horizontally.
• Chest pains that increase after eating.

Diagnosis of Achalasia

• Barium swallow (shows esophageal dilation and lack of peristalsis).
• Esophagoscopy (shows lower esophageal sphincter dilation and potential cancer/candida changes).
• Esophageal manometry (measures muscle contractions in the esophagus during swallowing, revealing lower esophageal sphincter failure to relax and lack of esophageal peristalsis).
• Biopsy (tissue sample during endoscopy which shows hypertrophied muscles and lack of specific nerve cells in the esophageal lining).

Treatment of Achalasia

• Medications (calcium channel blockers like nifedipine, and nitrates like nitroglycerin to relax the lower esophageal sphincter).
• Balloon (pneumatic) esophageal dilatation (to stretch the lower esophageal sphincter).
• Surgery (Heller myotomy or cardiomyotomy, which surgically separates the lower esophageal muscle).

Gastroesophageal Reflux

• A condition where stomach contents flow back into the esophagus (without vomiting or belching).
• A GIT condition due to abnormal gastric content regurgitation into the esophagus.

Cause of Gastroesophageal Reflux

• Changes in the barrier between the stomach and esophagus.
• Abnormal relaxation of the lower esophageal sphincter.
• Anatomical abnormalities such as hiatus hernia (stomach portion moves above the diaphragm).

Predisposing Factors for Gastroesophageal Reflux

• Obesity.
• Zollinger-Ellison syndrome (high gastric acidity).
• Pregnancy.
• Smoking.
• Hypocalcemia (increased gastrin production and acidity).
• Food types (high-fat, high-acid foods).
• Alcohol intake.

Signs and Symptoms of Gastroesophageal Reflux

• Heartburn (burning sensation behind the breastbone, usually after eating).
• Regurgitation.
• Chest pain that radiates to the neck and throat (from acid regurgitation).
• Dysphagia (difficulty swallowing).
• Odynophagia (painful swallowing).
• Nausea.
• Coughing, hoarseness, or wheezing (at night).
• Belching.
• Flatulence.
• Hiatus hernia.
• Nasogastric tube placement (>4 days).

Diagnosis of Gastroesophageal Reflux

• Esophagoscopy (to identify damage).
• Barium swallow (to assess esophageal damage).
• Continuous esophageal pH monitoring (to measure acid reflux).
• Esophageal manometry.
• Positive stool occult blood test (may indicate bleeding from esophageal irritation).

Treatment of Gastroesophageal Reflux

• Dietary changes (avoiding foods that trigger symptoms, managing weight if obese).
• Lifestyle changes (raising the head of the bed, avoiding lying down for hours after eating, quitting smoking).
• Medications (antacids for neutralization, proton pump inhibitors to reduce stomach acid production).
• Surgery (Nissen fundoplication to repair the lower esophageal sphincter, or vagotomy to reduce stomach stimulation).

Hiccups

• Esophageal contraction of the diaphragm that repeats frequently.
• A spasm of the diaphragm leading to a rapid, involuntary inhalation that is stopped by a sudden closure of the glottis, accompanied by a distinctive sound.

Causes of Hiccups

• Central and peripheral nervous system disorders (from injury/irritation of phrenic and vagus nerves)
• Toxic or metabolic disorders.
• Chemotherapy (certain drugs).
• Carbonated drinks/alcohol/spicy food.
• Prolonged laughter.
• Eating too fast.

Treatment of Hiccups

• Ordinary hiccups usually resolve without interventions.
• Home remedies (fright/shock, peanut butter, vinegar, water, breath holding, altered breathing patterns).
• Sedatives (diazepam, chlorpromazine) for severe, persistent hiccups.

Summary

• Discussion of mouth and esophagus conditions, with stomatitis defined as generalized inflammation in the mouth.
• Different types of stomatitis addressed (simple catarrhal, Vincent's, Hepatic, Monilia, parotitis).
• Diseases of the esophagus (achalasia, GERD) and hiccups also discussed.

Assignment

• State the common manifestations (signs and symptoms) of GIT conditions.

Test your knowledge on various types of stomatitis, including Simple Catarrhal Stomatitis and Vincent's Stomatitis. This quiz covers causes, symptoms, and treatments related to oral infections. Perfect for students and professionals in dental and medical fields.