Oral Health Self-Care (Symptoms) PDF

Oral health Questions Answers What type of conditions are gum diseases? Inflammatory Name the gum diseases -​ Gingivitis -​ Chronic periodontitis What are the characteristics o...

Oral health Questions Answers What type of conditions are gum diseases? Inflammatory Name the gum diseases -​ Gingivitis -​ Chronic periodontitis What are the characteristics of gingivitis? -​ Mostly caused by bacteria build up in dental plaque -​ Dental plaque -​ Calculus (tartar) -​ Does not affect support for teeth -​ Usually mild -​ Can be reversible What are the characteristics of chronic -​ Involves supporting tissues around periodontitis? teeth -​ Largely irreversible tissue damage -​ Slowly progressive -​ Tissue and bone damage, tooth loosens Describe the disease progression of gingivitis -​ Normal build up of plaque each day -​ Normal brushing should remove each day -​ But if you don’t brush -​ Bacteria produces calculus if built up over a few days -​ Sticks to teeth holding bacteria close -​ Enzymes and toxins released cause inflammation in gingiva (gum) over years mild damage results in a pocket forming between tooth and gum -​ Then tooth root erodes and tooth comes loose-periodontitis Name the symptoms of gingivitis -​ Inflammation of gum -​ Swollen, red and sore -​ Bleeds easily on mild trauma - bleedings with brushing, flossing, or eating hard food -​ Plaque visibility -​ No fever, or malaise Suspect periodontitis if… -​ Halitosis, foul taste in mouth, difficulty eating, pain -​ Gum recession or root sensitivity -​ Loosening or drifting of teeth -​ Sign of infection - abscess/pus Name the epidemiology (cause) of gingivitis -​ Poor nutrition -​ Ineffective oral hygiene -​ Pregnancy -​ Diabetes -​ Smoking -​ Immunocompromised -​ Age -​ Drugs causing dry mouth -​ Stress -​ Local factors How to question a patient with gingivitis? -​ Confirm symptoms - consistent with gingivitis? -​ Bleeding - with or without trauma -​ No trauma = likely periodontitis so refer -​ Toothbrushing technique -​ Too vigorous = gums bleed -​ Other medications? -​ E.g warfarin, heparins, NSAIDs -​ E.g. phenytoin s/e = gum hypertrophy What is the differential diagnosis of gingivitis? -​ Oral malignancy -​ Herpetic gingivostomatitis (viral) -​ Children, fever/malaise/pain -​ Desquamative gingivitis -​ White and red areas/bullae in mucosa -​ Bleeding disorder -​ Platelet disorder, vascular conditions -​ Gum hypertrophy -​ Drugs ADR, hormonal changes -​ Allergic reaction -​ Denture-associated trauma or candidiasis Outline the management of gingivitis -​ Advise regular review with dentist or hygienist -​ Identify risk factors and manage (e.g. Smoking) -​ Advice on oral hygiene -​ Brush teeth for 2 mins twice daily (morning and last thing at night) -​ Replace brushes every 1-3 months or when signs or wear appear if sooner -​ Powered electric toothbrushes are preferred -​ Brushes with small head with medium texture bristles -​ Use fluoride-containing toothpaste - “Spit don’t rinse” when cleaning -​ Dental floss or interdental brushes -​ Mouthwash not routinely recommended unless signs of inflammation -​ Bleeding common - check tooth-brush for wear, don’t apply too much pressure. -​ Give smoking cessation advice Outline treatment of gingivitis -​ Oral hygiene -​ Tooth cleaning (scale and polish) -​ Mouthwashes -​ Chlorhexidine gluconate mouthwash -​ Corsodyl or eludril -​ 10ml twice a day -​ Staining teeth and tongue brown with prolonged use -​ Hexetidine mouthwash -​ Oraldene -​ 15 ml twice to three times a day Name medical name for dry mouth Xerostomia What are the signs and symptoms of dry -​ Dry, sticky feeling in mouth or throat mouth? -​ Insufficient saliva -​ Saliva feels thick or stringy -​ Rough, dry tongue -​ Sore throat -​ Halitosis (bad breath) -​ Difficulty swallowing, chewing or talking -​ Signs of dryness - cracked lips, sores, split skin at corners of mouth -​ Burning sensation in mouth -​ Altered sense of taste -​ Oral infection in mouth Describe the functions of saliva -​ Protects, lubricates and cleanses oral mucosa -​ Aids chewing, swallowing and talking -​ Protects teeth against decay -​ Protects mouth, teeth, throat from infection -​ Supports and facilitates sense of taste Name the epidemiology (cause) of dry mouth -​ Dehydration due to fluid loss -​ Vomiting and diarrhoea -​ Hypercalcaemia -​ Uncontrolled diabetes Mellitus -​ Reduction in production of saliva -​ Medication -​ Medical conditions - sjogren’s syndrome, HIV, Hep C -​ Psychogenic - anxiety may cause temporary dry mouth by reducing saliva flow -​ Poor oral intake (e.g. dysphagia) -​ Damage to salivary glands after radiotherapy -​ Surgery involving salivary glands or buccal region -​ Obstruction, infection or malignancy affecting salivary glands -​ Mouth breathing -​ Colds, Nasal polyps, anxiety and stress, sleep apnoea, breathing technique What are the long term effects of dry mouth -​ Dental caries -​ Oral candidiasis -​ Infection of major salivary glands (usually parotid) -​ Dysgeusia (altered taste sensation e.g. metallic) -​ Dysosmia (altered sense of smell) -​ Halitosis -​ Oral dysesthesia (burning or tingling sensation in mouth) -​ Thick or ropey saliva -​ Mucosa appears dry -​ Dysphagia (difficulty swallowing and chewing) -​ Fissured tongue -​ Difficulty wearing dentures -​ Mouth soreness -​ Dry, sore, cracked lips and angles of mouth -​ Thirst Name non-drug treatment for dry mouth -​ Manage underlying cause if possible -​ Sipping or spraying water frequently -​ Sucking on ice cubes/lollies -​ Sugar-free boiled sweets, gum, pastilles or mints -​ Rubbing petroleum jelly -​ Avoiding mouth breathing -​ Avoiding caffeine, alcohol, tobacco -​ Using a humidifier at home Name drug treatments for dry mouth Oral conditions Questions Answers Describe how cold sores are contracted? -​ Virus particles pass to uninfected person via direct contact and infects epidermal and dermal cells -​ After initial infection > sensory ganglia -​ Moves to dorsal root ganglia of the trigeminal nerve where it lies dormant in a latent state -​ Activated or triggered by factors personal to patient -​ Moves from sensory ganglia to outer layer of skin -​ Cold sore lesion appears again Name the epidemiology of cold sores -​ Viral infection - herpes simplex virus (HSV) -​ Between 20-40% of people have had herpes simplex labialis at some point in their lifetime -​ Approx 2 episodes per year but 5-10%