Viral Infections of the Oral Cavity GN.pdf

24/09/2023 Viral Infections of the Oral Cavity Biomedical Science Sarah Balian 1 2 GDC Learning outcomes 1.1.2 Describe oral diseases and their relevance to...

24/09/2023 Viral Infections of the Oral Cavity Biomedical Science Sarah Balian 1 2 GDC Learning outcomes 1.1.2 Describe oral diseases and their relevance to prevention, diagnosis and treatment 1.1.3 Explain general and systemic disease and their relevance to oral health 1.1.4 Explain the aetiology and pathogenesis of oral disease 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their application to patient management 1.1.6 Describe relevant and appropriate physiology and explain its application to patient management 1.1.7 Explain the potential routes of transmission of infectious agents in dental practice, mechanisms for the prevention of infection, the cientific principles of decontamination and disinfection and their relevance to health and safety 1.9.1 Recognise and manage patients with acute oral conditions ensuring involvement of appropriate dental team members 1.11.1 Assess and manage the health of periodontal and soft tissues taking into account risk and lifestyle factors 2 1  24/09/2023 3 Intended Learning Outcomes By the end of this session students should be able to: List the most common viral infections that impact the oral cavity. Explain the features, diseases and demographics for common viral infections List the common signs and symptoms of common viral oral infections. Explain common strategies to support patients with viral oral infections. Explain the rationale for postponing treatment to a more appropriate time, particularly with herpes labialis. Explain the impact on the dental clinician in managing common oral viral infections. 3 Viral Infections of the Oral Cavity Varicella zoster Mumps 03 Herpes Simplex / 02 Zoster 04 HIV 01 Infective 05 Mononucleosis 06 Human Papilloma 4 2 viruses-microbe know no age 24/09/2023 -. 5 5 Varicella - Zoster 6 3  24/09/2023 7 Varicella-Zoster (human herpes virus 3) Chickenpox -primary infection Shingles - - re-activation of dicease. Varicella Herpes Zoster - different diseases from same organism. 7 8 Varicella-Zoster Common in children - - Usually mild and self-managed - More serious if contracted in adulthood other symptoms... 2 week incubation fever · Malaice Fever & rash · Papules become vesicular & itchy but painless Unlike rash in shingles Stay hyavated t lat le Ibruprofen/Paracetamol for fever - · 8 4  24/09/2023 9 skin , rash lays dormant and becomes reactivated, travels through neve fibres in. Virus unilaterally-I side of bac face. Varicella (herpes)- Zoster (Shingles) - : usually triggered by traumas drugs , immunosupresant. Dorsal root ganglia Trigeminal nerve I tends to sit here uncomfortable 9 10 Ramsay hunt affects Shingles of the facial nerve Rare Vesicular rash on tympanic membrane and auditory canal Unilateral facial palsy painful , can lead to paralysis / hearing loss on I side. Tinitis Change in tastelloss of taste - · · Difficulting Vertigo. · Drymouth seeing l eyes 10 5  24/09/2023 11 Unilateral presentation of Shingles. Oral lesion of Shingled I side. - only presents toothache may complain of Advicept seers medical help due to hypersensitivity. or ask for and opinion. 11 12 Hand Foot & Mouth Mainly caused by group A coxsackie viruses have temperature Main symptoms malaise may Spots can appear on buttock & groin Transmissible – air, coughing, faecal contact & contaminated objects Common outbreaks in nurseries in children. extreme or mild. 12 6  24/09/2023 13 causes sores within mouth-ulcers soft palate or eat food Herpangina maybe difficult to swallow 10 days Children 3-10 , Clears normally can be contagious 3-Sweeks after getting Main features – vesicles in the virus. mouth Coxsackie A Seasonal – occurs mostly in summer Symptoms malaise, sore throat Transmissible faecal / oral route or air droplets Self managed painkillers - 13 Epstein-Barr Virus – Human Herpesvirus 4 14 7  in Another virus that presents with ulcers mouth/palate herpetic gingival stomatitis I how to differenciate ? Herpagina - more posteriorly gingival stomatitis more anteriorly -.  24/09/2023 15 Epstein-Barr Virus Most people are infected by the Epstein-Barr virus (EBV) in early childhood. When teens or young adults become infected, it can cause infectious mononucleosis (glandular fever). EBV becomes dormant, and people remain infected throughout their lives without any symptoms. Lives in latent form in B-lymphocytes. Humans are only known host 15 16 tumor trigger response Disease caused by EBV: parasite naut -malignavia - rare but Common in Southchine groups ↳ dief Nasopharyngeal Glandular fever Burkitt’s Lymphoma I carcinoma · infective mononucleosis is common in teens very -not hairy -raised projective Oral Hairy Leukoplasia HIV + aids groups. - 16 8  24/09/2023 Paramyxoviridae 17 18 Swelling of parotid glands - 2-3 weeks for symptoms to appear. Mumps transmits-cougus sucesses. , Usually childhood illness Causes parotitis Painful swellings on side of face. Symptomatic If contracted after puberty – 1 in 4 males can have pain & swelling of testicle 1 in 20 females get swelling of ovaries - 1 in 20 temporary hearing loss H2 weeks - 1 in 1000 viral meningitis lasts - 1 in 20 acute pancreatitis normally - · manage Symptoms painkillers most contagious afew days before symptoms Bediest-hydration Soft diet ·. 18 9  24/09/2023 19 Measles - Measles morbillivirus Most highly infectious disease known – air droplets & surfaces Characteristic exanthematous rash- eruptive ragh-Zantnanous rash - can in appear n Enters through respiratory tract Associated symptoms: headache, fever, sore throat & Koplik’s spots Complications 1. Pregnancy – still birth & miscarriage canbeserene. 2. Vision loss 3. Fatal brain complication known as subacute sclerosing panencephalitis 1 in 25,000 4. Fits seizures 5. Encephalitis 19 20 measles oral Koplik’s Spots in cavity. 20 10  24/09/2023 London at risk of measles outbreaks with modelling estimating tens of thousands of cases UKHSA modelling suggests that, unless MMR vaccination rates improve, London could see a measles outbreak with tens of thousands of cases. From: UK Health Security Agency Published 14 July 2023 Last updated 14 July 2023 — See all updates London at risk of measles outbreaks with modelling estimating tens of thousands of cases - GOV.UK (www.gov.uk) 21 Herpes Simplex (HSV 1 & 2) 22 11  24/09/2023 23 HS1 & HS2 Generally – HS1 causes orofacial lesions or lesion ‘above the belt’ HS2 causes genital lesions ‘below the belt’. HS1 HS1 HS2 HS2 HS2 23 24 Primary infection -S-todays-no scarring - Canberecurring swellingofbranaa Primary Genital Herpes Herpetic whitlow Encephalitis gingivostomatitis I I I usually HS2 Usually prevents transmitted. very common sexually in dental subclinically 3. inflamed lymph nodes professional · milase 24 12  24/09/2023 25 - coldsores - herpes labialis Secondary infection lives in trigeminal ganglion. sit's in nerve bundles until reactivated. 25 26 usually a trigger Stimulation of activation of secondary herpes (cold sore) bitelip/Burn yu rays - ↑ Stress Trauma Sunlight Menstruation Immunosuppression Fatigue 26 13  24/09/2023 27 to cancel appointment Advise patients Herpes Labialis (Cold Sore) if have cold some Spread- 27 Common advice 28 14  24/09/2023 29 Common methods to alleviate symptoms if being self managed try nonsteroidalant Eat cool Avoid NSAIDS Cold soft foods triggers compress Sun block Hydration Rest 29 30 Additional Advice Isolation No kissing No oral sex Use a tissue No sharing – Do not touch Hand Good food, cutlery, – avoid hygiene cleaning towels spread practices 30 15  24/09/2023 31 31 32 General management recognizing somethings / not normal Staff Recognition protection Infection control Management of symptoms - patient comfort Referral ~ possibly 32 16  24/09/2023 HIV /AIDS ↳ STD Lecture & HiV/MDS Lecture 33 34 Refer to Sexually Transmitted Disease lecture 34 17  24/09/2023 35 What’s in that kiss? Somillion bacteria. + natural microflora. 35 36 Image references https://www.huffpost.com/entry/not-so-fast-3-ways-to-slo_b_12661378 https://www.cdc.gov/chickenpox/about/photos.html https://raisingchildren.net.au/guides/a-z-health-reference/hand-foot-mouth-disease https://www.afterhourskids.com/blog/hand-foot-and-mouth-disease https://www.msdmanuals.com/professional/infectious-diseases/enteroviruses/herpangina https://www.nejm.org/doi/full/10.1056/NEJMicm1404522 https://www.independentnurse.co.uk/clinical-article/diagnosis-and-management-of-glandular-fever-in-primary- care/223982/ https://www.msdmanuals.com/professional/hematology-and-oncology/lymphomas/burkitt-lymphoma https://www.verywellhealth.com/hairy-leukoplakia-hiv-associated-oral-disease-48956 https://www.thesun.ie/fabulous/584447/what-is-the-mumps-signs-and-symptoms-to-look-out-for-and-best-treatments/ https://www.smiles-for-kids.com/clinical-updates-set-1/ef3zlgwe8pft87s38ztd7zb9kteahw https://www.pulse.ng/lifestyle/beauty-health/genital-herpes-causes-symptoms-and-prevention-of-this-ailment/xnv9z5t https://www.news-medical.net/health/Diagnosis-and-Treatment-of-Encephalitis.aspx https://www.cell.com/trends/microbiology/fulltext/S0966-842X(20)30074-3 https://www.medicinenet.com/image-collection/herpes_simplex_virus_type_1_picture/picture.htm https://www.medicalnewstoday.com/articles/322620 36 18  24/09/2023 37 Recommended reading Bagg, J, (1994). Virology and the mouth. Rev Med Microbiol,5, 209-216. Scully, C., & Samaranyake, L,P. (2015) Emerging and changing viral diseases in the new millennium. Oral disease,22, 171-179. 37 19