Download The Mouth and salivary glands atlas

The Mouth & salivary glands
Atlas
Prof. Dr. Khalid A. Al-Khazraji
MBCHB, MD, CABM, FRCP, FACP
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• Stomatitis: is inflammation in the
mouth from any cause, such as illfitting dentures.
• Angular stomatitis is inflammation of
the corners of the mouth.
Angular stomatitis
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Glossitis
Glossitis is a red, smooth, sore tongue
associated with B12, folate or iron deficiency.
It is also seen in infections due to Candida
and in riboflavin and nicotinic acid
deficiency.
A black hairy tongue is due to a proliferation of
chromogenic microorganisms causing brown
staining of elongated filiform papillae. The
causes are unknown, but heavy smoking and
the use of antiseptic mouthwashes have been
implicated.
A geographic tongue is an idiopathic condition
occurring in 1–2% of the population and may
be familial. There are erythematous areas
surrounded by well-defined, slightly raised
irregular margins. The lesions are usually
painless and the patient should be reassured.
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Glossitis
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Geographic tongue
Black hairy tongue
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Lesions of the mouth
I- Aphthus.
II- Infectious.
(Viral , Bacterial , Fungal).
III- Neoplastic (ulcerative).
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Aphthus lesions
Types:
Minor aphthus
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Distinctions between Aphthous
and Herpetic Oral Ulcers
Condition
Mucosa
Location
Aphthous
unkeratiniz
ed
Lateral tongue, floor of the
mouth, labial and buccal
mucosa, soft palate, pharynx
Herpes
simplex
Keratinized Gingiva, hard palate, dorsal
tongue.
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Major Aphthus
Herpetiform aphthus lesion
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Herpes simplex
Infection with HSV commonly produces painful vesicles and
ulcers on the genitalia, eyes, lips, mouth, and skin.
Primary herpetic gingivostomatitis is caused by HSV type
1. Primary infection occurs in up to 90% of the
population before puberty. The illness is often mild and
mistaken for a routine upper respiratory tract infection;
it may include varying degrees of fever, malaise, and
adenopathy, together with oral and gingival ulcers.
Lesions may appear on the lips. They generally heal in
one to two weeks.
Recurrent orolabial herpes simplex is caused by
reactivation of HSV that has been dormant in
regional ganglia. Episodes may be precipitated by
fever, sunlight, and physical or emotional stress.
Typically, the lesions involve the lips and are
preceded by several hours of prodromal symptoms.
Vesicles then appear but soon rupture.
Labial and oral herpetic ulcers normally heal in less
than two weeks. Recurrent HSV is the most
common cause of recurrent erythema multiforme.
Management is palliative, but acyclovir, 400 mg three
times a day, may shorten the course and reduce severity.
Secondary bacterial infection is common and can be
treated topically.
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In immunocompromised patients, HSV can affect
any mucocutaneous surface and appear as large,
irregular, pseudomembrane-covered ulcers.
HSV is usually diagnosed from the history and
clinical findings. A cytologic smear showing
multinucleate giant cells is suggestive, although
viral cultures and monoclonal antibody staining
of smears are more sensitive and specific.
Systemic acyclovir is regularly used for treatment of
primary
or
recurrent
attacks
in
immunosuppressed patients (2 g orally in divided
doses, or 5 mg/kg intravenously three times daily
until lesions heal).
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Herpes simplex
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Oral erythema multiforme
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Acute necrotizing ulcerative gingivitis ANUG
( Vincent’s angina)
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Oral cancer
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Candidiasis
Oral candidiasis or candidosis (moniliasis, thrush)
typically appears as white curd-like patches or as
red (atrophic) or white and red friable lesions on
any mucosal surface.
Candidiasis often occurs during or after antibiotic or
glucocorticoid therapy, in denture wearers,
pregnant women, and older adults, and in patients
with anemia, diabetes mellitus, Hashimoto's
thyroiditis, Cushing's disease, or familial
hypoparathyroidism.
Oral candidiasis is also associated with xerostomia,
whatever the cause.
Topical therapy is most effective in patients with no
underlying chronic conditions and may use of the
following: (1) nystatin (Mycostatin), 100,000-U
vaginal tablet dissolved orally three to five times
daily; (2) clotrimazole (Mycelex), 10-mg troche to
be dissolved orally five times daily; or (3)
clotrimazole, 500-mg vaginal tablet, to be dissolved
orally at bedtime.
Topical agents are effective in the absence of
immunosuppression, whereas oral antifungal agents
are needed in immunocompromised patients.
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Candidiasis
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Addison’s disease
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Oral lichen planus
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Peutz-Jeghers Syndrome
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Causes of Halitosis
1- Poor oral hygiene.
2- Anxiety when halitosis is more imaginary
than real.
3- Esophageal stricture.
4- Pulmonary sepsis.
5- Gastric outlet obstruction.
6- Intestinal gastric fistula.
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Gingival swelling
hereditary
Drugs
Pregnancy
Scurvy
Leukemia
Wegeners granuloma
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Diseases of Salivary glands
1- Infectious.
2- Autoimmune ( Sjögren's syndrome ).
3- Inflammatory (Sarcoidosis ).
4- Neoplastic.
5- others ( chronic liver disease.)
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Parotitis
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Causes of Xerstomia
( dry mouth )
1- sjogren's syndrome.
2-
Drugs
(
e.g.
antimuscarinic,
antiparkinsonian, antihistamine, lithium)
3- radiotherapy
4- Psychogenic causes.
5- Dehydration, shock and renal Failure.
6- D.M
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Thank you
2015
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