dental 1223

INFECTIONS AND DISEASE STATES AFFECTINF THE ORAL REGIONS : 

PRESENTED BY: NIYATI PATEL INFECTIONS AND DISEASE STATES AFFECTINF THE ORAL REGIONS

AGENDA : 

STRUCTURE OF THE MOUTH ORAL FLORA IN THE MOUTH BACTERIA AND MICRO-ORGANISMS IN THE MOUTH ORAL FLORA-CONCLUDING POINTS INFECTIONS: NON-SPECIFIC FOCAL SELECTED BACTERIAL MYCOTIC VIRAL AGENDA

STRUCTURE OF THE MOUTH : 

STRUCTURE OF THE MOUTH

the basic structure of the human tooth : 

the basic structure of the human tooth

THE ORAL FLORA IN THE MOUTH : 

Generally the organisms in the human mouth can be divided into 3groups: THE ORAL FLORA IN THE MOUTH

mixed oral flora : 

mixed oral flora

BACTERIA IN THE MOUTH : 

BACTERIA IN THE MOUTH

MICRO-ORGANISMS OTHER THAN BACTERIA : 

Micro-organisms include several species of fungi, viruses and protozoa. MICRO-ORGANISMS OTHER THAN BACTERIA

CONCLUDING POINTS REGARDING ORAL FLORA : 

CONCLUDING POINTS REGARDING ORAL FLORA

INFECTIONS OF THE ORAL REGIONS : 

INFECTIONS OF THE ORAL REGIONS

NON-SPECIFIC INFECTIONS : 

NON-SPECIFIC INFECTIONS

A)    DRY SOCKET : 

It means that the blood clot which is formed following the removal of a tooth, thus exposing the bone and allowing some degree of infection to develop. A)    DRY SOCKET

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TREATMENT Flushing the depris and bacteria Removing the dental tissue slough Dressing is placed over the affected area Heeling is slow and may process from the deepest part of the socket upto the surface.

B) OSTEOMYELITIS : 

Inflammation of the bone (osteon) marrow (myelo) may occur from the introduction of many different types of bacteria either as pure or mixed cultures. The resulting infection leads to: B) OSTEOMYELITIS

C) TUBERCULOUS OSTEOMYELITIS : 

It is very rare. Seen in patients with advanced tuberculosis. The tubercle may enter the bone following trauma or tooth extraction or via blood stream. C) TUBERCULOUS OSTEOMYELITIS

D) SYPHILITIC OSTEOMYELITIS : 

Occurs in both congenitally acquired and tertiary forms of syphilis. Quite frequently the palate is involved. Mandible may be extensively affected. Fracture of the bone i.e. mandible may result. D) SYPHILITIC OSTEOMYELITIS

E) PERICORONITIS AND CELLULITIS : 

Infections may begin in a flap of tissue overlying an erupted tooth and around an impacted or partially erupted third molar. This pericoronitis, or inflammation (itis) around (peri) the crown (coronal), of the tooth may spread into the surrounding tissues, resulting in a cellulities, or diffuse inflammation of the soft tissues. Cellulites may follow any procedure which permits micro-organisms to enter deeper tissues. The bacteria involved here produce large amount of HYALURONIDASE & FIBRINOLYSIS. Many spreading infections are caused by STREPTPCOCCI. E) PERICORONITIS AND CELLULITIS

F) PERIODONTAL DISEASE : 

The disease of the tissues surrounding and supporting the teeth, gingivitis and periodontics in their many forms, can be grouped under the general heading of periodontal disease. F) PERIODONTAL DISEASE

HYPOTHESIS OF PERIODONTAL DISEASE : 

The periodontal disease is not caused by a particular bacterial species, but rather, results from certain enzymatic and related activities of organisms in intimate contact with tissues surrounding teeth. HYPOTHESIS OF PERIODONTAL DISEASE

G) GINGIVITIS : 

This condition defined as an inflammation of the gingiva. Such involvement of the marginal gingival is most common disease affecting the soft tissues of the oral cavity. G) GINGIVITIS

G) GINGIVITIS : 

G) GINGIVITIS

H) NECROTIZING ULCERATIVE GINGIVITIS (N.U.G) : 

The disease is also commonly called VINCENT’S INFECTION or TRENCH MOUTH. The infection is easily found among adolescents and young adults. Fatigue and anxiety evidently play a most important role in the predisposition of the oral cavity to its necrotizing lesions. As FUSOBACTERIUM FUSIFORME and the spirochete BORRELIA VINCENTII increase in numbers during the manifestation, they have been incremented as afctors in the etiology of the disease. H) NECROTIZING ULCERATIVE GINGIVITIS (N.U.G)

CLINICAL FEATURES : 

In acute phase of N.U.G. CLINICAL FEATURES

TREATMENT : 

TREATMENT

I) PERIODONTITIS : 

Inflammation of the periodontium is the direct result of untreated gingivitis. A common synonym for the condition is PYORRHEA. I) PERIODONTITIS

CLINICAL FEATURES : 

CLINICAL FEATURES

TREATMENT : 

TREATMENT

J) DENTAL CARIES : 

Dental caries is a disease of the calcified tissues of the teeth and is characterized by a decalcification of the inorganic substance, either followed or accompanied by a disintegration of the organic portion. J) DENTAL CARIES

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The STREPTOCOCCI produce extracellular polysaccharides from sucrose which enable them to adhere to one another and thus form colonies on the tooth’s surface.   Three polysaccharides producing streptococci are found in large numbers in humans : Streptococcus mutans, Streptococcus sanguis and streptococcus salivarius. Both water soluble and insoluble polysaccharides may be produced by them.

TREATMENT AND PREVENTION : 

TREATMENT AND PREVENTION

FOCAL INFECTIONS : 

A localized area of infection within the oral tissues or elsewhere is called a focus of infection. When organisms or their toxic products spread from this focus to distant tissues, either to form another site of infection or to produce a hypersensitive reaction, the process is known as  a focal infection. The importance of good oral hygiene, along with elimination of infection, is considered an important part of restoring and maintaining good health. FOCAL INFECTIONS

A)    RHEUMATIC HEART DISEASE AND SUB-ACUTE BACTERIAL ENDOCARDITIS (SBE) : 

The management of patients with the history of rheumatic heart disease has become increasingly important in the practice of dentistry. Sub-acute endocarditis may be a very serious complication of any dental procedure which allows bacteria to enter the blood stream of a patient with heart valve damage Bacteremia commonly results from extractions, endodontics, gingival surgical procedures, or from deep scaling and removal of material by means of scrapin   Extensive periodontal treatment and multiple extractions should be avoided in rheumatic heart disease.  For many years only 20-30% of all cases of bacterial endocarditis were caused by BETA HEMOLYTIC STREPTOCOCCI, the STREPTOCOCCUS VIRIDANS micro-aerophilics and enterococci. These organisms now account for approx. 40% of all cases. A)    RHEUMATIC HEART DISEASE AND SUB-ACUTE BACTERIAL ENDOCARDITIS (SBE)

CLINICAL FEATURES : 

Bacterial or vegetative endocarditis is a severe infection. It is characterized by a prolonged: septic febrile course, A change in cardiac murmur The growth of bulky, bacterial vegetation on the heart valves. These accumulations consists of irregular, amorphous, tangled masses of fibrin strands, platelets and blood cell debris along with the bacterial masses. CLINICAL FEATURES

SELECTED BACTERIAL INFECTIONS : 

Various bacterial pathogens can and do involve the oral cavity at sometime during their development cycles. A representative number of such agents are: SELECTED BACTERIAL INFECTIONS

GONOCOCCAL INFECTIONS : 

On rare occasions the oral cavity may be infected by NEISSERIA GONORRHOEAE from the hands of a person with gonorrhea, or by other contact with the infection. The oral lesions resemble an acute necrotizing gingivitis with whitish grey or yellow patches which may cover large areas of the mucosa. These adherent membranes will slough off in time, leaving a broad bleeding surface. The lesions are painful and are accompanied by inflammation and swelling. GONOCOCCAL INFECTIONS

TUBERCULOSIS : 

Oral lesions may involve any of the tissues of the mouth. However, the infections are common in the nasopharynx, pharynx and tongue. Only a few reports have appeared concerning gingival or mucous membrane involvement. The dentist may be the first to note the oral lesion which may in turn lead to discovery of another case of pulmonary tuberculosis. TUBERCULOSIS

CLINICAL FEATURES : 

CLINICAL FEATURES

MYCOTIC INFECTIONS : 

Fungus, pathogens as well as bacterial and viral agents of disease, involve the oral cavity either in superficial manner or as a consequence of systemic disease. CANDIDIASIS (MONILIASIS) MUCORMYCOSIS SOUTH AMERICIAN BLASTOMYOCOSIS MYCOTIC INFECTIONS

CANDIDIASIS (MONILIASIS) : 

COHEN reported that vitamin deficiencies, iron deficiency anemia, pregnancy and diabetes may predispose an individual to the development of monilial stomotitis CANDIDIASIS (MONILIASIS)

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CLINICAL FEATURES

MUCORMYCOSIS : 

The mycotic infection of men is extremely rare in the oral cavity. The infection is generally considered nuisance fungi and are found in soil and decaying vegetable matter. Mucormycosis occurs in patients who are debilitated by other diseases such as diabetes or leukemia. MUCORMYCOSIS

DIAGNOSIS : 

The organism cultured on Sabouraud’s glucose medium show rapid growth, with the formation of a large aerial mycelium. DIAGNOSIS

SOUTH AMERICIAN BLASTOMYOCOSIS : 

The chronic granulomatous fungal infection is presumed to be limited to South America. It occurs with some frequency with coffee plantation workers, possibly due to their habit of cleaning their teeth with small fragments of wood and of chewing of stems and leaves of various plants which might carry the causative agents. SOUTH AMERICIAN BLASTOMYOCOSIS

CLINICAL FEATURES : 

The primary lesion is commonly on the oral mucosa and may involve the tongue, gingival, palate, cheeks, lips, or nose. The lesions are painful and make eating difficult, which leaves patient debilitated. CLINICAL FEATURES

VIRAL INFECTIONS : 

FOOT AND MOUTH DISEASE HAND, FOOT AND MOUTH DISEASE HERPANGINA HERPES SIMPLEX MUMPS VIRAL INFECTIONS

A)    FOOT AND MOUTH DISEASE : 

This infection is mentioned here only because of severe inflammation of oral mucosa which can occur in humans. A)    FOOT AND MOUTH DISEASE

CLINICAL FEATURES : 

Patients who are affected experience: General ill-feeling with fever. Nausea Vomiting accompanied by painful red ulcerative lesions involving most oral tissues Some vasicular lesions of skin. CLINICAL FEATURES

B)    HAND, FOOT AND MOUTH DISEASE : 

This condition primarily affects young children. It is characterized by vasicular of mouth, hands and feet. B)    HAND, FOOT AND MOUTH DISEASE

CLINICAL FEATURES : 

CLINICAL FEATURES

HERPANGINA : 

This infection is specific and highly contagious. The disease is transmitted from one person to another through direct contact. It was first described in 1920 by ZAHORSKY, who later proposed the name HERPANGINA. Children upto 15years of age are commonly affected. HERPANGINA

CLINICAL FEATURES : 

Sudden onset of high fever, headache and sore throat, accompanied by papules, vesicles and later ulcers on the pillars of the fauces, the uvula and soft palate. CLINICAL FEATURES

HERPES SIMPLEX : 

This common viral disease affects the oral tissues, often remains localized, and produces considerable pain and discomfort for the patient. The lesion has been called by many names, including CANKER SORE, FEVER BLISTER, COLD SORE, APHTHOUS ULCER AND HERPES LABIALIS. The etiology of the lesions was conclusively demonstrated when herpes simplex virus was isolated from 27 of 28 patients. HERPES SIMPLEX

CLINICAL FEATURES : 

Primary lesion usually is in oropharyngeal mucosa as multiple, very small vesicles, which rupture and ulcerate. A bright red zone is present around the periphery. Fever, malaise, anorexia, and lymphadenopathy are present. Recurrent lesions of mucosa and lips are common. CLINICAL FEATURES

MUMPS : 

This worldwide acute, communicable disease is caused by a paramyxovirus. Man is the only natural host for the causative agent. The virus apparently is spread as a droplet infection or by direct contact with saliva and respiratory secretions. Mumps most frequently affect children between 8 and 15 years of age. Adults may develop mumps and often suffer severe complications. The oral tissues involved are salivary glands, most commonly the parotid glands. Unilateral swelling of one salivary gland will produce the same degree of immunity as found in multiple gland involvement. MUMPS

CLINICAL FEATURES : 

Painful swollen salivary glands, usually the parotid CLINICAL FEATURES