Stomatitis; predisposing causes, types, clinical features, treatment, complication

Introduction

Stomatitis is an inflammation of the oral mucosa which may involve the gum and lips.

Causes: Trauma, pathogens, irritants, and side effects of chemotherapy.

Clinical features: Excessive salivation. halitosis, sore mouth redness, tenderness.

Treatment: Oral hygiene, topical medication, bland diet, treatment of specific cause.

Gingivitis/Vincent’s Infection

This is an inflammation of the gum that may result in ulceration and necrosis.

Causative organism; fusiform bacilli, spirochetes

Predisposing causes of gingivitis include;

• poor oral hygiene
• malocclusions
• missing teeth
• faulty dentistry
• diet deficiency
• alcoholism
• blood dyscrasia

Clinical features

• Pain in the gum
• Bleeding gum
• Necrotic lesions
• Excessive secretion of saliva
• Mouth odour
• Anorexia
• Malaise

Treatment

• Frequent mouth wash with saline water or hydrogen per oxide
• Oral hygiene
• Soft nourishing diet
• Topical antibiotics
• Rest.

Complications

• Recurrence
• Ulcer of gum
• Abscess
• Periodontitis
• Oral thrush

Oral Thrush

It is an infection of the mucous membranes of the mouth caused by Candida albicans, or less commonly by Candida tropicalis. It is common in infants, immunosuppressive disorders. diabetics, smokers and could occur as a result of side effects of antibiotics and inhaled steroids.

Predisposing Cause

• Poor oral hygiene
• Irritants
• Trauma

Clinical Features

• White or cream -coloured deposits
• Redness
• Burnings and discomfort
• Oral candidiasis
• Oral thrush

Treatment

• Oral hygiene
• Topical antifungal drugs, such as nystatin, miconazole or amphotericin B which is given as oral suspension and used to wash the mouth and swallowed.
• Patients who are immunocompromised, either with HIV/AIDs or as result of chemotherapy, may require systemic treatment with oral or intravenous anti-fungal medication.

Dental Caries

This is bacterial processes that results in damage to enamel, dentin and cementum of the tooth. There is tissue break down causing holes in the teeth.

Causative organisms; Streptococcus mutants and lactobacilli

Predisposing Causes

• Excessive eating of sweets
• Poor oral hygiene
• Xerostomia (dry mouth due to poor secretion of saliva)
• Tooth resorption
• Appearance of new teeth from unknown origin
• Use of stimulants in persons with dry mouth
• Tobacco use

Pathophysiology

Bacteria collect around teeth and gum to form plague, the bacterium convert glucose, fructose and sucrose into lactic acid. There is demineralization and the tooth becomes soft. The bacteria penetrate the dentin creating cavities.

Clinical manifestation

1. Appearance of a chalk white spot on the surface of the tooth
2. Brown and shiny lesion suggests dental caries was once present but the demineralization process stopped, leaving a stain.
3. A brown spot which is dull in appearances is probably a sign of active caries.
4. Colour change in tooth which is also soft to touch
5. Pain; this is due to nerve exposure and worsen with exposure to heat, cold or sweet foods and drinks
6. Bad breath and foul taste.

Treatment

1. Good oral hygiene, avoidance of sweets, stops demineralization when brown sport is noticed.
2. Small lesions are treated with fluoride.
3. Where cavities form, regeneration is not possible. The degenerative tissues are removed and restorative material (amalgam proclaim and gold) used to feel cavity
4. Tooth extraction can be done

Prevention

• Oral hygiene
• Modification of diet
• Using dental sealants
• Using fluoride tooth paste and mouth wash
• Using calcium and fluoride supplements

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