Lesson Summary

 

  • ·  The oral microbial ecosystem operates in a delicate balance with the host’s immune system by maintaining an equilibrium between anti-inflammatory and inflammatory signals
  • The epithelial lining and subepithelial tissues of the mouth provide a physical barrier against infection, but also create additional protection through chemical secretions and by communicating with the immune system.
  • Most oral bacteria are anaerobic and the most common bacteria associated with odontogenic infections are the anaerobic, gram-positive Peptostreptococcus and Streptococcus milleri, and gram-negative Bacteroides.
  • Viruses are biologically different than bacteria or fungi in that viruses are not capable of replication and proliferation by themselves.
  • A typical presentation of papillomavirus infection on the face or mouth includes venereal and oral warts and squamous papillomas.
  • Amoxicillin is a broad-spectrum antibiotic that has been prescribed with growing frequency to treat oral infections that are resistant to penicillin.
  • In cases when oral topical antifungal treatments fail to resolve oral candidiasis, systemic antifungal treatments including fluconazole and ketoconazole are available.
  • An alternative, aggressive treatment for deep fungal infections in the oral chamber and surrounding tissue is amphotericin B, which can be used in conjunction with flucytosine and rifampin for infections.

·  Learning Outcomes

·  By the end of this module, you will be able to:

  • ·  Identify the risk factors for oral mucosal lesions.
  • List and explain the types of oral mucosal lesions.
  • Distinguish between oral surface lesions and soft tissue enlargement.
  • Discuss the properties of reactive soft tissue enlargement.
  • Summarize the treatment procedures for oral lesions caused by hereditary
  • Recall the treatment procedures for the most common salivary gland tumor.
  • Explain procedures for the evaluation of patients for oral mucosal lesions

·  Introduction

·  Oral lesions are bumps, lumps, sores, or ulcers in the mouth and involve the epithelium and sometimes the connective tissue adjacent to the epithelium. Some oral lesions are cancerous and may metastasize. Dentists, dental hygienists, and other oral health care professionals should screen for oral lesions each time a patient comes in for preventive care. 

 

Between visits, it is possible that the patient may contact the oral health care provider because of an oral lesion that is causing symptoms such as pain, discomfort, difficulty eating or trouble swallowing.

  • · 

Risk Factors of Oral Mucosal LesionsA person’s oral health involves more than just the teeth. Oral mucosal lesions can affect all the soft tissues in the mouth, and if left untreated, they can have serious impacts on a person’s teeth, gums, tongue, and other oral structures. 

 

Gonsalves explains that certain risk factors increase the risk of developing oral mucosal lesions (2007). These risk factors include poor oral hygiene, sexually transmitted infections, alcohol or tobacco use, age, and disorders of the immune system. 

 

During each patient visit, oral health care professionals should ask patients about these risk factors.

 

  • Evaluation of Oral Lesions

·         Primary care physicians and other doctors only rarely examine a patient’s mouth or perform an oral screening for lesions. Evaluation of oral lesions should be performed in a methodical manner using a diagnostic decision tree. This type of process helps the oral health care provider to arrive at a logical conclusion about the type of lesion the patient has. 

·          

·         The evaluation, identification, and treatment of oral mucosal lesions have a big impact on a patient’s health and well-being, which is why the lesions deserve special attention from oral health care providers.

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