Tuesday, 7 June 2011

Mouth diseases

The following are the list of some mouth diseases encountered in clinical practice: The candidiasis also known as the oral thrush or moniliasis is caused by growth of yeast cells. The causative agent is candida albicans. It is characterized as whitish plaques in the oral cavity seen most commonly in immunocompromised patients (e.g. acquired immunodeficiency syndrome or AIDS; severe combined immunodeficiency (SCID); diGeorge syndrome, a thymic hypoplasia) and also seen in those patients on prolonged inhalational steroids like in asthmatic patients who failed to wash their mouth every after steroid use.

Isolated inflammatory mouth diseases include: cheilitis or cheilosis; gingivostomatitis; aphthous stomatitis; laryngitis; tonsillopharyngitis and diphtheria. Cheilitis or cheilosis means inflammation of the lips such as in vitamin deficiency. Gingivostomatitis is an inflammatory condition of the gums and mouth which is most likely due to poor oral hygiene. Aphthous stomatitis is mouth ulcers, caused either by mechanical injury to the oral mucosa or due to some vitamin deficiency.

Throat infections like tonsillopharyngitis is commonly due to streptococcus termed as “strep throat”; common during cold or winter months and may spread to the entire members of the household. Although between a bacterium and a virus, the most common cause of sore throat is still viral in origin. However, recurrent bouts of strep throat may lead to serious complications such as acute rheumatic fever, rheumatic heart disease, subacute bacterial endocarditis (leading to a valvular heart problem). Furthermore, a hypertrophic tonsil also known as “kissing tonsils” due to recurrent tonsillitis may cause loud snoring and decrease air inflow during sleep leading to a condition known as obstructive sleep apnea. In this case, tonsillectomy is advisable to prevent nocturnal hypoxemia. Vocal cord infections also called laryngitis may also be due to viruses or bacteria. Laryngitis may be preceded by a tonsillopharyngeal infection which is left untreated hence, descending towards the voice box resulting to hoarseness or even loss of voice. A more serious throat infection is the highly contagious, diphtheria. This is a severe throat infection characterized with markedly swollen tonsils or adenoids, pharynx with exudates formation and cervical lymphadenopathy more common in infants and children. This is caused by corynebacterium diphtheriae but can be treated successfully with antibiotics. Immunization with DPT vaccine may give protection to a child because of antibody formation against the bacteria.

A surgical mouth disease is the congenital problem of incomplete fusion of the hard and soft palate or the mouth’s roof either with or without involving the lips is known as cleft palate or cleft lip. This condition is surgically corrected ideally before the child learns how to speak to avoid speech defects. In surgical repair, the “rule of 10s” ideally is followed which means surgery can be performed if the pediatric patient is around 10 pounds in weight, as early as 10 months’ old and with a hemoglobin of at least 10 mg/dl.

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