Pharmacology Chapter 12 – Oral Conditions and Their Treatment

(True/False) The dental healthcare worker is the first professional that patients visit when they notice a lesion in the oral cavity.
True

What is the first step to treat an oral lesion?
Diagnosis

What determines the course of treatment (reassurance, palliative, specific, or even surgical)?
Diagnosis

What has both bacteriologic and environmental factors, is a spreading ulcer associated with a distinctive odor, and is characterized by ulcerated interdental papilla, bleeding, and pain?
Acute Necrotizing Ulcerative Gingivitis (ANUG)

What can be treatments for ANUG?
Good oral hygiene, aspirin or acetaminophen (pain or fever), mouth washes (flushing action), antibiotics (if the patient is immunosuppressed or if there is evidence of systemic involvement), and vitamins/supplement (if eating is painful)

What is the manifestation of initial herpes infection called?
Primary herpetic gingivostomatitis or primary herpes

In what population does primary herpes principally in, caused by the Herpes Simplex Virus (HSV)?
Infants and children

What is primary herpes more commonly know as?
Cold sore or fever blister

What begins as an erythematous area; numerous ulcers with a circumscribed area of erythema appear and vesicles form that become scabbed?
Primary herpes or cold sore

What infection is self limiting without treatment in the patient with normal immunity?
Herpes infection

What percentage of the adult population has been exposed to HSV?
80%-90%

What type of HSV is involved in most oral lesions?
HSV-1

What type of HSV is usually responsible for genital herpes and is transmitted sexually?
HSV-2

(True/False) Both types of herpes can be spread to other parts of the body (eyes, genitals, fingers)?
True

In what stage are herpetic lesions contagious and can survive for several hours on surfaces?
Vesicle stage

Should patients with active herpetic lesions postpone elective dental treatment?
Yes

(True/ False) The patient may experience recurrent outbreaks of HSV after the primary episode that occur at irregular intervals.
True

What events could precipitate an outbreak of HSV?
Sunlight, hormonal changes, lip pulling, emotional stress, rubber dam, viral infections, or respiratory infections

(True/False) Treatment of HSV may include an antiviral agent.
True

(True/False) Acyclovir is an antiviral agent to treat HSV and is available in tablets, capsules, oral suspension, ointment, cream, and parenteral forms.
True

What are approved indications for the use of Acyclovir?
Immunocomprimised patients – primary and recurrent HSV
Nonimmunocomprimised patients – primary outreak and prophylaxis

What is the prophylactic dose of Acyclovir?
400mg bid

What possibly cause resistance to Acyclovir?
Long term use

What drug used to treat HSV is only available topically and reduces lesion duration and viral shedding by 0.7 days?
Penciclovir (Denavir)

What drug used to treat HSV is the only antiviral drug available over the counter, is a topical 10% cream applied at onset of symptoms, and reduces lesion duration by a half of a day?
Docosanol (Abreva)

What drugs used to treat HSV are prodrugs that are converted to active antiviral agents and are indicated in the treatment of acute localized varicella-zoster infections and recurrent genital herpes in immunocompetent adults?
Famciclovir and Valacyclovir

What type of treatment for HSV involves treating the patient’s symptoms?
Palliative treatment

What is a fungal infection caused by Candida albicans that often affects the oral and vaginal mucosa?
Candidiasis

(True/False) Because candida is part of the normal oral flora, it is always present in the oral cavity in small numbers.
True

(True/False) Antibiotics, such as tetracycline can predispose a patient to candidiasis.
True

(True/False) Although candidiasis can appear in several different forms, the lesions are typical and can usually be diagnosed by clinical appearance.
True

What is another way that candidiasis lesions can be diagnosed?
Culture

What tablets are taken orally once daily to help treat chronic candidiasis?
Ketoconazole

What other topical antifungal product can be used to treat oral candidiasis that are available in a suspension, tablets and lozenges?
Nystatin

What appears as a simple redness, fissures, erosion, ulcers, and crusting located at the angles of the mouth that may be painful?
Angular cheilitis/cheilosis

What can angular cheilitis/cheilosis result from?
Drooling or moisture in the corner of the mouth or deficiency of vitamin B6 or B12

What is alveolar osteitis commonly called?
Dry socket

What is the treatment of dry socket?
Rinsing with saline water and debridement, placement of a pack, analgesics, and supportive therapy

What is sometimes called canker sore, is seen in about 20% of the population, unknown in etiology, and presents clinically as a few small to many large ulcers?
Recurrent aphthous stomatitis (RAS)

What is the most common therapy for RAS?
Corticosteroids

(True/False) Steroids can help reduce inflammation.
True

What are two ways steroids can be introduced to the body?
Systemically and topically

What drug for RAS is a new drug that is used topically and is applied 4 times daily?
Aphthasol

What drug for RAS is the preferred drug because of its local anesthetic action?
Diphenhydramine (DPH)

What drug for RAS is used as a last result to treat severe aphthous ulcers?
Immunosuppressives

What is a skin condition that often involves lesions on the oral mucous membranes and can present in striated, plaque like, and erosive forms?
Lichen planus

(True/False) Symptoms of lichen planus can vary between no pain and extreme pain depending on the presence of ulceration.
True

The treatment for lichen planus can depend on the symptoms, what can some treatments be?
Oral steroids, topical steroids, oral retinoids, and immunosuppressants

What condition is where the tongue may have lesions that typically appear to be a map of the world, with lesions appearing to be the continents, and the eitology is unknown?
Geographic tongue

What is inflammation of the tissue around the crown of the tooth and repeated episodes may occur with erupting third molars?
Pericoronitis

What can reduce root sensitivity?
Using a toothpaste at home that is concentrated with sodium chloride and 0.4% stannous fluoride

What is long term exposure of the lip to the sun can cause irreversible tissue changes?
Actinic cheilitis

What is an inflammation of the mucus lining the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth?
Stomatitis

(True/False) Xerostomia may result from a drug, a disease, age, or radiation.
True

(True/False) Certain drugs may produce an increase in saliva termed sialosis, sialism, or sialorrhea.
True

What drugs can cause gingival enlargement?
Phenytoin (Dilantin), Cyclosporine, calcium channel blockers

What are the two gastrointestinal disorders? Gastroesophageal reflux disease (GERD) and ulcers What is the most common GI disease in the U.S.? “Heartburn” (GERD) WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE …

Microorganisms producing disease pathogenic Microorganisms that do not produce disease nonpathogenic WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample What does the defense mechanisms include? intact skin and mucosa …

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What is pharmacology? The study of drugs What is a drug? Also referred to as a ligand. A chemical that is used in the diagnosis, treatment, or prevention of diseases in the body. WE WILL WRITE A CUSTOM ESSAY SAMPLE …

Abscess Localized area of pus originating from an infection Acute inflammation Minimal and short-lasting injury to tissue WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample Biopsy Removal of tissue …

What type of lesions are below the surface? Ulcers What type of lesions are below the surface? Blisters WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample What type of …

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