OM Sheet #1 By Ahmad Alshamary

by **Sura** 23/9/2012, 11:07 pm

http://www.4shared.com/file/Z51_eMae/OM_1.html?

by **Shadi Jarrar** 15/11/2012, 6:39 pm

Our lecture today is about the oral ulcerative lesion

Traumatic ulcer :

It's one of the most common oral ulcerations

The etiology of the traumatic lesion is physical or mechanical or chemical or thermal

examples of Physical and mechanical lesion :biting ,trauma due to sharp restorations 'denture ' anything sharp in the oral cavity might lead to oral ulcer

the patient presented 2 the clinic 4 the first time of a resent onset of single ulcer and there is no recurrence '

Painful ulcer, sensitive 4 hot and spicy

Diagnosis: from history

*no history of recurrence

*single

It's like aphthus ulcer but what make us differentiate between them ( the previous 2 points )

Treatment of traumatic ulcer:

*chlorohixidin mouth wash

*anesthetic mouth wash

*topical sceloid gel ( 5 times / day )

Any ulceration combined with lympho adino pathy we give antibiotic

Eosinophillic ulcer :

It's uncommon benign ulcer that happen suddenly

Most common side is the lateral and dorsal service of tongue

Second most common side is the lower lip

-it's crush injury due to biting that lead to crush the muscle unlike the traumatic ulcer that is superficial injury

-it's more common in middle age and elderly and we don't see it in child

-painful

-if we leave it without treatment it will limit itself within 1 month

- treatment :

1.mouth wash antiseptic , anesthetic

2.topical steroid

3.if lymph node enlarged we give antibiotic and then it should heal within 2 weeks if not we do biopsy ( slide 13-17)

Riga-fed disease:

It's eosinophilic ulcer that develop on infants from 1 week to 1 year

-chronic irritation to anterior ventral service of the tongue during breast feeding due to primary teeth (lower teeth most common) (slide 180

-treatment ; if the tooth is not stable we extract the tooth if it's stable we do protective sheet

Psychiatric ulcer :

Some patient come to the clinic with scar on his face

-it's ulcer induced by patient by his finger nail or by chemicals

-single ulcer in the anterior part and there is no clear history

-if patient hurt himself to the level of scar we call it stomatitis artefacta (slide20)

-if it's on skin we call it dermatitis artifacta

It's self induced injury by patient (slide21-22)

Iron deficiency anemia :

-it's the most common hematological depeted

*inadequate intake

*loss of blood

*poor absorption

*growth spurt

* pregnancy

Early anemia

When the patient come to the clinic complain of red burning sensation of tongue u have 2 exclude hematological deficiency

Depapilation partial – complete : it take month to year to develops

It usually combined with angular chelitis

-investigations:

*cbc * serum foliate *red cell foliate

- treatment : without scar

1.iron supplement

With scar

1.feric sulfate or gluconate (3 month )

2.vitamin c

3.mouth wash (chlorohixidin)

Plummer Vinson deficiency:

-it's glossitis , dysphgya , iron deficiency anemia

-it's more common in middle age females

-asophygial web and it can convert to malignant (slide300

-investigations :

1. upper endoscopy

2. radiology

3. biopsy

-treatment :

1. iron supplement

2. mouth wash

Vit B12 deficiency:

Second most common hematological disorder

-it's idiopathic but it could be due to anything in GI track ,any disease of ileum

-vit B12 an animal products so the vegetarian people have deficiency

-red raw beefy tongue or strawberry tongue all the tongue dorsum mucosa red and in late stage it wil be similar to iron deficiency anemia

-the difference between iron and B12 level that there is no angular chilitis

- investigations

1.cbc

2. cerum B 12 level

Then we do anti parietal cell antibody if it's + then we do chilling test

-treatment :

1..cyanocalapamin

Folic acid deficiency :

No mucosal atrophy just angular chilitis

-causes :

1.glutten sensitivity

2. cytotoxic chemotherapy

3. pregnancy

4.alcoholics

-investigations :

1.cbc

2.cerum foliate

3. red cell foliate

If some one have folic acid deficiency if he take large dose of folic acid it's to dangerous so if we give him folic acid we should give him v.B12 with it because there is reverse relation between them

Cyclic neutropenia :

Wbc rare blood disorder

Recurrent episode of low neutrophilic in blood the cause is elastase A2

It's lead to neutropinic ulcer

-investigations :

1.diffrential WBC count

-treatment :

1. topical anesthetic

2.chlorohicidin mouth wash

Ahmad alshammary

22/9/2012

OM Sheet #1 By Ahmad Alshamary

OM Sheet #1 By Ahmad Alshamary

Re: OM Sheet #1 By Ahmad Alshamary