DISORDERS OF THE ORAL CAVITY

1. ORAL DISORDERS
PRESENTED BY:
V.RAMYA
TUTOR
SRMTCON

2. STRUCTURE OF THE MOUTH

3. INTRODUCTION
 Oral health is a very important component of a
persons physical and psychological sense of well
being.
 Peridontal diseases, which encompases both
gingivitis and periodontitis (which involves the
soft tissue and bone supporting the teeth),is the
most common cause of tooth loss among adults

4. Incidence
Ninety- five percent of the
population in india suffers from
periodontal disease.

5. DENTAL PLAQUE AND CARIES

6. DENTAL PLAQUE AND CARIES
 Tooth decay is an erosive process that begins with the action of
bacteria on fermentable carbohydrates in the mouth, which produces
acids that dissolve tooth enamel .
 Despite the fact tooth enamel is the hardest substance in the human
body,caries and periodontal disease can occur for several reasons.
 Contributing factors include nutrition ,soft drink concumption,and
genetic predisposition.
 In addition ,the extent of damage to the teeth may be related to the
following:

7. DENTAL PLAQUE AND CARIES
 Presence of dental plaque,which is a gluey,gelatin like
substance that adheres to the teeth.
 The initial action that causes damage to a tooth occurs
under dental plaque
 Length of time acids are in contact with the teeth.
 Strength of acids and the ability of saliva to neutralize
them.
 Susceptibility of the teeth to decay.

8. ABNORMALITIES OF THE LIPS
 Actinic cheilitis

9. SIGNS AND SYMPTOMS
 Irritation of the lips associated with
 scaling ,
 crusting ,
 fissure:
 white over growth of horny layer of epidermis.
 Considered a premalignant squamous cell skin
cancer

10. POSSIBLE CAUSES AND SEQUELAE
 Exposure to sun ;
 More common in fair skinned people and in
hose whose occupations involve sun
exposure ,such as farmers.
 Chronic inflammatory lesion that may lead
to squamous cell cancer of the lip.

11. NURSING CONSIDERATIONS
Educate patient on importance of
protecting lips from the sun by
protecting ointment such as sun block.
Instruct patient to have a periodic
checkup by primary provider.

12. CHANCRE

13. SIGNS AND SYMPTOMS
Reddened circumscribed lesion
that ulcerates and becomes
crusted.

14. POSSIBLE CAUSES AND SEQUELAE
Primary lesion of syphilis.

15. NURSING CONSIDERATIONS
 Use comfort measures such as cold soaks to
lip,mouth care.
 Administer antibiotics as prescribed
 Instruct patient regarding contagion.
 Use topical over the counter agents
(e.g,Blistex,carmex )
 or antiviral agents (e.g, acyclovir ,penciclovir) as
prescribed.

16. CONTACT DERMATITIS
I.e, allergic contact cheilitis

17. SIGNS AND SYMPTOMS
Red area or rash: itching

18. POSSIBLE CAUSES AND SEQUELAE
Allergic reaction to
lipstick,cosmetic ointments,
or tooth paste

19. NURSING CONSIDERATIONS
Instruct patient to avoid possible
causes
Administer corticosteroids

20. Herpes simplex virus -1
 Cold sore
 or fever blister

21. SIGNS AND SYMPTOMS
Symptoms may be delayed up to 20
days after exposure;
 singular or clustered ,
irregular,
painful vesicles throughout the oral
cavity and lips that may rupture.

22. POSSIBLE CAUSES AND SEQUELAE
An opportunistic infection;
Frequently seen in patients who
are immunosuppressed
May recur with menstruration
,fever or sun exposure

23. NURSING CONSIDERATIONS
Use acyclovir ointment or systemic
medications as prescribed.
Administer analgesic agents as
prescribed.
Instruct patient to avoid irritating
foods.

24. ABNORMALITIES OF THE MOUTH
 Leukoplakia

25. SIGNS AND SYMPTOMS
White patches ; may be
hyperkeratotic;typically
painless

26. POSSIBLE CAUSES AND SEQUELAE
Fewer than 2% are malignant
,but may progress to cancer
(premalignant)

27. NURSING CONSIDERATIONS
Insruct patient to see the primary
provider
 if Leukoplakia persists > 2 weeks

28. ORAL HAIRY LEUKOPLAKIA

29. SIGNS AND SYMPTOMS
White patches: with rough hairlike
projections; typically found on
lateral border of the tongue.

30. POSSIBLE CAUSES AND SEQUELAE
Common among tobacco users possibly
viral
Related to smoking and the use of
tobacco
Associated with HIV infection

31. NURSING CONSIDERATIONS
 Eliminate the risk factors such as
cigarettes,smokeless tobacco
Instruct patient to see the primary
provider
if condition persists >2 weeks

32. LICHEN PLANUS

33. LICHEN PLANUS SIGNS AND SYMPTOMS
Radiating while striations on
the tongue and buccal mucosa
;often association with painful
ulcerations and erythema.

34. POSSIBLE CAUSES AND SEQUELAE
Chronic inflammatory condition of
unknown case.
Recurrence in common.
May lead to a malignant process .

35. NURSING CONSIDERATIONS
 Apply topical corticosteroids such as
fluocinolone acetonide gel.
 Avoid foods that irritate
 Administer corticosteroid systematically or
intralesionally as prescribed.
 Instruct the patient of need for followup if
condition is chronic.

36. CANDIDIASIS

37. CANDIDIASIS SIGNS AND SYMPTOMS
Chessy white plaque that looks
like milk curds ;
 when rubbed off ,it leaves an
erythematous and often
bleeding base.

38. POSSIBLE CAUSES AND SEQUELAE
Candida albicans fungus;
Predisposing factors include
diabetes ,antibiotic therapy,and
immunosuppression

39. NURSING CONSIDERATIONS
 Antifungal medications such as nystatin or
clotrimazole may be prescribed as suspensions or
troche;
 when used as a suspension,instruct the patient to
swish vigorously for at least one minute and the
swallow.
 If these treatment fail, oral agents such as
fluconazole may be prescribed.

40. APHTHOUS STOMATITIS
 (canker sore)
 (Classified as major or minor depending upon size)

41. SIGNS AND SYMPTOMS
 Shallow ulcer with a white or yellowcenter and
typically a well defined red border ;
 seen on the inner side of the lip and cheek or on
the tongue;
 it begins with a burning or tingling sensation and
slight swelling;
 painful ;
 usually lasts 7- 10 days ( minor ) and heals without
scar.

42. POSSIBLE CAUSES AND SEQUELAE
 Immune mediated inflammatory disorder associated
with HIV infection.
 Associated with emotional or mental stress ,fatigue,
 hormonal factors ,
 minor trauma (e.g ,biting ),
 allergies ,
 acidic foods
 and juices and dietary deficiencies.

43. NURSING CONSIDERATIONS
 Instruct the patient in comfort
measures(e.g, saline rinses)and a soft or
bland diet.
 Antibiotics or corticosteroids may be
prescribed.
 Use over the counter benzocaine as
indicated.

44. NICOTINE STOMATITIS
(SNOCKERS PATCH)

45. SIGNS AND SYMPTOMS
Two stages – begins as a red
stomatitis ;
over time,
the tongue and mouth become
covered with a creamy ,thick, white
mucous membrane ,which may slough
,leaving a beefy red base.

46. POSSIBLE CAUSES AND SEQUELAE
Chronic irritation by tobacco

47. NURSING CONSIDERATIONS
 Cessation of tobacco use; if condition
 exists >2 weeks
 A primary provider should be consulted and
a biopsy may be needed.

48. ERYTHROPLAKIA

49. SIGNS AND SYMPTOMS
Red patch uniformly raised with
smooth velvety appearance without
ulceration or bleeding on the oral
mucous membrane ;
in indian culture ,need to rule out
betel nut chewing.

50. POSSIBLE CAUSES AND SEQUELAE
More frequently turn to oral
malignancy than Leukoplakia;seen
in older adults ;
warrants biopsy and further
treatment.

51. NURSING CONSIDERATIONS
Instruct the patient to visit the
primary provider.

52. KAROSI SARCOMA

53. SIGNS AND SYMPTOMS
 Appears first on the oral mucosa as a
red,purple,or blue lesion ;
 may be singular or multiple ;
 may be flat or raised
 Lesions can occur in other parts of the
body;
 skin,lymph nodes, lungs,digestive tract.

54. POSSIBLE CAUSES AND SEQUELAE
Cancer that develops from the cells
that lines the blood vessels and lymph
system
Associated with HIV infection men who
are sex with men,organ
transplantation,and geographic region

55. NURSING CONSIDERATIONS
Instruct patient regarding side
effects of planned treatment of hiv

56. STOMATITIS

57. SIGNS AND SYMPTOMS
Mild erythema and edema; severe
forms include painful ulcerations
,bleeding ,and secondary infection

58. POSSIBLE CAUSES AND SEQUELAE
 Inflammaton of the mucous linning of the
mouth
 Associated with chemotherapy;radiation
therapy;
 Severe drug allergy
 Myelo suppression ( bone marrow
depression)

59. NURSING CONSIDERATIONS
 Prophylactic mouth care,
 including brushing,
 flossing,
 and rinsing,for any patient receiving chemotherapy or
radiation therapy.
 Educate patient about proper oral hygiene,
 including the use of a soft – bristled toothbrush and
nonabrasive toothpaste; for painful ulcers,

60. NURSING CONSIDERATIONS
 Oral swabs with spongelike applicators can
be used in place of a toothbrush;
 Avoid alcohol - based mouth rinses and hot
or spicy foods.
 Apply topical anti- inflammatory ,
 antibiotic,
 and anesthetic agents as prescribed.

61. BIBLIOGRAPHY
 Brunner and Suddarth’s Text book of Medical – Surgical Nursing
 South Asian edition volume I ,Page referred 840 -843
 Ansari and kaur ,Medical – Surgical Nursing ,Published by Pee vee,
 2011 edition page referred 446-460.
 https://www.slideshare.net/kpriyatham/diseases-of-mouth-palate-
lips-cheek
 https://www.slideshare.net/ManpreetNanda1/diseases-of-oral-cavity-
70539576
 https://www.slideshare.net/kpriyatham/diseases-of-mouth-palate-
lips-cheek