CANDIASIS, HERPES SIMPLEX GINGIVOSTOMATITIS

1. CLASS PRESENTATION
ON
CANDIASIS , HERPES SIMPLEX GINGIVOSTOMATITIS ,
STOMATITIS , RECURRENT APHTHOUS ULCERS ,
ANKYLOGLOSSIA , CARCINOMA OF ORAL CAVITY.
PRESENTED BY
TANUSHREE MANDAL
3RD SEMESTER,2ND YEAR
BASIC B.SC NURSING, WBGCON,SSKM HOSPITAL

2. INTRODUCTION:
Oral inflammation and infections may be due to specific mouth diseases or secondary
to systemic disorders such as leukemia or vitamine deficiency. The patient who is
immunosuppressed(Receieving chemotherapy for cancer),diabetics or using cortico
steroids inhalant treatement for asthma is at risk for oral infection(candiasis). Oral
infections may predispose the patient to infection in other body organ. For example,
the oral cavity is a potential reserver for respiratory pathogens. Oral pathogens have
been assosiated with diabetes and heart disease.

3. :CANDIASIS OR MONILIASIS:
DEFINITIONS: Candiasis is a fungal infection due to any type of candida. When it effects the mouth, in some
countries it is commonly called Thrush.
Candiasis is also called Moniliasis. Candida ordinarily causes no ill effects , except among infants and in persons
debilated by illness such as diabetes.
CAUSES: Candiasis in the mouth ,throat or Esophagus is uncommon inhealthy adult. People who are at higher
risk for getting candiasisin the mouth and throat include babies, espeicially those younger than 1 month of age
with at least one of these factors-
wear dentures
 have diabetes
have cancer
have HIV or Aids
take antibiotics or cortico steriods
take medications that cause dry mouth
cigerrete smoking

4. CONTD...

5. CONTD..
1)Oral antifungal medication => Fluconazole and Clotrimazole
2)An antifungal mouthwash => Nystatin
3)An oral antifungal medication for those people who have HIV => Intraconazole
4)To treate severe cases of oral thrush => Amphotericin B
MANAGEMENT:

6. :HERPES SIMPLEX GINGIVOSTOMATITIS:
DEFINITION: HERPES SIMPLEX GINGIVOSTOMATITIS is inflammation of the gums and lips caused by the herpes virus - the
same virus that later causes cold sores. This inflammation damages the skin , resulting in painful ulcers in the mouth and
blisters on the lips.
CAUSE:
1)Predisposing factors of upper respirator
throat infections.
1)Excessive exposure to sunlight .
2)Food allergies.
3)Emotional tension.
4)Onset of menstruation.
SIGN AND SYMPTOMS: It may show no
symptoms but it shows the following symptoms-
Fever
Irritability
Painful mouth ulcers and lip blisters.
Poor appetite or reluctance to drink.

7. CONTD...
DIAGNOSTIC EVOLUTION:
Herpes zoster
Primary chickenpox
Bechet disene
Burns, chemical and thermal
PHARMACOLOGICAL MANAGEMENT: Antiviral medications are-
1)Acyclovir(400mg)
2)Famiciclovir(500mg)
3)Valacyclovir(1g)
Oral analgesia - paracetamol

8. :STOMATITIS:
DEFINITION: A condition that causes painful swelling and sores inside the mouth.
Stomatitis may be caused by a disease,an infection, an allergic reaction or irritation foods or chemicals.
CAUSES:

9. CONTD…
SIGN AND SYMPTOTMS:
• Mouth ulcers with a white or yellow layer and red base , usually inside the lips and
cheeks or the tongue.
• Red patches.
• Blisters.
• Swelling.
• Oral dysesthesia – a burning feeling in the mouth.
DIAGNOSTIC EVALUTION:
a) History: A patient will complain of pain burning sensation, intolerance to
temperature extremes.
b) Physical exam: Includes inspection of lips , tongue and cheeks.
c) Test: swabs both bacterial and viral, tissues scrapping , biopsy
blood test and patch test to identify allergy.

10. CONTD…
PHARMACOLOGICAL MANAGEMENT:
• Anti inflammatory drug: Corticosteroids including prednisone are the most effective
treatment as they will reduce swelling and pain.
• Antibiotics: Tetracyclines , Doxycycline, Minocycline.

11. :RECURRENT APHTHOUS ULCERS:
DEFINITION: Recurrent aphthous ulcers is a common condition in which round or
ovoid painful ulcers recur on the oral mucosa.
CAUSES:

12. CONTD…
SIGN AND SYMPTOMS:
• A small white or yellow oval shaped ulcer in oral cavity .
• A painful red area for mouth.
• A tingling sensation in mouth.
• Swollen lymph nodes.
• Fever.
• Not feeling well.
TYPES:

13. CONTD…
DIAGNOSTIC EVOLUTION:
1. CBC tests.
2. Serum ferritin.
3. Serum folate.
4. Serum vitamin B12.
5. Biopsy.
PHARMACOLOGICAL MANAGEMENT:
• Colchicine (0.5 – 2 mg daily) is helpful for the majority of patient with chronic recurrent
oral aphthous ulcers.
• Antibiotics – Doxycycline
• Mouth gel – Candid tube (10gm)
• Tetracycline oral suspension.

14. CONTD...
NON-PHARMACOLOGICAL MANAGEMENT:
Brush your teeth twice a day, beetr yet after meal or snack.
Use a soft toothbrush and replace it at least every three months.
Consider using an electric toothbrush which may be more effective at removing
plaque tartan.
Floss daily.
Use mouth rinse to help reduce plaqe between your teeth, if recomended by your
dentist.
Don’t smoke or chew tobacco.

15. :ANKYLOGLOSSIA:
DEFINITION: A condition that tongue protrusion beyond lower incisors.
The condition is present at birth . A short, tight bond of tissue tethers the tongue’s tip
to the floor of the mouth.
CAUSES:
• Tongue tie occurs when the frenulum fails to separate from the tongue before birth.
• This may be caused by genetics when Methylenetetrahydrofolate reductase
(MTHFR) genetic mutation occurs.

16. CONTD…
SIGN AND SYMPTOMS:

17. CONTD…
DIAGNOSTIC EVOLUTION:
1. Physical Examination: During oral , physical examination we can diagnose the
ankyloglossia or tongue tie disease.
2. For infants, the doctor might use a screening tool to score various aspects of the
tongue’s appearance and ability to move.
MANAGEMENT:
1. Surgical Management:
• Frenotomy: A simple surgical procedure called a frenotomy can be done with or
without anaesthesia in the hospital.
Doctor examine the scissor to snip the frenulum free.
• Frenuloplasty : Surgical alteration of frenulum.

18. CONTD…
2. Non- pharmacological management:
• Speech therapy: Treats people with Ankyloglossia by speech therapy.
• Monitoring: Regular follow-up to evaluate for improvement.
• Self-care: Feeding a baby with breast milk may be treated
ankyloglossia sometimes.

19. :CARCINOMS OF ORAL CAVITY:
DEFINITION : Common types of
malignancy are salivary gland
tumor(adenoid cystic Ca)
,sarcoma lymphoma ,age is more
than 40 years ,male are more
common female.

20. CONTD…
CAUSES :

21. CONTD…
TYPES AND CHARACTERISTICS OF ORAL CANCER :
1. LIPS : Clinical manifestation –
- Indurated
- Painless ulcers
2. TONGUE : Clinical manifestation –
-ulcer or area of thickening
-soreness or pain increased salivation
-slurred speech and dysphagia
-toothache and earache
3. ORAL CAVITY : Clinical manifestation –
- leukoplakia , dysphagia
-sore spot ,ulceration
-rough area ,pain
-a lump or thickening in the cheek

22. DIAGNOSTIC EVOLUTION :

23. CONTD…
MANAGEMENT :
• SURGICAL MANAGEMENT :
1. Mandibulectomy : removal
of the mandible
1. Hemiglossectomy: removal
of half of the tongue
1. Glossectomy : removal of
tongue

24. CONTD…
• PHARMACOLOGICAL MANAGEMENT :

25. CONTD...
NON-PHARMACOLOGICAL MANAGEMENT:
Nutritional Therapy: Many patients are malnaurished before surgery . They
may require placement of a percutaneous endo scopic gestrostomy(PEG) and
external nutrition before radiation treatement of surgery.
Observe for feeding tolerance and adjust the amount, time and formula if
nausea, vomiting or distention occurs.

26. CONCLUSION
Good oral health is not only essential to good overall health and freedom from
the pain and suffering associated with oral disease; it also affect self esteem,
quality of life and performance at school and at work. Therefore the public
health community must view oral health as essential.

27. THANK YOU!