Oral and dental disease Seminar presentation.pptx

SALALE UNIVERSITY COLLEGAE OF HEALTH SCIENCE
DEPARTMENT OF ADULT HEALTH NURSING
Seminar Presentation on common oral and dental
emergencies
Presented by; Sufa Mengiste(191/15) & yordanos Lema(195/15)
Presented To: Mr. Tadale K. {BSc, MSc.Ass’t. prof}
June 2023
Salale , Fitche
7/3/2023 Sufa and Yordanos 1

Content
 Anatomy and physiology of oral cavity
 Dental Caries
 Non-Dental Caries
 Pulpitis
 Periodontal Disease
 Trench Mouth
 Thrush
 Mouth ulcer
 Hepatic Gingiva Stomatitis
 Mumps

Objectives
 Describe over view of anatomy and physiology
 Explain dental and non-dental caries
 Explain Periodontal disease
 Describe oral thrush and mouth ulcer
 Explain hepatic gingiva stomatitis
 Describe Mumps

ANATOMY AND PHYSIOLOGY OF THE TEETH
Tooth is made up of enamel, dentine, pulp and
cement. Enamel is the hardest part of the
tooth with the greater part of it covering the
crown.

Cont…
Dentin
This sensitive ivory like substance that forms the body of
the whole teeth
Pulp
This is an extremely sensitive mass of thin nerve and
blood vessels which enter through apical canal at the
apex of each root.
Cement
This is a thin hard bone-like layer which covers the
roots.
Enamel
This is the protective outer layer of each tooth

FUNCTION OF THE TOOTH
Incisors: Biting of the food initially
Canines: Tearing of tough pieces of food.
Premolars and Molars: Grinding the food in to small
pieces before swallowing

DISEASE OF THE HARD TISSUE OF THE TEETH
Disease of the hard tissue is disease which affects
the enamel and dentine part of the tooth.
They are classified as dental caries and none
caries diseases
None caries diseases include:
attrition,
erosion,
abrasion and fluorosis

DENTAL CARIES
Definition:
 Tooth decay, also known as dental caries or cavities,
is a breakdown of teeth due to acids made by
bacteria.
 The cavities may be a number of different colors
from yellow to black.
 The most common bacteria associated with dental
cavities are the; mutans Streptococcus and
Streptococcus sobrinus, and lactobacilli.

ETIOLOGY
 Accumulation of food
particles.
 Accumulation of
bacteria in gelatinous
mass. Called
as “plague”.
 Release of lactic acid
 Breakdown of minerals
 present in enamel.

CLASSIFICATION OF DENTAL CARIES
 Dental caries may be classified in many ways.
 By anatomical structure
 By the depth of the cavity
 By its stage.
 Anatomical classification: pits and fissure cavity
(occlusal cavity),smooth surface of oral cavity

G.V. BLACK’S CLASSIFICATION
 Dr. G.V Black’s classification is based on the location of
the carious lesion on the tooth. It was formulated 150
years ago and it is one that is widely used today.
Class I. It occurs in pits and fissures of all teeth.
This classification is essentially intended for bicuspids
and molars.

Cont..
Class II. A cavity occurring on the proximal surface of a
posterior tooth. It can involve both mesial and
distal surfaces or only one surface tooth
Class III A cavity occurring on the mesial or distal
surface of any incisor or bicuspid. The shape of the
cavity is circular.
Class IV. A lesion on the proximal surface of an anterior
tooth from which the incisal edge is also missing.

Cont..
Class V. It is gingival cavity or smooth surface cavity. It
can occur on with the facial or lingual surfaces, the
predominant occurrence of the lesion is the buccal and
labials surface of the tooth.
Class VI. This cavity is found on the tips of cusps or
along the cutting edge of incisors. This classification is
additional to the original Black's
classification.

SITES OF ATTACKS OF DENTAL CARIES
1. Fissures, pits ,grooves, occlusal surfaces.
2. Proximal surfaces
3. At the gingival junction on the facial and lingual
surfaces.
4. Near the junction of the enamel and cement after
recession of gum.

TREATMENT OF DENTAL CARIES
 The treatment depends on the class or depth of the
cavity ¾ Restoration is done if the resources are
accessible and the there is a professional skilled in
the clinic.
 Recently there is a treatment developed for dental
caries especially for developing countries like
Ethiopia.

Cont…
 This type of treatment is known as a traumatic
restorative treatment (ART).
 This just to clean and curette the diseased part
of the enamel and dentin with hand instruments
and seal the cavity with simple restorative
material in order to avoid further advancement of
the caries.

Cont..
 ¾ If the above restoration is not possible and
referral is not accepted by the patient for some
reason extraction will be done after clear
explanation of all versions.

NON-DENTAL CARIES
1. Abrasion
Is a pathologic wearing away of the tooth substance
through some abnormal mechanical process.
 Site:- Exposed root surface
 Cause:-
 Use of abrasive dentifrices
 Habit of opening pins
 Occupation

Cont…
2. Attrition:-is the wearing of teeth during function.
This is normal wearing of the teeth during contact with
opposing teeth in occlusion. It has relation with aging.
3. Erosion:- is defined as a loss of tooth substance by a
chemical process that does not involve known
bacterial action.

ETIOLOGY AND SITE
Etiology:- Unknown
Site:- Labial and buccal surface of the teeth.

PULPITIS
 It is the inflammation of the dental pulp.
Main causes
1. Infection: spread of dental caries to the pulp,
2. Trauma.
3. Physical irritation: excessive heat during cavity
preparation.
4. Chemical irritation i.e. filling materials.
5. Mixed microorganisms which are found in the
oral cavity.

CLASSIFICATION
 There are different classifications of pulpitis. Some of
them are as follows.
1. Acute closed
2. Acute open
3. Chronic closed
4. Chronic open
 All acute pulpitis are known as vital pulpitis.
 All chronic pulpitis are known as non-vital pulpitis.

CLINICAL PICTURES OF VITAL PULPITIS
 Self initiated pain
 Pain which radiates to the ear and to that side of
the face.
 Severe pain which wakes you up from sleep.
 If by chance the pain was stimulated, no relief on
removal of the stimuli.

DIAGNOSIS AND TREATMENT
Diagnosis;
Is made by clinical pictures and dental x-ray.
Treatment:
• Root canal therapy
• Tooth extraction if no alternative treatment

CLINICAL PICTURES OF NON VITAL PULPITIS
 No response to stimuli
 Fistula at the gum around the root of the affected
 tooth and pussy discharge.
 Bluish red or black discoloration

PERIODENTAL DISEASE
 Periodental disease is a serious gum infection that
damage the soft tissue and destroys the bone that
support the teeth.
 Periodental disease can cause teeth to loosen or lead
to tooth loss.
 It is a common disorder but largely preventable.

TYPES OF PERIODENTAL DISEASE
A. Gingivitis
™
Acute gingivitis
™
Chronic gingivitis
B. Prepubortal
™
Juvinale
™
Rapidly progressive
™
Chronic (adult)
™
Refractory
C. Periodontitis
™
Acute periodontitis
™
Chronic periodontitis
™
(Apical, marginal)
D. Dystrophic disease
™
Hyperplasic condition
™
Atrophic condition
™
Degenerative condition

GINGIVITIS
 Most children have signs of some inflammation of
the gingival tissue at the necks of the teeth; among
adults, the initial stage of gum disease is prevalent.

CAUSE AND CLINICAL FEATURE
Cause: accumulation of bacterial plaque at or near the
gingival margin.
Clinical feature
 Redness of the gum
 Gum bleeding
 edema of the gum
 Tenderness of the gum

TREATMENT:
 Oral hygiene
 Plaque control
 Oral dine mouth wash
 Administration of antibiotics

PERIODONTITIS
 When periodontal disease affects the bone and
supporting tissue, it is termed periodontitis and is
characterized by the formation of pockets or spaces
between the tooth and gums.

CAUSE OF PERIODONTITIS
 A Local
• Microbial components
of plaque,
• Food impaction,
• Mouth breathing,
• Chemical irritation.
• Truma
• Drug toxicity
 B. Systemic
• Pregnancy
• Diabetes mellitus
• Allergy
• Hereditary

SYMPTOMS
Signs and symptoms of periodontitis can
include:
• Swollen or puffy gums
• Bright red, dusky red or purplish gums
• Gums that feel tender when touched
• Gums that bleed easily
• Painful chewing

DIAGNOSIS AND TREATMENT
 Diagnosis ; X-ray result shows widening of the
periodontal space in chronic cases.
 Treatment
• Scaling – removal of calculus
• Treatment of dental caries
• Oral hygiene
• Extraction, if hopelessly diseased

PREVENTION
 Proper hygiene of teeth
 Brushing properly on a regular basis
 Regular dental check-ups and professional
teeth cleaning as required.

TRENCH MOUTH
 It is a severe gum infection
caused by abuild up of bacteria.
 It is generally occur in HIV
infected patient.
 It is severe periodentis.

CAUSES
 Poor dental hygiene
 Poor nutrition
 Smoking
 Stress
 Infection of mouth,teeth or throat.
 HIV and AIDS
 diabetes

Symptoms and Treatment
Symptoms
 Bad breath or bad taste
in the mouth.
 Bleeding in response to
irritation or pressure.
 Ulcers in the mouth
 Fatigue
 Fever
 Grayish film on the
gums.
Treatment
 Antibiotics to stop the
infection from
spreading further.
Examples
 amoxicillin, clindamycin,
deoxycyclin.
 Pain relievers
 Professional cleaning
from a dental hygienist.

THRUSH
 The immune system and the body's normal
bacteria usually keep Candida in balance.
 When this balance is interrupted, it can result in an
overgrowth of the Candida fungus, causing thrush, a
yeast infection of the mouth or throat.

PREVENTION
 Brushing regularly.
 Cleaning denture.
 Attending dental appointment regularly.
 Keeping diabetes under control.
 Rinsing the mouth after corticosteroid.
 Stopping smoking

TREATMENT
 Fluconazol, Clotrimazol lozenge, Itraconazole which
are oral antifungal drug.
 Nystatin, which is a antifungal mouthwash.
 Amphotericin B, which is a drug used to treat severe
infection

HEPATIC GINGIVA STOMATITIS
 It is a viral infection of
the oral mucous
membrane caused by
herpes simplex
virus- I(HSV-I).
 Usually HERPES
SIMPLEX VIRUS TYPE I
(HSV-1), and rarely TYPE
II (HSV-2)

SYMPTOMS and TREATMENT
Symptoms
 High fever
 Anorexia
 Irritability
 Sore mouth lesions
 Not able to chew or
swallow
 Halitosis (bad breath)
Treatment
 Treatment includes fluid
intake
 Good oral hygiene
 Gentle debridement of
the mouth
 Drugs used are-
Acyclovir,
famcicyclovir, valacyclovir

MUMPS
 Mumps is a contagious
disease caused by a virus
that passes from one person
to another through saliva,
nasal secretions, and close
personal contact.

Cont…
 The condition primarily affects the salivary glands,
also called the parotid glands.
 There are three sets of salivary glands on each side
of your face, located behind and below your ears.
 It is a communicable disease, mode of transmission
iscontaminated saliva and respiratory droplet.
 The mumps virus is an enveloped single-stranded,
linear negative-sense RNA virus of the Rubulavirus
genus and Paramyxovirus family

SYMPTOMS AND PREVENTION
Symptoms
 Fatigue weakness
 Body aches
 Headache
 Loss of appetite
 Low-grade fever
 Muscle pain
 painful swelling
Prevention
 The most common
preventative measure
against mumps is a
vaccination with a mumps
vaccine
 The vaccine may be given
separately or as part of
the MMR immunization
vaccine that also protects
against measles and
rubella

MOUTH ULCER
Mouth ulcers — also known as canker sores —
are normally small, painful lesions that develop
in mouth or at the base of your gums.

Cont…
 There are three types of canker sores: minor, major,
and herpetiform.
1. Minor
Minor canker sores are small oval or round ulcers that
heal within one to two weeks with no scarring.
2. Major
Major canker sores are larger and deeper than minor
ones.
3. Herpetiform
Herpetiform canker sores are pinpoint size, occur in
clusters of 10 to 100, and often affect adults.

CAUSES
 Minor mouth injury from dental work, hard brushing,
sports injury, or accidental bite
 Lack of essential vitamins, especially B-12, zinc,
folate, and iron
 Allergic response to mouth bacteria
 Dental braces
 Hormonal changes during menstruation
 Emotional stress or lack of sleep
 Bacterial, viral, or fungal infections

TREATMENT
 Using a rinse of saltwater and baking soda
 Placing milk of magnesia on the mouth ulcer
 Covering mouth ulcers with baking soda paste
 Applying ice to canker sores
 Using a mouth rinse that contains a steroid to reduce pain
and swelling
 Placing damp tea bags on your mouth ulcer
 Taking nutritional supplements like folic acid, vitamin B-6,
vitamin B-12, and zinc
 Trying natural remedies such as chamomile tea, echinacea,
myrrh, and licorice root

ACKNOWLEDGEMENT
First of all we would like to thanks my almighty of God.
Next to this we would like to express they deepest gratitude
and appreciation to our Lecturer Mr. Tadale K. {BSc,
MSc.Ass’t. prof} for his remarkable teaching on Medical
Surgical and for giving us this opportunity.
At the Last but not Least we would like to thanks Salale
University for Library and WIFI Service.

REFERENCE
1) Systemic Disease Manifestations in the Oral Cavity
Geraldine Nurse, DO, FACOFP Doctors Hospital
Family Practice, Grove City, Ohio
2) Touyz, SW, Liew VP, Tseng P. Oral and dental
complications in dieting disorders. Int J Eat Disord.
1993 Nov;14(3):341-7

BEST WISHES TO ALL OF YOU!!!!!!
WE THANK YOU ALL!!!!!!

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