Chemical injuries of oral cavity/certified fixed orthodontic courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

LEARNING OBJECTIVES
At the end of the lecture student should be able to
– Describe chemical injuries of oral cavity
– Enlist injuries due to chemotherapeutic agents
– Describe allergic disorders

DEFINITIONS
 INJURY:-Harm or damage to body.
 CHEMICAL:-A substance derived/used in
chemical reaction.
 So chemical injury is caused by use of chemicals
in form of either drugs/medicaments or restorative
materials.

CLASSIFICATION
Chemical
injuries
Non-allergic
Local Systemic
Allergic
Immediate Delayed

Non-allergic Reaction From
LOCAL APPLICATION
 DRUGS & INJURIES CAUSED
DRUG USE CAUSE INJURY
ASPIRIN Analgesic/
Anti-
inflammatory
Placement
against aching
tooth
Aspirin burn
burning
sensation
PHENOL Cauterization Caustic nature Painful burns

LOCAL APPLICATION
 DRUGS & INJURIES CAUSED
DRUGS USE CAUSE INJURY
Na
PERBORATE
In mouth
washes
Over use Oedema
ulcers
SILVER
NITRATE
Cauterization Over use Painful burns
T.C.A. Cauterization Over use Ulcers
V. OILS Flavours Over use Oedema

SYSTEMIC USE
ARSENIC
Used in both forms
A) Organic B) Inorganic
Produce both type of symptoms
a) Acute b) Chronic
Oral Manifestations:-
-Inflammation
-Gingivitis
-Ulceration (local )
-Excessive Salivation (systemic)

BISMUTH -
 ORAL MANIFESTATION:-
-“BISTHUTH LINE”(Contains Bi Sulphide Granules)
-Burning Sensation ,
-Metallic taste
 HISTOLOGIC/FEATURES:-
-Diffuse/perivascular black coloured granules
 TREATMENT:-
-Good oral hygiene.
-Bleaching with H2O2.

 DILANTIN SODIUM
-Anticonvulsant
 O/M:-
-Fibrous hyperplasia(40-50% CASES)
-Confined to tissue surrounding teeth
- Growth is dense, insensitive.
 H/F:-
-Thick Keratinised Epithelium
-Test tube rete pegs
T/t:-Surgical excision
-Discontinue drug

MERCURY:-
POISONING:-A)ACUTE B)CHRONIC.
-It is occupational & therapeutic hazard.
C/F:-
-G.I. disturbances
-Excitability
-Head ache
-Tremors of fingers
-Desquamative stomatitis
-Nephritis

 O/M:-
Increase salivary flow
Metallic taste
Ulcerations
Pigmentation
Swollen salivary glands
Destroys alveolar bone.
 T/t:-Supportive & secondary to T/t OF poisoning

 ACRODYNIA
 ETIOLOGY:- Mercurial toxicity
 C/F:-AGE: 1-6 yrs
 Extremities - nose, ear, cheek become pink, cold &
clammy described as ‘raw beef’
skin peels on affected side pruritic mucopapular
rash
Sweating
Photophobia
Irritation
Insomnia

LEAD
 C/F:-
-Poisoning called ‘Plumbism’ -
- nausea, vomiting, colics
-perineuritis
-hypochromic anemia with basophilic stippling of
RBC’s
 O/M:-Lead line
-Ulcerations
-Excessive salivation
-Metallic taste
T/t:-No specific/discontinue use

SILVER
 Also called ‘Argyria/Argyrosis’
 O/M:- ‘Amalgam Tatoo’ amalgam appears as black
brown granules present in nerve sheath or muscle
fibers or in basement membrane
 T/t:- No specific t/t required

 TETRACYCLINE
 Antibiotic
 Reponsible for discolouration of deciduous teeth
 Crosses placental barrier
 Discolouration depend upon dosage time period &
form of drug
 C/F:-Yellowish-brownish-gray discolouration
-on U.V. Exposure shows fluorescence
-dentine more stained than enamel
 T/t:- Bleaching


 TEETH AFFECTED ACCORDING TO DRUG
DOSE
4 months in utero – 3
month P.P.
Deciduous Max & Man
C.I.
5 months in I.U. - 9
months P.P.
Deciduous Max. & Man.
Canine
3-5 months of P.P to 7
yrs
Permanent Max.& Man.
C.I.

CANCER CHEMOTHERAUPATIC AGENT
 ANTINEOPLASTIC DRUGS
 C/F:-
-Alopecia
-stomatitis
-radiation recall/radiation sensitization
 O/M:-
-Erosions
-ulcerations
-hyperpigmentation
 T/t:- No Specific T/t.
Secondary to major problem

ALLERGIC
DRUG ALLEGRY (IDIOSYNCRASY, DRUG
SENSITIVTY STOMATITIS MEDICAMENTOSA)
C/F:-Skin lesions
-Arthralgia
-Fever skin
-Eruptions at same site.
O/M:-(Stomatitis medicamentosa)
 Diffuse erythematous erosions
 Vesicle bullae formation
 Desquamation of filiform papille

 DRUG ALLERGY
 T/t:- NO SPECIFIC T/t.
DISCOTINUE USE
 ANTIHISTMICS
CORTISONE
ANGIONURATIC OEDEMA
(ANGIOEDEMA QUINCKES ‘OEDEMA)
2 TYPES 1)hereditary 2) non-hereditary
1) hereditary:-as autosomal dominant trait
2)non-hereditary:-food, drug allergy

ANGIONUROTIC OEDEMA
 C/F:- Swelling involving lip, chin, eyes, tongue
hands, feet, eyes
-lips puffy
- prickling sensation
 Age 24-36yrs
 MECHANISM:-Vasodilatation by histamine &
histamine like substances
 T/t:-Prevention of contact
antihistamics - aminocarpin & androgens

ALLERGIC
 CONTACT STOMATITIS
 (At localised site after repeated contact)
chemical agent + cell-protein=>antigen. Antigen
stimulate formation of antibodies=> A g – A b
Reaction
 C/F:-Itching, burning sensation eruptions, vesicles

ALLERGIC
 O/M:-burning sensation, pruritis ulcers
 T/t:-Discontinue use

Summary
 Chemical injuries of oral cavity
 Injuries due to chemotherapeutic agents
 Allergic disorders

BIBLIOGRAPHY
 Text book of oral pathology Shafer's, 5 & 6th
edition
 Color Atlas of Oral Diseases Cawson, R. 2nd
edition
 Oral and Maxillofacial Pathology Neville, Brad W.
2nd
 Lucas’s Pathology Of Tumor’s of the Oral Tissues
 Cawson, R. A., Bennie, W. H 5th edition

Chemical injuries of oral cavity/certified fixed orthodontic courses by Indian dental academy

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