-contents defination of GIT disorders -inflammatory collitis dental management -ulcerative bowel disease dental management -gastroesophageal reflux disease (GERD) dental management peptic ulceration dental management - eatinng disorders dental management - gastrointestinal syndromes dental management

2. CONTENTS:
INTRODUCTION
 INFLAMMATORY BOWEL DISEASE
- ULCERATIVE COLITIS
- CROHN’S DISEASE
 GASTROESOPHAGEAL REFLUX DISEASE
 PEPTIC ULCERATION
 EATING DISORDERS
 GASTROINTESTINAL SYNDROMES
 CONCLUSION

3. INTRODUCTION
GASTROINTESTINAL DISEASES refer to disease involving
the gastrointestinal tract , namely the esophagus, stomach,
small intestine, large intestine and rectum
There is increased need for the knowledge regarding the
oral manifestations of these disorders so as to recognise,
diagnose, and treat oral conditions associated with GI
disorders

4. ETIOLOGY

5. ULCERATIVE COLITIS
DENTAL MANAGEMENTRECURRENT APTHOUS
ULCERS:
Topical analgesic(2% lidocaine
gel)
Topical and systemic
corticosteroids
Tetracycline mouthwash
Vitamin b12 ,folic acid
PYOSTOMATITIS
VEGETANS:
Topical corticosteroids like
triamcinolone(0.1%),
clobetasol(0.05%)
 SULFA DRUGS :medical
management with sulfasalazine
helps to clear the lesion
Patient may benefit from zinc
supplementObtain readings of blood
pressure, blood glucose level
before treatment
Supplement glucocorticoids
before and after surgery
obtain the levels of WBC’s,
haemoglobin, RBC count,
platelet count before
procedure
Liver function test should be
completed

6. CROHN’S DISEASE
DENTAL MANAGEMENT
• Palliative rinses of
sodium bicarbonate
• topical ointment
•topical steroids
Preventive and routine
dental care to monitor
oral health and to
prevent destruction of
hard and soft tissue
Evaluation of patients
blood glucose and blood
sugar levels
Topical steroid therapy
(halobestol,
triamcinolone ,
clobestol) should be
short term and monitored
• obtain the levels of
WBC’s, haemoglobin, RBC
count, platelet count
before procedure
• Liver function test
should be completed

7. Gestroesophageal reflux disease (GERD) is a digestive disorder that affects lower
esophageal sphincter(LOS) in which the gastric contents(chyme) passively move up
from stomach into the esophagus
EROSION ESOPHAGEAL STRICTURES
MUCOSAL ERYTHEMADYSPHAGIA

8. NaHCO3
mouthrinse to
minimize dysgeusia
due to acid reflux
Topical fluoride
application to
ensure optimal
mineralization
Patient advised to
have adequate fluid
intake
DENTAL MANAGEMENT
Adequate
restorations on
affected teeth to
prevent further
damage
Patients on
CIMETIDINE/H2
RECEPTOR
ANTAGONIST may
experience reaction
to lidocaine if given
intravascularly
Oral PREVENTIVE
MEASURES at earliest
to minimize need of
extensive restorations

9. PEPTIC ULCERS are common benign ulceration of epithelial lining of
stomach(gastric ulcer) or duodenum(duodenal ulcer)

10. DENTAL MANAGEMENT

11. ANOREXIA NERVOSA
BULIMIA NERVOSA
• INTENSIONAL STARVING
even if the patient is already
underweight
• patients use laxatives and
diuretics to lose body weight
•Patient CONSUMES LARGE
AMOUNT OF FOOD due to LACK
OF CONTROL OVER APETITE
• self induced vomiting , laxatives
and diuretics are used to lose body
weight

12. DENTAL MANGEMENT
Support the patient psychologically by demonstrating a
caring and compassionate attitude
Avoid elective dental procedures until patient is
stable
Complex restorative treatment should be avoided
until the purging has been corrected
Emphasis on oral hygiene maintenance
Crowns may have to be placed if thermal symptoms are
present in actively purging patient

14. DENTAL MANAGEMENT
GARDNER’S SYNDROME(familial multiple polyposis)
Dental radiography provides earliest indication
Prophylactic colostomy is recommended
Excision of jaw osteomas and epidermoid cysts for cosmetic
reasons may be indicated
Removal of one or more supernummary teeth for
orthodontic/occlusal consideration
Patients with 3 to 6 osteomatous lesions should be questioned
about possibility of Gardner's syndrome
PLUMMMER VINSONSYNDROME
Esophageal dilation(if symptoms of web) by upper
endoscopy
Iron replacement- ferrous sulphate
Follow up – developing carcinoma
Patient is advised to eat slowly and in small pieces
Address the cause of iron deficiency

15. CONCLUSION
 It is essential to recognise oral manifestations of
gastrointestinal diseases as they are useful in development of
differential diagnosis for patients with GIT complaints.
 The severity or prognosis of the disease can be monitored by
the presence or extent of oral manifestations.
 The success of the management of gastrointestinal diseases
may be reflected in response to oral tissues
 Hence, the oral physicians play a critical role in recognising,
diagnosing and treating oral conditions related with
gastrointestinal diseases and also to provide dental care to
afflicted individuals

16. THANK
YOU
SUBMITTED BY:VIDUSHI
SUBMITTEDTO :Dept. of
oral radiology and oral
medicine