For 2nd year B.Sc Nursing students

1. Oral
Disorders
Presented By:
Mr. Nandish. S
Asso. Professor
Mandya Institute of Nursing Sciences

2. Cheilitis
Definiton :
It is an irritation & inflammation of lips associated
with scaling, crusting, fissure and white over growth
of horny layer of epidermis.

4. Types :
1)Actinic Cheilitis:
 It is also termed as “Solar cheilosis” as it is the
result of chronic over – exposure to ultraviolet
radiation in sunlight.
 It occurs on the lower lip. It causes dryness, scaling
and wrinkled grey – white in appearance.
 It is common in people who spend lot of time
outdoors.

5. 2) Angular Cheilitis:
 It is inflammation of one or both of the corners of
mouth.
 It commonly affects elderly people.
 The common possible causes are nutritional
deficiencies (Iron, Vitamin B, Folate), infections
(candida albicans, staphylococcus aureus), use of
dentures.

6. 3)Drug related cheilitis:
 It is also called as “drug induced ulcer of lip”.
 It is described as being characterized by painful or
tender, well defined ulceration of the lip without
induration.
 Common drugs which induce cheilitis are Indinavir,
Protease inhibitors, Atorvastatin, Tetracycline,
Streptomycin, etc.

7. 4) Exfoliative cheilitis:
 It is a rare reactive condition, presenting as
continuous peeling of lips.
 It usually seen in patients with localised form of
Psoriasis.
 It can also trigger by mouth breathing, lip biting,
bacterial or yeast infection.
 Whatever the cause, excessive keratin formation
results in abnormal peeling of lips.

8. Stomatitis :
 It refers to inflammation of the mucous lining /
membrane of mouth with or without ulceration.
 It is derived from the word “stoma” means mouth.
 It is caused due to malnutrition (malabsorption or
nutritional deficiency like iron & vitamin B),
autoimmunity, denture, chemotherapy, radiation
therapy, severe drug allergy, herpes infection, pipe
smokers, etc.
 It is characterised by mild erythema, edema, painful
ulcerations, bleeding and secondary infection.

11. Management :
 Prophylactic mouth care like brushing, flossing &
rinsing (cancer patients).
 Educate patient about proper oral hygiene including
use of soft bristled toothbrush, non abrasive
toothpaste, swabs with sponge like applicators can
be used as replacement for brush.
 Avoid smoking & alcohol.
 Restrict hot and spicy foods.
 Apply topical anti – inflammatory, antibiotic &
anesthetic agents.

12. Gingivitis :
 It is the non – destructive disease that causes
inflammation of Gums.
 Without treatment, gingivitis can progress to
periodontitis that results in tissue destruction and
bone resorption around the teeth.
 Gingivitis is reversible with good oral hygiene.

14. Causes:
Bacterial infections (both gram positive & gram
negative), viral infections, fungal infections.
Use of dentures
Risk Factors:
Aging
Osteoporosis
Low dental care utilization
Poor oral hygiene
Mouth breathing (during sleep)
Smoking
Stress
Genetics
Medications that dry mouth.
Trauma

15. Signs & symptoms:
- Swollen gums
- Bright red gums
- Tender gums
- Bleeding after brushing
- Bad breath

16. Treatment :
 The focus of treatment is to remove plaque. It is
performed by using scaling, root planning,
curettage, mouth wash by using chlorhexidine &
hydrogen peroxide and flossing.
 Using interdental brushes.
 Use toothpaste which contains Triclosan,
chlorhexidine digluconate, combination of Thymol,
Menthol, Eucalyptol and methyl salicylate.
 Oral irrigation daily with mouthwash containing
antibiotic can control gingivitis. (Amoxicillin)

17. Glossitis :
 It is the inflammation of tongue with depapillation
of the dorsal surface of the tongue leaving
eryhtematous surface.
 It is also called as soreness of the tongue.
 It is termed as atrophic glossitis.

19. Causes :
Anemia (Iron deficiency , pernicious, megaloblastic)
Vitamin B Deficiency
Bacterial, Viral or Fungal infections (Syphilis,
candidiasis)
Malnutrition / Malabsorption
Exposure to irritants like tobacco / alcohol, hot
foods.
Allergic reaction to tooth paste, mouth wash, breath
freshners.

20. Clinical manifestations:
- Smooth & shiny appearance of tongue.
- Tongue swelling
- Strawberry tongue
- Difficulty in chewing, swallowing & speaking.
- Burning sensation of tongue.

21. Treatment :
 Goal of treatment is to reduce inflammation.
 Good oral hygiene including brushing twice a day.
 Topical applicants (prednisone )
 Antibiotics, Antifungal or Antiviral agents.
 Dietary supplements rich in iron, Vitamin B & E to
be provided in excess.
 Avoid hot or spicy foods, alcohol & tobacco to
minimize discomfort.

22. Parotitis :
 Salivary glands consists of Parotid glands,
submandibular glands & sublingual glands.
 It is an inflammation of one or both parotid glands
which are located on both the sides of face.
 It is the most common inflammatory condition of
salivary glands.

25. Causes :
- Dehydration
- Infectious parotitis :
1) bacterial – Staphylococcus Aureus, E.Coli,
Mycobacterium Tuberculosis.
2) viral – Paramyxovirus (Mumps) is a single
stranded RNA Virus.other viruses include Hepatitis C,
Adenovirus, Cytomegalovirus….
- Autoimmunity
- Blockage of Parotid Duct due to salivary stone,
mucous plug, tumour …..
- Masseteric hypertrophy (enlargement of Masseter muscle)

26. Clinical Manifestations:
- Swelling of the Face
- Dry mouth
- Fever
- Chills
- Tachycardia & Tachypnoea
- Headache
- Pain aggravates during eating.
- Redness & shining of overlying skin.
- Difficulty in swallowing.

27. Treatment :
- Adequate nutrition & more fluid intake.
- Good oral hygiene.
- Topical analgesics.
- Antipyretics.
- Antibiotic Therapy
- If antibiotic therapy is not effective, plan for
parotidectomy (surgical procedure to drain glands).

28. Dental Caries / Tooth Decay:
 It is a prevalent common chronic infectious problem
that results in breakdown of teeth due to acids
produced by bacteria.
 Acid is produced when debris or sugar is found on
the tooth surface.
 Around 48% of the population have dental caries in
their permanent teeth at some point in their life
time.

30. Causes :
Four things for caries to form are – tooth surface,
caries causing bacteria, fermentable carbohydrates
(Sucrose) and time.
Bacterias : the most common bacterias associated
are streptococcus Mutans, Lactobacilli, Acidophilus
and streptococcus Sobrinus.
Dietary Sugars : organisms convert glucose,
fructose & sucrose into acid (lactic acid) through
glycolytic process called Fermentation.

31. Exposure: the frequency with which teeth are
exposed to acidic environment. After meals or snacks
bacterias act and decreases pH
Teeth : Molar incisor hypo-mineralization is common
factor which contributes in decay of Molar & Incisors.
The process begin within days of eruption if the diet
is sufficiently rich in suitable carbohydrates.
Other Factors :
- Reduced salivary flow rate.
- Any changes in the metabolism of Teeth.
- Tobacco Smoking.
- Lower Socio – Economic status.

32. Diagnosis :
 History collection & Physical Examination (visual
and tactile inspection)
 Dental Radiography
 Sharp end dental explorers
 Hypomineralization of teeth
 Laser speckle image

33. Prevention :
Adequate oral hygiene : it consists of tooth
brushing and flossing. It helps to prevent formation
of plaque.
Using of toothpaste containing Arginine have greater
protection than regular Fluoride toothpaste.
Dietary modification: decreasing the consumption
of carbohydrate rich foods (candy, cookies, crackers,
potato chips).
Supplying more calcium and Fluoride in the food.
 visit dental clinic once in 6 months.
Supervised tooth brushing upto the age of 8 years.

34. Treatment :
- Regular application of topical Fluoride.
- Repairing or replacement of filling.
- Stepwise caries removal.
- Local Anesthetics.
- Dental restoration (Amalgam, Composite Resin,
Porcelain, Gold, Glass ionomer Cement, stainless
steel)
- Endodontic Therapy (Root canal therapy).
- Extraction.