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DISEASES OF ORAL CAVITY
(Digestive Block)
Punik Mumpuni. Drg. M.Kes
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General Characteristics
The major components
of the digestive system
that we will cover can
be seen in figure 1
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The Mouth
The mouth (see figure 3) is
extremely complicated
anatomically because it has
to cope with a varietyofdifferent functions.
Speaking, eating, breathing
The most important digestive
role of the mouth is
mastication.
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The Mouth
This is the physical breakdown of
food by chewing.
interactions between the highly
muscular tongue, cheeks and lips
to position the food bolusbetween
the teeth, and strong crushing and
shearing movements of the tooth
surfaces controlled by the muscles
of mastication pulling on the jaws
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Teeth
Humans have a dental formula of 2:1:2:3
This means that an adult human has
2 incisors,
1 canine,
2 premolars
and 3 molars
on their up per jaw, and the same on their lower jaw.
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Dental Caries
Dental caries, also known as tooth
decayor cavity, is a diseasewhere
bacterial processes damage hard tooth
structure (enamel, dentinand
cementum).
These tissues progressively break
down, producing dental cavities (holes
in the teeth).
Two groups of bacteria are responsible
for initiating caries, Streptococcus
mutans and Lactobacilli
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KARIES GIGI
Karies gigi disebabkan karena
adanya demineralisasi/larutnya
mineral gigi akibat asam yang
dihasilkan oleh bakteri plaq.
Bakteri plaq sendiri meningkatdengan adanya komsumsi
makanan yang lengket dan
mengandung gula.
Jika tidak dirawat, karies gigi akan
menyebabkan pulpitis (dengan
rasa yang sangat sakit dan
berlanjut dengan kematian pulpa
(gangren pulpa).
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Pulpitis and its complications:
periapical abscess and cellulitis.
Pulpitis, an inflammation of the
dental pulp, can occur when
caries or its bacterial by
products encroach on the
dental pulp, leading to infection,
or when pathogens enter the
pulp through the apical foramen
or through a tooth fracture
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Tongue
The tongue has
several important
functions in eating.
the tongue containsthe taste receptors.
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Non cancerous lumps, bumps
and abnormalities in the mouth
Tori and exostoses (hard bony tumors on the palateand
gums)
Tongue abnormalities
Burning mouth/tongue syndrome (BMS) Bald tongue (atrophic glossitis) (beefsteak tongue)
Lingual tonsils
black or white hairy tongue
Geographic tongue
Macroglossia Enlarged Circumvallate papillae
Median Rhomboid Glossitis
Ankyloglossia (tongue tied)
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Abnormalities of the gums
Gingivitis
Periodontitis
Trench Mouth
(ANUG) Pericoronitis
Parulus
Pyogenic granuloma
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Abnormalities of the lips and
inside of the cheeks
Canker sores (aphthous)
Stenson's duct
Cold sores (herpes Labialis)
Angular cheilitis
Mucocele
Fordyce granules
lichen Planus
Fibroma
Nicotinic Stomatitis (smokers palate)
Amalgam Tatoo
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Tori and exostoses (hard bony
tumors on the palate and gums)
Torus palatinusmerupakan
suatu exostosis.
Exostosis :pertumbuhan
benigna jaringan tulang yang
menonjol keluar dari
permukaan tulang. Secara
khas keadaan ini ditandai
dengan tertutupnya tonjolan
tersebut oleh kartilago
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Torus Mandibularis
These are the same type of growths as
the Torus Palatinus except that they
grow on the inside of the lower jaw.
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Tongue abnormalities
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Bald tongue (Atrophic
glossitis)
As people begin to reach theirsenior years, sometimes theynotice that their tongue begins toburn when eating sharp tastingfoods
The first factor is
nutrition. Atrophic glossitis ismost often caused by a lack of Bvitamins in the diet.
The addition of daily doses of folicacid, niacin, vitamin B12,pyroxidine, riboflavin, and even
Iron, all in the form of a simpledaily multiple vitamin tablet mayhelp to restore the tongue andrelieve the burning on eating.
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Fungal Infections
Candidiasis (Thrush)
Thrushis a common problem for
infants since their immune
systems are not yet fully
developed.
In healthy adults, however, it
happens only rarely, and usually
is an indication of a lowered
immune response.
Often it is due to illnesses other
than AIDS such as general viral
infections or stress related
fatigue.
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Lingual Tonsil-
Whenever you seesomething you think may
be an abnormality in your
mouth, look for another
one on the opposite sideof the mouth.
If you see a "matched
set", they are probably
"normal anatomy".
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Black or white hairy tongue
When a patient is suffering fromany of a number of febrilediseases, he/she may developan overgrowth of filliformpapillae on the tongue. The
technical name for this conditionis white hairy tongue
If the coating is stained by fooddebris, black hairy tongue(see image at right). When this
condition develops, anaerobicbacteria can thrive over theentire dorsum of the tongueproducing more serious odorproblems
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Geographic tongue
This condition is characterized by thedisappearance of the filiform papillaefrom irregular patches on the topsurface of the tongue.
No one knows why some people get
this condition. It is thought to be anoral form of psoriasis (a common skincondition).
Patients who live with this problemfrequently complain of pain on eatingsharp foods.
Seen more frequently in AIDSpatients, however the presence ofgeographic tongue certainly doesNOT mean that the patient has AIDS.
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Macroglossia (large tongue)
The tongue normally resides on the
inside of the arch formed by the
lower teeth.
Most people's tongues fit neatly into
this space, however, a minority of
people have tongues which are a bit
larger than the space available.
The tongue is a very flexible organ,
and can accommodate itself to the
prevailing conditions easily.
This condition is often associated
with burning around the edges of the
tongue.
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Ankyloglossia (tongue tied)
When the tongue is anchored to
the floor of the mouth by a very
short lingual frenum
It tends to limit the mobility of the
tongue.
This limits the ability of the patient
to "stick out" the tongue and
negatively effects speech.
This condition is called
ankyloglossia (literally "tiedtongue").
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Abnormalities of the gums
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Gingivitis
If plaque is left around the necks of the
teeth for a long time, however, the
margins of the gums react by
becoming red, swollen, and sometimes
misshapen as seen in the image to the
right.
Although this looks terrible, the
condition generally goes away with the
removal of the plaque through good,
once a day oral hygiene.
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Type I (Gingivitis)
Type I periodontal disease
is characterized by swollen
and red gums. In fact, this
condition is calledgingivitis.
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Type II (incipient and moderate )
Periodontal Disease
In type II periodontal disease,
some bone loss has occurred.
The difference between
incipient periodontal disease
(gingivitis) and moderate
periodontal disease is the
increased depth and
distribution of the pocketing.
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Type III (severe) Periodontal
Disease
The bone loss is so
much more pronounced.
It involves not only
gingival (soft tissue)pocketing, but also
"in f rabony" pocket ing
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Periodontitis
All the bony and soft
tissue that supports the
tooth is called the
periodontiumand when
this organ becomes sick,
we say the patient hasPeriodontal disease.
If oral hygiene remains
very poor for long periods
of time after the age of
25, the damage to thegums goes beyond a
simple inflammation of
the margin of the gums.
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Pericoronitis
It is simply an
infection around an
unerupted tooth.
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Parulus
Better known as a "gum boil", this sore happens on thegums at the tip of the root of a tooth in which the nervehas died.
The nerve in the tooth dies because of deep decay, orbecause of some other traumatic event that disturbs theblood flow to the nerve.
The parulus is the result of the pressure of an abscessin the bone due to the toxic nature of dead nerve tissue.
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Pyogenic granuloma
(Pregnancy tumor)
That happens in responseto chronic irritation.
In the case pictured here, itappeared as a response to
chronic irritation from theaccumulation of plaqueunder an orthodontic wire.
It is frequently seen inpregnant women where it is
triggered by hormonalimbalance due topregnancy.
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Abnormalities of the lips and inside of
the cheeks
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aphthous ulcer
Aphthous ulcers occur generallyon the soft unattached gingiva,in the vestibuleor on the cheekmucosa, on the floor of themouth, or on the under-surfaceor lateral borders of the tongue.
They are characterized by awhite center surrounded by athin red, inflamed border.
No one knows exactly why somepeople seem prone to thesesores, or why they occur at
all. They are NOT due to adietary deficiency!
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Stenson's duct
The opening of the duct of theparotid saliva glandis calledStenson's Duct.
This is most likely to happen
when saliva flow is reducedfrom its normal levels, oftendue to prolonged usage ofdecongestants andantihistamines or other drugswhich cause dry mouth.
The usual treatment is a courseof antibiotics (generally penicillinor Zithromax)
Nicotinic Stomatitis (smokers
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Nicotinic Stomatitis (smokers
palate)
condition characterized by inflammation ofthe soft palate due to the irritation ofexcessive amounts of cigarette smoke.
it is often associated with the conditioncalled leukoplakia,
Leukoplakia is considered a pre cancerouslesion which cantransform into squamous
cell carcinoma. Nicotinic stomatitis is caused almost
exclusively by pipe smoking
however, that the development of thiscondition is an indication that the patientmay be prone to the development ofsmoking related cancers.
Perhaps very long exposure of the palataltissues to hot, caustic pipe smoke can breakdown the resistance of the palatal tissuesand stimulate dysplasia there.
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Thank You