Diseases of the oral cavity: classification
To date diseases of the oral cavity are not uniform in the approved classification. Most often used to categorize diseases of the mouth classification adopted by the Department of therapeutic areas of dentistry in 1965. Today, the system of the world by Soviet specialists, modified in accordance with the international classification of diseases and has a somewhat more clear structure.
Classification of diseases of the oral cavity
In the modern version of the systematization of diseases of oral cavity in adults as follows:
- Traumatic injury, chemical, physical or mechanical factors (burns, wounds, microtrauma and associated diseases of the oral cavity);
- Infectious disease:
- Viral disease (herpetic stomatitis);
- Bacterial processes (stomatitis streptococcal etiology)
- Fungal disease (mycoses)
- Of sexually transmitted diseases (syphilis)
- Allergic (angioedema, aphthous stomatitis, glossitis);
- Poisoning by drugs and salts of heavy metals (bismuth, mercury, lead);
- Secondary dental pathology that occurs in diseases:
- Of the endocrine glands;
- Gastrointestinal tract;
- Heart and blood vessels;
- System krovoobrashseniya;
- Nervous system;
- Collagen diseases;
- Changes arising dermatoses (lichen planus, pemphigus);
- Congenital anomalies of development (geographic tongue, gusseted tongue);
- Independent cheilitis (cheilitis glandular, microhylid);
- Precancerous condition of oral mucosa;
- Disease oral cancer;
For a deeper understanding of the nature and characteristics of each of the pathological processes listed above, it is necessary to consider them separately.
Diseases of the human mouth traumatic origin are of secondary nature. The fact that exposure to mechanical or chemical factors that led to the violation of the integrity of the mucous membrane, usually accompanied by infection. In a person’s mouth contains a huge number of microorganisms. Part of these bacteria leads to the development of inflammatory processes. Another, the largest part, is opportunistic and in contact with the wound provokes the start of inflammation.
Mechanical trauma can be chronic and simultaneously. A momentary injury occurs as a result of a short-term factor (prick with a sharp object, fish bone), after which disappears. Chronic damage to the formed under the action of factor long-lasting (acute fragment of a tooth in the oral cavity).
Infectious diseases of the mucous membranes of the mouth develop upon exposure to pathogenic bacteria, viruses, and fungi. As a rule, the pathology occurs when a reduced level of immune responses, which may be a consequence of hypovitaminosis hypothermia, malnutrition, diseases associated with the development of acquired immunodeficiency syndrome (AIDS).
As a rule, infectious disease manifested in the form of stomatitis, and fungal infections of various etiologies, the treatment of which requires hospitalization of the patient and conducting a massive antibiotic therapy. With the exception of diseases of the oral cavity, developed on the background of HIV-positive status of the patient. Treatment in the clinic (outpatient) are subject to abscesses of the gums and jaw arising from infection in the deep structures of the jaw with deep caries.
Changes that occur in the oral cavity during dermatoses
Some skin diseases manifest themselves in the form of disease of the oral mucosa. One such disease is pemphigus. In the mouth of the patient form vesicles filled with exudate. Further, depending on the form of the disease, the vesicles may burst and form scars, or necrotic ulcerations. Usually, bubbles are a little painful after a breakthrough bleed.
The causes of the disease are not fully understood. It is assumed that the pathology is an autoimmune nature, and is kind of a result of sensitization. The treatment is carried out comprehensively with the use of corticosteroids, cytostatics, immunosuppressors. Topically applied rinsing with antiseptic solutions, applications hormonal ointments and regenerating.
Local allergic reactions dental profile develop, as a rule, by local contact with allergen. Most often it serves as a lipstick, lip gloss, food components, insect bites. The severity of reactions can vary from mild stomatitis and local erythema to angioedema affecting not only the soft tissues of the mouth, but and respiratory tract.
The mainstay of treatment of local allergic reactions is to avoid contact with the allergen and conduct desensitizing therapy. Swelling of the mouth in adults and children should be docked immediately. For this patient, in/in struino injected fluids Allergy drugs (suprastin, tavegil), hormones (prednisone, dexamethasone), calcium chloride.
Poisoning by drugs and salts of heavy metals
Among the heavy metals include lead, mercury, bismuth, thallium, antimony, and iron. Most often there is a mercury poisoning. In this patient there is swelling, redness, stomatitis. The process of swallowing can be disrupted due to severe pain. Subjective the patient may complain of a metallic taste in the mouth. Objectively, on examination revealed inflamed and swollen mucosa often covered with ulcerations and necrotic areas.
Diseases associated with lesions of the oral cavity associated with intoxication by heavy metals, require systemic detoxification of the body. Stomatitis developed as a result of poisoning, are secondary and require only symptomatic treatment and prevention of superinfection (rinsing with antiseptics, the use of local anaesthetic drugs). In General, measures for detoxification are:
- a massive infusion of saline and plasma-substituting solutions;
- specific antidote therapy.
To reduce swelling of the mucosa may apply hormonal ointments, vasoconstrictors in the form of gargles or applications.
Generally, disease of the mucous membrane of the mouth, which bears a secondary character, manifested in the form of stomatitis of one sort or another. The true cause of the disease can be impaired humoral or neural innervation of tissues and organs (including tissues of the oral cavity), malnutrition of the tissues due to poor absorption of nutrients (diseases of the stomach and intestines) or failure in the delivery mechanism of nutrients and oxygen to the tissues (vascular pathology).
Disease of the mucous coating of the mouth, which bears a secondary character, requires urgent treatment of the underlying pathology. With this rinse the mouth with antiseptics and antibiotics, preventing further infection.
Install the secondary nature of the disease may be difficult. Generally, professionals come to similar conclusions empirically, based on knowledge of clinical manifestations of a particular disease and the patient’s complex of symptoms.
Congenital anomalies of development of organs of the oral cavity are separate diseases that often provoke the development of secondary processes. So, tongue-tie leads to disruption of feeding, malnutrition, difficulties in the development of speech skills. Small oral vestibule leads to local gingivitis, chronic course, and creates a child with some aesthetic disadvantages.
The main causes of pathology lie in the presence of genetic defects in the parents and the fetus, exposure to teratogenic factors during the formation of the oral apparatus. Treatment is mainly surgical. Required plastic structures of mouth, aims to recreate the anatomically correct structure. Operation performed under General anesthesia, require a long rehabilitation period, often held in several stages.
Independent cheilitis represent inflammation of the mucous membrane of the lips, caused by chemical, physical and thermal factors. As a rule, the disease is caused by negative climatic influences (cold, wind, heat). The patient’s lips are swollen, hyperemia appears. Slight tenderness to touch. Your lips may appear flakes and cracks.
Considered a disease of the oral cavity treated by the treatment of lips moisturizing creams and ointments. In severe purulent forms of the disease might local application of glucocorticosteroid agents combined with antibiotics (ointment «Celestoderm B» garamizinom). General treatment in independent primary helitech not required.
Among the precancerous conditions of the mouth include:
- Erosive-ulcerative lupus erythematosus;
- Radiation stomatitis;
- Limited hyperkeratosis;
- Warty precancer;
- Chronic ulcerative processes and more.
The main forms of precancerous lesions develop due to prolonged exposure to tobacco smoke, work in the chemical industries, the use of a carcinogen in quantities that are not sufficient for the rapid development of intoxication, and UV radiation. Malignancy (malignancy) of the process can occur at different times. It depends on the General condition of the patient, level of immune protection, the propensity to development of cancer. The use of alcohol and tobacco greatly increases the likelihood that the disease becomes malignant over.
Therapy of precancerous processes need to be comprehensive and to influence not only the nidus but also on the etiological factor causing it. So, the patient should stop Smoking, drinking alcohol, change jobs more environmentally friendly. If you cannot do this you should minimize the impact of the pathological factor (use of personal protective equipment to avoid prolonged stay in contaminated areas). In conjunction with the overall treatment of patients may be prescribed a course of cytostatic therapy, preventing further development of proliferative processes.
Cancer affected mouth may outwardly look like the following:
- Nodules – the tumor has the appearance of a seal on the mucous membrane, which does not change its color. Further cover on the bundle may become whitish. The tumor increases rapidly in size. In the later stages of development, there is a pronounced pain syndrome.
- Ulcer – indolent ulcer defect, quickly increasing in size. This form of the disease most common.
- Papillary – tight hanging in the mouth the tumor. The color and characteristics of the mucosa over it does not change.
The cancer may be localized in almost all areas of the mouth, you’ll be proliferative growth (sprouting through the fabric, not pushing them), has the ability to metastasize. The individual tumor cells from the blood are carried to other parts of the body, where it ends up and begin to share. Developed new foci of disease.
Classification of diseases of the mucosa of the oral cavity cancer of the character is produced by the appearance of the tumor, its localization, stage of development and the cellular varieties.
The mainstay of treatment of malignant tumors is their surgical removal. It follows the principle of oncological radicalism. The tumor is removed along with surrounding tissue and, if necessary, with affected lymph nodes. This approach can significantly reduce the risk of recurrence of the disease. After surgery, the patient undergoes a course of anticancer chemotherapy or radiation therapy. In case of impossibility of surgical intervention of drug and radiation treatment is used as an independent method.
Complete cure of oncological diseases is possible only with early diagnosis. Worse amenable to therapy ulcerative form of the disease, is best treated papillary cancer. After discharge from hospital the patient is recommended for several years to undergo regular examination by a medical oncologist. In addition, the mandatory reorganization of the mouth, treatment of decayed teeth, and chronic infection foci.