Applied Oral Pathology through Interactive

Learning

Applied Oral Pathology through Interactive

LearningInfectious Diseases

Rachel S. Ennis MDH707 Spring 2011

Infectious Diseases

Rachel S. Ennis MDH707 Spring 2011

Infectious DiseasesChapter 4 Objectives

Infectious DiseasesChapter 4 Objectives

Inflammatory and immune response Causes of opportunistic infection Organisms involved in specific

infectious diseases Oral candidiasis; five forms Herpes labialis; clinical features Recurrent intraoral herpes simplex

infection; clinical features Minor aphthous ulcers; clinical features

Inflammatory and immune response Causes of opportunistic infection Organisms involved in specific

infectious diseases Oral candidiasis; five forms Herpes labialis; clinical features Recurrent intraoral herpes simplex

infection; clinical features Minor aphthous ulcers; clinical features

Objectives continued:Objectives continued:

Herpes Zoster; clinical characteristics

Epstein-Barr Virus; four associated diseases

Coxsackie virus and oral manifestations

Oral manifestations of HIV infection; clinical appearance

Herpes Zoster; clinical characteristics

Epstein-Barr Virus; four associated diseases

Coxsackie virus and oral manifestations

Oral manifestations of HIV infection; clinical appearance

Any ideas?Any ideas?

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Acute Necrotizing Ulcerative GingivitisAcute Necrotizing

Ulcerative Gingivitis Edematous and erythematous gingiva Cratered or “punched out”

interdental papillae Painful Foul odor Metallic Taste Associated with decreased resistance Caused by Fusiform bacilli,

and spirochetes

Edematous and erythematous gingiva Cratered or “punched out”

interdental papillae Painful Foul odor Metallic Taste Associated with decreased resistance Caused by Fusiform bacilli,

and spirochetes

Inflammatory and Immune Response

Inflammatory and Immune Response

Inflammatory response: body’s first line of defense against tissue injury and disease-producing microorganisms

Immune response: defends body against injury, remembers past instances of injury

Inflammatory response: body’s first line of defense against tissue injury and disease-producing microorganisms

Immune response: defends body against injury, remembers past instances of injury

Opportunistic InfectionOpportunistic Infection

Alteration in the oral micro flora Organisms that are normally

nonpathogenic are able to cause disease

Alteration in the oral micro flora Organisms that are normally

nonpathogenic are able to cause disease

Opportunistic infections of the oral cavity

Opportunistic infections of the oral cavity

Dental caries

Periodontal disease

Dental caries

Periodontal disease

Infectious Diseases and the organisms involved

Infectious Diseases and the organisms involved

Impetigo: Staph Aureus, Staph pyogenes. Tonsillitis and Pharyngitis: Streptococci, Adenoviruses,

Influenza, and Epstein-Barr virus Tuberculosis: Mycobacterium tuberculosis Actinomycosis: Actinomyces israelii Syphilis: Treponima pallidum Veruca vulgaris: Human papilloma virus Condyloma acuminatum: Human papilloma virus Primary herpetic gingivostomatitis: Herpes simplex

virus Acute Necrotizing Ulcerative Gingivitis: Borrelia

vincentii fusiform bacillus, and spirochete

Impetigo: Staph Aureus, Staph pyogenes. Tonsillitis and Pharyngitis: Streptococci, Adenoviruses,

Influenza, and Epstein-Barr virus Tuberculosis: Mycobacterium tuberculosis Actinomycosis: Actinomyces israelii Syphilis: Treponima pallidum Veruca vulgaris: Human papilloma virus Condyloma acuminatum: Human papilloma virus Primary herpetic gingivostomatitis: Herpes simplex

virus Acute Necrotizing Ulcerative Gingivitis: Borrelia

vincentii fusiform bacillus, and spirochete

ImpetigoImpetigo

Adult male with impetigo Child with impetigo on chin on chin

Adult male with impetigo Child with impetigo on chin on chin

Syphilis chancreSyphilis chancre

Dorsal surface of tongueDorsal surface of tongue

ActinomycosisActinomycosis

Left mandibleLeft mandible

Condyloma acuminatumCondyloma acuminatum

Lower lipLower lip

Oral Candidiasis(thrush)

Oral Candidiasis(thrush)

Pseudomembranous Erythematous Denture stomatitis (chronic

atrophic candidiasis) Chronic hyperplastic candidiasis Angular cheilitis

Pseudomembranous Erythematous Denture stomatitis (chronic

atrophic candidiasis) Chronic hyperplastic candidiasis Angular cheilitis

Angular cheilitisAngular cheilitis

Commissure of lipsCommissure of lips

Pseudomembranous candidiasis

Pseudomembranous candidiasis

Hard palateHard palate

Herpes LabialisHerpes Labialis

Caused by herpes simplex virus

Also called “cold sore or fever blister”

Vermillion of lips

Caused by herpes simplex virus

Also called “cold sore or fever blister”

Vermillion of lips

Herpes LabialisHerpes Labialis

Vesicles on lips and vermillion boarderVesicles on lips and vermillion boarder

Herpes LabialisHerpes Labialis

Lower lipLower lip

Recurrent intraoral herpes simplex infection

Recurrent intraoral herpes simplex infection

Herpes simplex virus Keratinized mucosa (hard palate,

and gingiva May be caused by sunlight, menstruation,fatigue,fever,stress Painful, focal crops of vesicles Prodromal symptoms:

pain,burning,tingling

Herpes simplex virus Keratinized mucosa (hard palate,

and gingiva May be caused by sunlight, menstruation,fatigue,fever,stress Painful, focal crops of vesicles Prodromal symptoms:

pain,burning,tingling

Primary Herpes Simplex Infection

Primary Herpes Simplex Infection

Dorsal surface of tongueDorsal surface of tongue

Minor aphthous ulcersMinor aphthous ulcers

Nonkeratinized mucosa One to several ulcers present No vesicle preceding ulcer Pain <1cm Round to oval Can recur

Nonkeratinized mucosa One to several ulcers present No vesicle preceding ulcer Pain <1cm Round to oval Can recur

Minor aphthous ulcerMinor aphthous ulcer

Floor of mouthFloor of mouth

Major Aphthous UlcerMajor Aphthous Ulcer

Soft palateSoft palate

Herpes ZosterHerpes Zoster

Shingles Unilateral, painful eruption of

vesicles along sensory nerve May affect three branches of

trigeminal nerve Prodromal symptoms: pain,

burning,paresthesia May last several weeks

Shingles Unilateral, painful eruption of

vesicles along sensory nerve May affect three branches of

trigeminal nerve Prodromal symptoms: pain,

burning,paresthesia May last several weeks

Herpes ZosterHerpes Zoster

ShinglesShingles

Varicella ZosterVaricella Zoster

Lips and palate Lips and palate

Epstein-Barr VirusEpstein-Barr Virus

Infectious Mononucleosis Palatal petichiae kissing disease Nasopharyngeal carcinoma Burkitt lympoma Hairy Leukoplakia usually on lateral border of tongue

Infectious Mononucleosis Palatal petichiae kissing disease Nasopharyngeal carcinoma Burkitt lympoma Hairy Leukoplakia usually on lateral border of tongue

Hairy LeukoplakiaHairy Leukoplakia

Lateral boarder of tongueLateral boarder of tongue

CoxsackievirusCoxsackievirus

Discovered in Coxsackie, NY Transmission by fecal-oral

contamination, saliva, respiratory droplets

May cause: Herpangina Hand-Foot-and Mouth Disease Acute Lymphonodular Pharyngitis

Discovered in Coxsackie, NY Transmission by fecal-oral

contamination, saliva, respiratory droplets

May cause: Herpangina Hand-Foot-and Mouth Disease Acute Lymphonodular Pharyngitis

Coxsackie virusCoxsackie virus

Sores on dorsal surface of tongue and palateSores on dorsal surface of tongue and palate

HIV and Oral LesionsHIV and Oral Lesions Candidiasis Herpes simplex infection Herpes Zoster Hairy Leukoplakia Human papilloma virus lesions Atypical gingivitis and periodontitis Kaposi sarcoma Non-Hodgkin lymphoma Aphthous ulcers Mucosal pigmentation Bacterial salivary gland enlargement and xerostomia Spontaneous gingival bleeding resulting from

thrombocytopenia

Candidiasis Herpes simplex infection Herpes Zoster Hairy Leukoplakia Human papilloma virus lesions Atypical gingivitis and periodontitis Kaposi sarcoma Non-Hodgkin lymphoma Aphthous ulcers Mucosal pigmentation Bacterial salivary gland enlargement and xerostomia Spontaneous gingival bleeding resulting from

thrombocytopenia

HIV associated thrushHIV associated thrush

Soft palateSoft palate

PapillomaPapilloma

Papilloma on soft palatePapilloma on soft palate

Papilloma Papilloma

Lateral boarder of tongueLateral boarder of tongue

PapillomaPapilloma

Buccal MucosaBuccal Mucosa

Kaposi sarcomaKaposi sarcoma

HIV infectionHIV infection

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ReferencesReferences

Ibsen, O., Phelan, J.A. (2009). Oral pathology for the dental hygienist, 5thed.

St. Louis, MO: Saunders Elsevier.

Langlais, R. P. , Miller, C.S. , Nield-Gehrig, J. S. (2009) Color atlas of common

oral diseases, 4thed. Philadelphia, PA: Lippincott Williams and Wilkins.

Ibsen, O., Phelan, J.A. (2009). Oral pathology for the dental hygienist, 5thed.

St. Louis, MO: Saunders Elsevier.

Langlais, R. P. , Miller, C.S. , Nield-Gehrig, J. S. (2009) Color atlas of common

oral diseases, 4thed. Philadelphia, PA: Lippincott Williams and Wilkins.